Breathing Systems Part II (Ericksen) Exam 2 Flashcards
Which of the following are components of a Mapleson circuit? (Select 5)
A) Reservoir Bag
B) Corrugated Tubing
C) Oxygen Concentrator
D) Patient Connection
E) Inspiratory Valve
F) CO2 Absorber
G) Heat Exchanger
H) Fresh Gas Inlet
I) Expiratory Valve
J) APL Valve
A)Reservoir Bag
B)Corrugated Tubing
D) Patient Connection
H) Fresh Gas Inlet
J) APL Valve
Not all Maplesons have all these components
Rabbits Can Play Fun Activities
Mapleson circuits do not include a __________.
A. Reservoir Bag
B. CO2 Absorber
C. Corrugated Tubing
D. Patient Connection
B. CO2 Absorber
Unlike more complex anesthesia circuits, Mapleson circuits lack __________ , which then negates the use of separate pathways for inspiratory and expiratory limbs.
A. Fresh Gas Inlets
B. Patient Connections
C. Reservoir Bags
D. Unidirectional Valves
D. Unidirectional Valves,
Mapleson circuits are also known as __________ or __________.
A. Closed Circuits, Fresh Gas Flow Systems
B. High Flow Circuits, Flow-Controlled Breathing Systems
C. Carbon Dioxide Washout Circuits, Flow-Controlled Breathing Systems
D. Dual Limb Circuits, Low Flow Circle Systems
C. Carbon Dioxide Washout Circuits, Flow-Controlled Breathing Systems
In the Magill’s System or Mapleson A circuit, the fresh gas flow (FGF) enters near the __________, which is opposite of the patient.
A. Adjustable Pressure-Limiting (APL) Valve
B. Reservoir Bag
C. Patient Connection
D. Corrugated Tubing
B. Reservoir Bag
The APL valve in a Mapleson A circuit is positioned near the __________.
A. Fresh Gas Inlet
B. Reservoir Bag
C. Patient Connection
D. Overflow valve
C. Patient Connection
Mapleson A circuits are the MOST efficient for __________ ventilation and worst for __________ ventilation.
A. Controlled, Spontaneous
B. Spontaneous, Controlled
C. Manual, Automatic
D. Spontaneous, Manual
B. Spontaneous, Controlled
To prevent rebreathing in a Mapleson A circuit, the fresh gas flow must be ________ than or equal to the ____________ volume during spontaneous ventilation.
A. Greater/ Tidal
B. Greater/ Minute
C. Less/ Inspiratory
D. Less/ Minute
B. Greater/ Minute
Which of the following statements are true about the Mapleson A circuit? (Select 2)
A. Requires less than 20L/min of minute ventilation to prevent rebreathing
B. Rebreathing during controlled ventilation occurs unless minute ventilation is very low
C. Rebreathing during controlled ventilation occurs unless FGF is very high
D. Requires more than 20L/min of FGF to prevent rebreathing
C. Rebreathing during controlled ventilation occurs unless FGF is very high
D. Requires more than 20L/min of FGF to prevent rebreathing - this is considered wasteful during controlled ventilation
What gasses are represented by the blue, orange and red color?
Blue - Fresh Gas Flow
Orange - Dead Space Gas
Red - Alveolar Gas
To prevent rebreathing, Fresh Gas Flow must be __________ than or equal to minute volume to prevent rebreathing during spontaneous breathing.
A) Greater
B) Less
C) Easier
D) Harder
A) Greater
*When the patient is expiring, a lot of gas goes out of the pop-off valve, but the FGF has to be very high >20L/min in order to help ventilate off that gas. *
When the patient is inspiring, they get a little bit of the dead space and alveolar gas with some FGF
During controlled ventilation with a Mapleson A system, rebreathing occurs unless FGF is more than __________L/min
A) 10
B) 20
C) 30
D) 40
B) 20L/min
* A lot of this FGF is wasted through the APL valve during inspiration, so patient only gets a little bit of FGF with dead space and alveolar gas*
In the Mapleson B circuit, the APL valve and fresh gas flow (FGF) are positioned near the __________.
A. Reservoir Bag
B. Patient
C. End of the system
D. Opposite the patient
B. Patient
The reservoir bag in the Mapleson B system is located at the __________ of the system.
A. Beginning
B. Middle
C. End
D. Last Third
C. End
Mapelson B
Much of the fresh gas flow (FGF) is vented through the APL valve during __________, making the system inefficient.
A. Inhalation
B. Exhalation
C. Both Inhalation and Exhalation
D. The Expiratory Pause
B. Exhalation
For the Mapleson B system to be efficient, the fresh gas flow (FGF) should be ________ times the minute volume during spontaneous and controlled ventilation to prevent rebreathing.
A. 1x
B. 2x
C. 3x
D. 4x
B. 2x
What is the Mapelson B considered, due to it being unrealistic and not used anymore.
A) Current
B) Modern
C) Obsolete
D) Updated
C) Obsolete
In the Mapleson B, since the FGF is near the APL valve, gas will take the path of least resistance and a lot of FGF and ____________ gas will be vented out.
A) Dead Space
B) Fresh
C) Alveolar
D) Mixture
C) Alveolar
*Patient will get some FGF but not a lot *
The Mapleson C circuit is identical to the Mapleson B circuit except that it omits the __________, making it similar to an AMBU bag.
A. APL Valve
B. Reservoir Bag
C. Corrugated Tubing
D. Fresh Gas Inlet
C. Corrugated Tubing
Not losing as much FGF and Alveolar Gas to atmosphere through the APL valve
The Mapleson C circuit is almost as efficient as the Mapleson A circuit during __________ ventilation.
A. Controlled
B. Spontaneous
C. Manual
D. Assisted
B. Spontaneous
In the Mapleson C system, the fresh gas flow (FGF) should be __________ times the minute volume.
A. 1x
B. 1.5x
C. 2x
D. 3x
C. 2x
The Mapleson C system is commonly used for __________.
A. Routine Surgery
B. Emergency Resuscitation
C. Long-term Ventilation
D. Chronic Respiratory Failure
B. Emergency Resuscitation
EMERGEN - C
Looks like an AMBU bag
The Mapleson C system’s efficiency during spontaneous ventilation is based on __________.
A. Fresh gas flow rate
B. Expiratory pause length
C. Position of the APL valve
D. Reservoir bag size
B. Expiratory pause length
As long as it is a minimal expiratory pause
The Mapleson D circuit consists of a 3-way T-piece, which includes the patient connection, fresh gas inlet, and __________.
A. Reservoir Bag
B. Corrugated Tubing
C. APL Valve
D. CO2 Absorber
B. Corrugated Tubing
In the Mapleson D system, the fresh gas flow (FGF) should be __________ times the minute ventilation.
A. 1x
B. 2x
C. 2 - 2.5x
D. 2.5 - 3x
C. 2 - 2.5x
The Mapleson D system is considered the most efficient system for __________ ventilation.
A. Spontaneous
B. Manual
C. Controlled
D. Assisted
C. Controlled
In the Bain modification of the Mapleson D circuit, the fresh gas flow is __________, inside the corrugated tubing.
A. Parallel
B. Coaxial
C. External
D. Intermittent
B. Coaxial
*With the fresh gas inlet its like an inspiratory limb with flow going towards the patient. *
Worry about disconnections, pay attention to kinks of inner hose
In the Mapleson D system, __________ valves may be added to provide extra pressure and support during ventilation.
A. PEEP
B. APL
C. Inspiratory
D. Demand
A. PEEP
During spontaneous ventilation with the Mapleson D system, the APL valve is __________.
A. Closed
B. Partially Closed
C. Open
D. Sealed
C. Open
In the Mapleson D system, since the fresh gas flow (FGF) is closer to the patient, it is more likely to __________.
A. Get vented out
B. Go to the reservoir bag
C. Go to the patient
D. Mix with dead space gas
C. Go to the patient
In the Mapleson D system during spontaneous ventilation, the patient receives a mix of __________ and __________ gas.
A. Dead Space, Fresh Gas Flow (FGF)
B. Alveolar, Dead Space
C. Fresh Gas Flow (FGF), Alveolar
D. CO2, O2
C. Fresh Gas Flow (FGF), Alveolar
Some of the alveolar is vented out through the APL valve, Dome of the dead space may get vented out or caught in reservoir bag
With manually controlled ventilation in the Mapleson D system, the APL valve is __________ to increase pressure in the system.
A. Fully open
B. Partially closed
C. Fully closed
D. Slightly open
B. Partially closed
When squeezing the reservoir bag during inspiration in manually controlled ventilation with the Mapleson D system, some of the __________ gas and some of the __________ gas get vented out of the Pop-off valve.
A. Dead Space, Alveolar
B. Fresh Gas Flow (FGF), Alveolar
C. Dead Space, Fresh Gas Flow (FGF)
D. Alveolar, O2
A. Dead Space, Alveolar
In the Mapleson E (Ayre’s T-piece) system, the __________ attached to the T-piece forms the reservoir.
A. APL Valve
B. Reservoir Bag
C. Corrugated Tubing
D. Fresh Gas Inlet
C. Corrugated Tubing
End of system from the corrugated tubing is open to atmosphere
The Mapleson E system does not include a __________ or __________, which decreases resistance in the system to the atmosphere.
A. Corrugated Tubing, Fresh Gas Inlet
B. Reservoir Bag, APL Valve
C. Patient Connection, Fresh Gas Flow
D. CO2 Absorber, Fresh Gas Inlet
B. Reservoir Bag, APL Valve
This decreases resistance in the system
The Mapleson E system is preferred in __________ due to its decreased resistance.
A. Adults
B. Teenagers
C. Geriatrics
D. Pediatrics
D. Pediatrics
p-EEEEE-diatrics
The Mapleson E system is used in __________ patients to deliver oxygen.
A. Controlled Ventilation
B. Manually Ventilated
C. Spontaneously Breathing
D. Mechanically Ventilated
C. Spontaneously Breathing
Can pinch the end of the corrugated tubing to do controlled ventilation. Pinch to increase pressure and assist in breathing and open the end for expiration. Hard to gauge pressure, monitor chest rise and fall to not put too much pressure .
Why would we use the Mapleson E instead of simple mask, NRB or nasal cannula?
A) Delivers higher O2 flow rates
B) Delivers higher pressures
C) Delivers lower pressures
D) Removes more Deadspace gas
A) Delivers higher O2 flow rates
Cannot assist to take a DEEP breath
The (Jackson Rees) Mapleson F system is a modification of the __________ system.
A. Mapleson A
B. Mapleson B
C. Mapleson D
D. Mapleson E
D. Mapleson E
In the Mapleson F system, a __________ is added when compared to the Mepleson E system.
A. PEEP Valve
B. Reservoir Bag
C. CO2 Absorber
D. One-way Valve
B. Reservoir Bag (with a hole at the end)
Can see volume increasing and decreasing and helps moniotr RR
The recommended fresh gas flow (FGF) for the Mapleson F system is __________ times the minute ventilation.
A. 1 - 1.5x
B. 1.5 - 2x
C. 2 - 2.5x
D. 2.5 - 3x
C. 2 - 2.5x
The Mapleson F system is less likely to develop excessive pressure because it does not have a(n) __________.
A. Fresh Gas Inlet
B. Reservoir Bag
C. APL Valve
D. PEEP Valve
C. APL Valve
To increase pressure or assist in breathing, pinch off end at reservoir bag.
Where would you see the Mapleson F used mostly?
A) OR
B) ICU
C) ER
D) All the above
See this for patient transport also ICU to OR or vice versa
The Mapleson F system is functionally similar to the __________ system.
A. Mapleson A
B. Mapleson B
C. Mapleson D
D. Mapleson E
C. Mapleson D
Dead space gas is going out of the reservoir bag to the atmosphere through the hole at the end
Mapleson D does not have a hole in its reservoir bag like F…
In the Mapleson F system, the patient primarily receives a mix of __________ and __________.
A. Dead Space gas, Fresh Gas Flow (FGF)
B. Alveolar gas, Dead Space gas
C. Fresh Gas Flow (FGF), Alveolar gas
D. CO2, O2
C. Fresh Gas Flow (FGF), Alveolar gas
For spontaneous ventilation, which Mapleson system has the best efficiency?
A. Mapleson A
B. Mapleson B
C. Mapleson C
D. Mapleson D
A. Mapleson A
For controlled ventilation, which Mapleson system is considered the worst in terms of efficiency?
A. Mapleson D
B. Mapleson E
C. Mapleson F
D. Mapleson A
D. Mapleson A
Improved rebreathing efficiency in Mapleson circuits is due to the location of the __________ relative to FGF.
A. Reservoir Bag
B. Pop-off Valve
C. Patient Connection
D. Corrugated Tubing
B. Pop-off Valve
In BC systems, significant amounts of fresh gas are vented through the pop-off valve at __________.
A. Start of Inspiration
B. End of expiration
C. Middle of inspiration
D. During the entire respiratory cycle
B. End of expiration
In DEF systems, the fresh gas flow (FGF) drives exhaled alveolar gas __________ the patient.
A. Towards
B. Away from
C. Bypass
D. Under
B. Away from
Which order for spontaneous ventilation is from best to worst?
A) DFE BC A
B) A DFE CB
C) A CB DFE
D) DEF BC A
B) A(best) DFE CB(worst)
All Ducks Fly East Carrying Balloons
Which order for controlled ventilation is from best to worst?
A) A DFE CB
B) A DEF CB
C) DFE CB A
D) DFE BC A
D) DFE(best) BC A(worst)
Dinosaurs Fly Every Blue Cloud Around
One of the advantages of Mapleson circuits is that they are __________. Select 3
A. Expensive
B. Simple
C. Heavy
D. Lightweight
E. Difficult to assemble
F. Inexpensive
B. Simple
D. Lightweight
F. Inexpensive
An advantage of Maplesons is changes in the fresh gas flow (FGF) composition result in __________ changes in the circuit.
A. Slow
B. Minimal
C. Rapid
D. Unnoticeable
C. Rapid
An advantage of Mapleson circuits is that they have __________ resistance to gas flow.
A. High
B. Moderate
C. Low
D. Variable
C. Low
One advantage of Mapleson circuits is that they produce no toxic products due to the lack of __________.
A. Potassium hydroxide
B. Volatile gasses
C. CO2 Absorbent
D. Corrugated Tubing
C. CO2 Absorbent
Mapleson circuits do not degrade with __________.
A. Temperature changes
B. High pressure
C. Volatile Anesthetics
D. Long-term use
C. Volatile Anesthetics
One disadvantage of Mapleson circuits is that they require __________ fresh gas flow (FGF).
A. Low
B. Moderate
C. High
D. Variable
C. High
remember to have a FULL O2 tank when transporting patient to and from OR
The conservation of heat and humidity in Mapleson circuits is __________.
A. More efficient
B. Less efficient
C. Extremely efficient
D. Unchanged
B. Less efficient
Scavenging is challenging in Mapleson circuits except in Mapelson D because the APL valve is located __________ from the patient.
A. Close
B. Directly
C. Away
D. Next to
C. Away
The Mapleson circuit that only has the APL valve is closer to the reservoir bag?
A. Mapleson A
B. Mapleson B
C. Mapleson C
D. Mapleson D
D. Mapleson D
Mapleson circuits are not suitable for patients with malignant hyperthermia (MH) because it may not be possible to increase FGF to remove excess __________.
A. O2
B. N2
C. CO2
D. H2O
C. CO2
The Circle System allows for __________ flow.
A. Bidirectional
B. Unidirectional
C. Variable
D. Oscillatory
B. Unidirectional
What is A?
Expiratory Valve
What is B?
Pressure transducer port
What is C?
Pressure Gauge
What is D?
Bag-ventilator selector switch
What is E?
APL valve
What is F?
Scavenger outlet
What is G?
Peep Valve
What is H?
Reservoir Bag