capnography

Question 1

what are the 4 effects of hypercarbia

Answer 1

respiratory acidosis
increased CBF (inc ICP)
increase pulmonary vascular resistance
potassium shifts from intracellular to intravascular

Question 2

5 effects of hypocarbia

Answer 2

respiratory alkalosis
decreased CBF
decrease pulmonary vascular resistance
potassium shifts to the intracellular space
blunts normal urge to breath

Question 3

besides providing information on ventilation capnography can also provide information on

Answer 3

pulmonary blood flow
aerobic metabolism
placement of tube
integrity of breathing circuit
estimates the adequacy of cardiac output

Question 4

what does the bohr equation calculate

Answer 4

physiological dead space

Question 5

what is dead space

Answer 5

volume of each breath inhaled that does not participate in gas exchange

Question 6

what is anatomic dead space

Answer 6

conducting zone of the airway
Nose, trachea, bronchi

Question 7

what is physiologic dead space

Answer 7

airway deadspace and alveolar dead space

Question 8

high speed time capnography

Answer 8

user can interpret information about each breath

Question 9

slow speed time capnography

Answer 9

appreciation of the expired and inspired trend

Question 10

what is side stream

Answer 10

aspirated gas sample and analyzes away from airway at a rate of 50-200mL/min

Question 11

what is mainstream

Answer 11

analyzes gas sample directly in the breathing circuit
no time delay; rise time is faster

Question 12

where is end tidal CO2 measured during the waveform

Answer 12

end point of phase III

Question 13

causes of increased PetCO2; increase CO2 production and delivery to the lungs

Answer 13

increased metabolic rate
fever
sepsis
seizures
malignant hyperthermia
thyrotixicosis
increased CO (due to CPR)
bicarb administration

Question 14

increased PetCO2; decrease alveolar ventilation

Answer 14

hypoventilation
respiratory center depression
partial muscular paralysis
neuromuscular disease
high spinal anesthesia
COPD

Question 15

increased PetCO2; equipment malfunction

Answer 15

rebreathing
exhausted CO2 absorber
faulty inspiratory expiratory valve

Question 16

decrease PetCo2; decrease CO2 production and delivery to the lungs

Answer 16

hypothermia
pulmonary hypo perfusion
cardiac arrest
pulmonary embolism
hemorrhage
hypotension

Question 17

decreased PetCO2; increase alveolar ventilation

Answer 17

hyperventilation

Question 18

decrease PetCO2; equipment malfunction

Answer 18

ventilator disconnect
esophageal intubation
complete airway obstruction
poor sampling
leak around endotracheal tube cuff

Question 19

what is the difference between PaCO2 and ETCO2

Answer 19

5mmHg

Question 20

3 problem the increase the difference of PaCO2 and ETCO2

Answer 20

V/Q mismatching (PE, endobronchial intubation)
breathing patterns that fail to deliver alveolar gas at the sampling site (neonates, COPD, bronchospasm)
problems with the capnograph (sampling line leak, calibration error, slow response time relative to breathing pattern)

Question 21

Clinical measurement most commonly relies on

Answer 21

IR light absorption techniques

Question 22

the greater the CO2 in the sample the _______ IR light that reaches the detector

Answer 22

less

Question 23

with the chemical indicator, purple color change indicates

Yellow?

Answer 23

no CO2- purple
CO2 - yellow

Question 24

Phase 1 of the capnograph

Answer 24

baseline
exhalation of anatomical DS and the apparatus
NO CO2

Question 25

phase 2 capnograph

Answer 25

expiratory upstroke begins, CO2 rich alveolar gas sampling of alveolar gases normally steep

Question 26

phase 3 capnograph

Answer 26

plateau phase normally representative of CO2 in alveolus can be representative of ventilation heterogeneity, slight increasing slope

Question 27

phase 0 capnography

Answer 27

also called phase IV inspiration of fresh gas remaining CO2 washed out downstroke returns to baseline

Question 28

what happens in the occasional phase IV

Answer 28

sharp upstroke in PCO2 at the very end of phase III results from closure of lung units with lower PCO2 Allows for regions with higher CO2 to contribute to more of the exhaled gas sample seen in pregnant and obese patients with decreased FRC and lung capacity

Question 29

alpha angle separates_____? what is the angle? when will increase?

Answer 29

separates phase II and III 100-110 degrees increases with expiratory airflow obstruction (COPD, bronchospasm, kinked ETT)

Question 30

beta angle separates? degree? increases with?

Answer 30

separates phase III and 0 90 degrees malfunctioning inspiratory unidirectional valves, rebreathing and low tidal volume with rapid respiratory rate

Question 31

Answer 31

mechanical ventilation

Question 32

Answer 32

spontaneous ventilation

Question 33

Answer 33

inadequate seal

Question 34

Answer 34

faulty inspiratory valve

Question 35

Answer 35

sample line leak

Question 36

Answer 36

hyperventilation

Question 37

Answer 37

hypoventilation

Question 38

Answer 38

airway obstruction

Question 39

Answer 39

cardiac oscillations

Question 40

Answer 40

NMBD wearing off

Question 40

Answer 40

rebreathing soda lime exhaustion

Question 41

Answer 41

over breathing

Question 42

Answer 42

esophageal intubation