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1-Physics Exam 2 > Carbon Dioxide Analysis > Flashcards

Carbon Dioxide Analysis Flashcards

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1
Q

What are components of carbon dioxide?

A

A polyatomic structure and can be measured using infrared absorption analysis

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2
Q

What are two less common methods for measuring carbon dioxide analysis?

A

Fluorescence quenching and the Severinghaus CO2 electrode

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3
Q

When is a Colorimetric Carbon Dioxide Sensor used?

A

A special situation for measuring carbon dioxide is when away from the anesthesia machine (i.e. ICU or code of floor)

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4
Q

What is Colorimetric Carbon Dioxide Sensor used to determine?

A

Assure correct placement of endotracheal tube (ETT).

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5
Q

What is analyzed in Colorimetric Carbon Dioxide Sensor?

A

Exhaled CO2

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6
Q

What is the principle of Colorimetric Carbon Dioxide Sensor?

A

utilizes a change in color of a chemically treated paper

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7
Q

What happens to the Colorimetric Carbon Dioxide Sensor when exposed to C02?

A

An instant reaction will change the color of the paper indicating the presence of CO2.

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8
Q

What is true about newer Colorimetric Carbon Dioxide Sensor?

A

Some newer colorimetric sensors will even give estimate of the amount of CO2 detected.

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9
Q

The appearance of a purple color on the Colorimetric Carbon Dioxide Sensor indicates a CO2 of ____ mmHG and _______ % CO2.

A

<4 mmHg and <0.5%

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10
Q

The appearance of a tan color on the Colorimetric Carbon Dioxide Sensor indicates a CO2 of ____ mmHG and _______ % CO2.

A

4-15 mmHg and 0.5-2% CO2

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11
Q

The appearance of a Gold color on the Colorimetric Carbon Dioxide Sensor indicates a CO2 of ____ mmHG and _______ % CO2.

A

CO2 >15 mmHg and >2%

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12
Q

What is the difference about CO2 Fluorescence Quenching?

A

CO2 does not have the ability to do florescence quenching.

Instead, CO2 will change the pH, liberating hydrogen ions, which react with a quenching agent in the sensor.

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13
Q

CO2 will change the _____, liberating hydrogen ions, which react with a quenching agent in the sensor.

A

pH

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14
Q

What causes the change in florescence in terms of CO2 Fluorescence Quenching?

A

Changed florescence is caused by CO2 and this change can be measured

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15
Q

CO2 Fluorescence Quenching- the change is directly proportional to the concentration of _______ present

A

CO2

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16
Q

What is the severinghaus electrode?

A

modified glass electrode;

  • The electrode contains some sodium bicarbonate, which reacts with the CO2;
  • The reaction changes the pH in the electrode, which corresponds to a change in potential difference, and this is measured.
  • The CO2is then inferred from the change in pH
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17
Q

Severinghaus PCO2 Electrode: The CO2dissolved in the sample diffuses into the middle compartment of the electrode via a _______________.

A

thin (silicon polymer) membrane

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18
Q

Severinghaus PCO2 Electrode: Once inside, the CO2finds itself in a _____________

A

bicarbonate solution

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19
Q

Severinghaus PCO2 Electrode: The reaction which takes place is an old familiar _________________.

A

Carbonic acid dissociation equilibrium:

CO2 + H2O ⇌ H2CO3 ⇌ H+ + HCO3-

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20
Q

Severinghaus PCO2 Electrode: What cause the generate a current of electrical charge?

A

Hydrogen ions are liberated

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21
Q

Severinghaus PCO2 Electrode: The ________ of the solution in the middle chamber changes.

A

pH

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22
Q

Severinghaus PCO2 Electrode: The change in pH is completely dependent on the pCO2, provided the ______ and _______ remain constant.

A

temperature and pressure

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23
Q

Severinghaus PCO2 Electrode: So from the change in pH, the _____ can be calculated.

A

PCO2

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24
Q

Severinghaus PCO2 Electrode: This current is _________ to the carbon dioxide concentration present.

A

proportional

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25
Q

How does oxygen enter human circulation?

A

Enters the lungs and then is passed on into blood.

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26
Q

What is the main way that oxygen is carried to our body?

A

Hemoglobin

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27
Q

What is deoxy Hb?

A

The hemoglobin without oxygen is de oxygenated hemoglobin

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28
Q

What is oxy Hb?

A

The hemoglobin with oxygen, we will call oxygenated hemoglobin

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29
Q

What is oxygen saturation?

A

the percentage of the available hemoglobin that carries oxygen

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30
Q

What does pulse oximetry use to determine O2?

A

Light

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31
Q

What is the basic foundation of pulse oximetry?

A

Light is emitted from light sources which goes across the pulse oximeter probe and reaches the light detector.

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32
Q

How does placing a finger in between a light source help to determine pulse oximetery?

A

Part of the light will be absorbed by the finger and the part not absorbed reaches the light detector.

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33
Q

What two principles help to determine the amount of light passing through a finger in pulse oximetery?

A

principals of the physics laws by Lambert and Beer.

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34
Q

What is Lambert’s Law?

A

The intensity of transmitted light decreases as the distance traveled through the substance increases.

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35
Q

What is Beer’s Law?

A

The intensity of transmitted light decreases as the concentration of the substance increases

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36
Q

What two components are important in determining how much light is absorbed in pulse oximetry?

A

The concentration of the solution and the distance the light must travel

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37
Q

What will hemoglobin absorb?

A

Light

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38
Q

What is the relationship of light and Hb in blood?

A

The amount of light absorbed is proportional to the concentration of Hb in the blood vessel.

39
Q

How can the pulse oximetery determine how much light has been absorbed?

A

By measuring how much light reaches the light detector

40
Q

More Hb in the finger= ________ absorbed

A

more light

41
Q

Less Hb in the finger= ________ absorbed

A

Less

42
Q

What law analyzes the relationship of light and Hb in blood?

A

Beer’s Law

43
Q

What does light have to travel through, according to Lambert’s Law?

A

Artery

44
Q

Lambert’s Law: Amount of light absorbed is ______ to the length of the path that the light has to travel.

A

Proportional

45
Q

When type of artery will light have a shorter path of travel?

A

Narrow artery

46
Q

When type of artery will light have a longer path of travel?

A

Wider artery

47
Q

According to lambert’s law, will the concentration of Hb be different based on the size of the artery?

A

Though the concentration of Hb is the same in both arteries, the light meets more Hb in the wider artery, since it travels in a longer path.

48
Q

Longer path the light must travel =_______ absorbed.

A

More light

49
Q

Shorter path the light must travel =_______ absorbed.

A

Less light

50
Q

How does pulse oximetry measure SpO2?

A

Comparing oxyhemoglobins and deoxyhemoglobins differential absorption of light.

51
Q

What two types of lights used in pulse oximetry?

A

Red and Infrared Light

52
Q

What is the wavelength of red light?

A

660 nm

53
Q

What is the wavelength of Infrared light?

A

940 nm

54
Q

What is important about the wavelengths of red and infrared light?

A

the absorption of oxyhemoglobin and deoxyhemoglobin differs greatly

55
Q

What light spectrum will oxyhemoglobin absorbs more light?

A

Infrared spectrum (940 nm)

56
Q

What light spectrum will deoxyhemoglobin absorbs more light?

A

Red spectrum (660 nm)

57
Q

What does the pulse oximeter module calculate?

A

Oxyhemoglobin/deoxyhemoglobin ratio- compares this ratio to an empirical algorithm (which varies by company) and displays a corresponding value on the digital read out.

58
Q

What determines the empirical algorithm in pulse oximetry?

A

Established by testing healthy volunteers when given a hypoxic mixture

59
Q

What is the range for the established empirical algorithm in pulse oximetry?

A

70-100%

60
Q

SPO2 reading of 100% describe the absorbance of Oxy Hb

A

Infrared light absorbed>Red light

61
Q

SPO2 reading of 0% describe the absorbance of Deoxy Hb

A

Absorption of Red light> Infrared Light

62
Q

SPO2 reading 75% describe absorbance pattern

A

The absorbance pattern is now somewhere in between the oxy Hb curve and deoxy Hb curve. The ratio of absorbed red light and infrared light is different and using this information, the pulse oximeter is able to calculate the oxygen saturation as 75 %.

63
Q

What is present in the blood at a wavelength of SPO2 reading 75%?

A

The blood has both, oxy Hb and deoxy Hb

Red light absorption> Infrared light

64
Q

What is absent in blood when the SP02 is 100%?

A

Deoxygenated hemoglobin

65
Q

What is absent in blood when the SP02 is 0%?

A

Oxygenated hemoglobin

66
Q

SPO2 is 50% describe the absorbance pattern

A

The absorbance pattern is different, the ratio of red light and infrared light absorbed is also therefore different and the pulse oximeter uses this to calculate the saturation

Red light > Infrared Light

67
Q

What can the pulse ox distinguish?

A

Pulsatile flow

68
Q

What is the process that pulse ox uses to measure pulsatile flow?

A

Plethysmography

69
Q

What is plethysmography?

A

which measure volume it is possible to distinguish which ratio corresponds with the highest volume reading

70
Q

What is the highest volume reading in plethysmography?

A

Arterial wave

71
Q

What corresponding readings does the pulse oximeter make?

A

Ratio and volume every second

72
Q

Plethysmography, will filter out ____________

A

The readings and only keeps the reading corresponding to the highest volume

73
Q

What is arterial blood gas (ABG)?

A

Measures dissolved gases in, and other properties (pH, etc.) of arterial blood gas

74
Q

What is the comparison of ABGs to Pulse oximeter?

A

Pulse oximeter is less invasive and more often used; however, it does not predict the percentage as precisely nor does it offer information on other properties of the arterial blood.

75
Q

What is the body sensitive to?

A

pH level

76
Q

What occurs to the body if pH is not in acceptable range?

A

Proteins are denatured and digested, enzymes lose their ability to function.

77
Q

What three components tightly regulate the body’s pH?

A

Respiratory system, Renal system and buffering agents

78
Q

What impact does the respiratory system have in effecting ABGs?

A

Changes in the amount of dissolved CO2 in the blood affects the amount of carbonic acid and therefore the pH.q

79
Q

Increased CO2 ventilation ____________ pH

A

Increase Blood PH (alkalotic)

80
Q

Decreased CO2 ventilation __________ pH

A

Decrease Blood pH (acidotic)

81
Q

What is respiratory compensation?

A

A process that occurs rapidly to restore homeostasis

82
Q

What impact does the renal system have in effecting ABGs?

A

Changes the retention and secretion of bicarbonate and hydrogen ions.

83
Q

If the renal tubular cells retain more bicarb and secret more H+, then blood pH will _________

A

Increase (alkalotic).

84
Q

If the renal tubular cell secrete bicarb and retain H+, then blood pH will __________

A

Decrease (acidotic)

85
Q

What is metabolic compensation?

A

A much slower process than respiratory compensation.

86
Q

Define pH.

A

Acidity or alkalinity of the blood

7.35-7.45

87
Q

Define PaCO2.

A

Used to assess the respiratory component of acid/base regulation
35-45 mmHg

88
Q

Define PaO2.

A

The patient’s oxygenation status

75-100 mmHg

89
Q

Define HCO3.

A

Used to assess the metabolic component of acid/base regulation
22-26 mEq/L

90
Q

Define O2 Saturation

A

Saturation of hemoglobin

95-100%

91
Q

Define Base excess

A

An isolated view of the metabolic component.

+ or - 2 mmol/ L

92
Q

Review ABG interpretations and how to determine if compensation is occurring or not

A

Last slides 60-65 slides of power point

93
Q

ABG interpretations: Opposite directions indicate a ________

A

Primarily respiratory disorder

94
Q

ABG interpretations: Same directions indicate a ________

A

Primarily metabolic disorder

1-Physics Exam 2 (4 decks)

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