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Anesthesia > Chapter 4 > Flashcards

Chapter 4 Flashcards

1
Q

Anesthetic chambers

A

A clear, aquarium-like box used to induce general anesthesia in small patients that are feral, vicious, or intractable or that cannot be handled without undue stress.

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2
Q

Anesthetic masks

A

A cone shaped device, ideally made of transparent material, used to administer oxygen and anesthetic gases to non-intubated patients via the nose and mouth. Also used to administer pure oxygen to dyspenic, hypoxic, or other critically ill patients requiring supplemental oxygen.

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3
Q

Anesthetic vaporizer

A

The anesthetic machine system that vaporizes liquid inhalant anesthetic and mixes it with the carrier gases. Vaporizers are classified as precision or non-precision and vaporizer out of circuit (VOC) or vaporizer in circuit (VIC).

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4
Q

Asphyxiation

A

The act of cutting off the supply of oxygen; suffocation.

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5
Q

atelectasis

A

Collapse of a portion or all of one or both lungs

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6
Q

Ayre’s T-Piece

A

Non-rebreathing circuit with a fresh gas inlet entering at the patient end of the breathing tube at a 90 degree angle (like the base of the letter T) and without a reservoir bag at the opposite end of the breathing tube; Mapleson E circuit

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7
Q

Brain block (universal control arm)

A

Also known as a universal control arm. A device that when attached to a brain coaxial circuit, provides a conventional pop off valve and manometer, increasing the ease and accuracy with which manual ventilation can be provided.

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8
Q

Bain coaxial circuit

A

A non rebreathing circuit with a tube within a tube configuration that discharges fresh gas at the patient end of the breathing tube. Both the overflow valve and the reservoir bag are located away from the patient at the opposite end of the breathing tube; modified Mapleson D circuit

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9
Q

breathing circuit

A

The anesthetic machine system that conveys the carrier gases and inhalant anesthetic to the patient and removes exhaled carbon dioxide. Breathing circuits are classified as rebreathing circuits or non- rebreathing circuits.

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10
Q

breathing tubes

A

Corrugated tubes that complete a rebreathing circuit by carrying the anesthetic gases to and from the patient. Each tube is connected to a unidirectional valve at one end and to the Y piece at the other end.

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11
Q

Carbon dioxide absorber canister

A

The part of a rebreathing circuit that holds the carbon dioxide absorbent granules. These granules, primarily made of calcium hydroxide, remove expired CO2

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12
Q

Closed rebreathing system

A

A rebreathing system in which the pop off valve is kept nearly or completely closed and the flow of oxygen is relatively low, providing only the volume necessary to meet the patient’s metabolic needs.

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13
Q

common gas outlet

A

The point where the o2 inhalant anesthetic and N2o, if used, exit the anesthetic machine on the way to the breathing circuit.

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14
Q

Compressed gas cylinders

A

A container that holds a large volume of highly pressurized gas. Oxygen, nitrous oxide, medical air, and co2 are stored in compressed gas cylinders

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15
Q

compressed gas supply

A

The anesthetic machine system that supplies carrier gases (O2 and sometimes nitrous oxide)

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16
Q

Endotracheal tube

A

ET tube; a flexible tube placed inside the trachea of an anesthetized patient and used to transfer anesthetic gases directly from the breathing circuit into the patient’s trachea, bypassing the oral and nasal cavities, pharynx, and larynx.

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17
Q

Flowmeter

A

A glass cylinder of graduated diameter that indicates carrier gas flow expressed in liters of gas per min (L/min). Reduces the pressure of the gas in the intermediate-pressure line from about 50 psi (about 345 kPa) to 15psi (about 100kPa)

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18
Q

Fresh gas inlet

A

The point at which the carrier and anesthetic gases enter the breathing circuit.

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19
Q

jackson rees circuit

A

A non- rebreathing circuit with a fresh gas inlet at the patient end of the breathing tube and a reservoir bag at the opposite end. The fresh gas inlet enters the breathing tube at a 45 to 90 degree angle; Mapleson F circuit.

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20
Q

lack circuit

A

A non rebreathing circuit with the fresh gas inlet, the overflow valve, and the reservoir bag located away from the patient at the opposite end of the breathing tube. Modified Mapleson A circuit

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21
Q

laryngoscope

A

A device consisting of a handle, a blade, and a light source; used to increase visibility of the larynx during placement of an endotracheal tube.

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22
Q

line pressure gauge

A

A gauge that indicates the pressure in the intermediate pressure gas line between the pressure reducing valve and the flow meters.

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23
Q

magill circuit

A

A non rebreathing circuit with an overflow valve at the patient end of the breathing tube. Both the fresh gas inlet and the reservoir bag are located away from the patient at the opposite end of the breathing tube; Mapleson A circuit

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24
Q

mapleson classification system

A

Any one of a number of non rebreathing circuits as classified by WW Mapleson, in which the position of the fresh gas inlet, the reservoir bag, and the pressure limiting valve varies.

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25
Q

non rebreathing system

A

An anesthetic machine fitted with a non rebreathing circuit. In this system, little or no exhaled gases are returned to the patient but are instead removed from the circuit by use of appropriately high flow rates of carrier gas and evacuated by a scavenger connected to a pressure limiting valve or other exit port. Used most commonly for patients under 2.5 to 3 kg in body weight.

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26
Q

Norman mask elbow

A

A non rebreathing circuit with a fresh gas inlet at the patient end of the breathing tube and a reservoir bag at the opposite end. The fresh gas inlet enters the breathing tube at a 45 to 90 degree angle, and the endotracheal tube connector is at right angles to the breathing tube, Mapleson F circuit.

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27
Q

oxygen flush valve

A

A button or lever that rapidly delivers a large volume of pure oxygen (at a flow rate of 35 to 75 L/min) directly to the common gas outlet or breathing circuit of a rebreathing system, bypassing the anesthetic vaporizer and oxygen flow meters.

28
Q

pop off occlusion valve

A

An occlusion valve that temporarily prevents air escaping from the pop off valve as long as a button is pressed. Used most commonly during manual ventilation.

29
Q

pop off valve

A

Also known as the pressure relief valve, exhaust valve, adjustable pressure eliminating (APL) valve, or overflow valve, this valve is the point of exit of anesthetic gases from the breathing circuit.

30
Q

pressure manometer

A

A gauge that indicates the pressure of the gases within the breathing circuit, and by extension the pressure in the animal’s airways and lungs. Expressed in centimeters of water (cmH2O), millimeters of mercury (mmHg) or kilopascals (kPa).

31
Q

pressure reducing valve

A

A valve that reduces the pressure of a compressed gas to a constant safe operating pressure of 40 to 50 psi (275 to 245 kPa) regardless of pressure changes within the tank.

32
Q

rebreathing system (circle system)

A

An anesthetic machine fitted with a rebreathing circuit. In this system, exhaled gases minus CO2 are recirculated and rebreathed by the patient, along with variable amounts of fresh O2 and anesthetic. Appropriate for most patients over 2.5 to 3 kg in body weight.

33
Q

reservoir bag

A

Also called a rebreathing bag. A rubber or plastic bag that serves as a flexible storage reservoir for expired and inspired gases. it also allows the anesthetist to observe respirations, confirm proper endotracheal tube placement, and ventilate for the patient.

34
Q

Respiratory minute volume

A

RMV; the amount of air that moves into and out of the lungs in a minute. The tidal volume multiplied by the respiratory rate.

35
Q

scavenging system

A

The anesthetic machine system that disposes of excess and waste anesthetic gases outside of the building, so that inhalation by occupationally exposed individuals is minimized.

36
Q

semiclosed rebreathing system

A

A rebreathing system in which the pop off valve is positioned partially open, and the flow of O2 is relatively high, providing more volume than is necessary to meet the patient’s metabolic needs.

37
Q

supraglottic airway device

A

A device used to maintain an open airway in an anesthetized patient that connects with the opening of the glottis, but unlike an endotracheal tube, does not invade the tracheal lumen.

38
Q

tank pressure gauge

A

A device attached to the yoke of an anesthetic machine or the pressure regulator of an H tank. Indicates the pressure of gas remaining in a compressed gas cylinder measured in pounds per square inch (psi) or kilopascals (kPa).

39
Q

tidal volume (VT)

A

The volume of a normal breath (approx 10 to 15ml/kg body weight)

40
Q

unidirectional valves

A

The inspiratory valve or expiratory valve of a rebreathing circuit. Controls the direction of gas flow through a rebreathing circuit as the patient breathes.

41
Q

unidirectional valve

A

The inspiratory valve or expiratory valve of a rebreathing circuit. Controls the direction of gas flow through a rebreathing circuit as the patient breathes.

42
Q

Universal control arm (brain block)

A

Also known as a Bain block. A device that, when attached to a Bain coaxial circuit, provides a conventional pop-off valve and manometer, increasing the ease and accuracy with which manual ventilation can be provided.

43
Q

Vaporizer in circuit

A

VIC; a vaporizer that is located in the breathing circuit non-precision vaporizers are often positioned this way.

44
Q

vaporizer out of circuit

A

VOC: A vaporizer in which carrier gas from the flow meters flow into the vaporizer before entering the breathing circuit. Precision vaporizers are positioned this way.

45
Q

When the H oxygen tank is half full the tank pressure gauge will read approximately

A

1100psi

46
Q

What state is nitrous oxide present in the tank?

A

Gas and a liquid

47
Q

What indicates the amount of oxygen a patient receives under anesthesia

A

Flow meter

48
Q

Flowmeters that have a ball for reading the gauge should be read from the _______of the ball.

A

Middle

49
Q

What oxygen flow rate range is recommended for a 15kg dog on a semiclosed rebreathing system when you wish to increase anesthetic depth and when you want to maintain the current depth.

A

1L/min; 500ml/min

50
Q

How is the minimum reservoir bag size calculated?

A

50ml/kg

51
Q

What does the one way valves on an anesthetic machine help

A

Controls the direction of movement of gases

52
Q

What does the pop off valve do?

A

Prevents excess gas pressure from building up within the breathing circuit.

53
Q

When a small animal is bagged the pressure manometer reading should never exceed

A

20cm H2O

54
Q

Rebreathing systems when used with standard small animal corrugated breathing tubes are best reserved for animals weighing more than 7kg.

A

True

55
Q

Rebreathing of expired gases is determined primarily by the

A

Fresh gas flow

56
Q

Non-rebreathing systems should have maintenance flow rates that are

A

Very high at least 100 to 200ml/kg/min

57
Q

The negative pressure relief valve is particularly important when

A

There is a failure of oxygen flow through the system.

58
Q

The tidal volume of an anesthetized animal is considered to be _________ml/kg of body weight

A

10

59
Q

A scavenging system is generally attached to the

A

pop off valve

60
Q

A reservoir bag that is not moving well may indicate that

A

the endotracheal tube is not in the trachea
The animal has a decreased tidal volume
There is a leak around the endotracheal tube

61
Q

The anesthetist will know when the granules in the carbon dioxide absorber have been depleted because the

A

Granules will be brittle
granules may change color
granules may be hard

62
Q

An increase in the depth of anesthesia can be achieved quickly by

A

having high oxygen flow rates
bagging the animal with the precision vaporizer on

63
Q

The concentration of anesthetic delivered from a non-precision vaporizer can depend on

A

temperature of the liquid anesthetic
Flow of the carrier gas through the vaporizer
back pressure
type of anesthetic in the vaporizer

64
Q

When an anesthetic machine is operating correctly, the pressures in the machine are always

A

40 to 50psi between the pressure reducing valve and the flowmeters
15psi between the flowmeters and breathing circuit
15psi entering a VOC vaporizer

65
Q

Given a 5kg cat and a conventional machine with a vaporizer out of circuit (VOC) precision vaporizer, what type of circuit and oxygen flow rate would normally be used?

A

Because the cat weighs less than 7kg, a Bain coaxial circuit or other non-rebreathing system is preferred although a rebreathing system with pediatric hoses could also be used. The flow rate recommended for the Bain system is 100 to 200ml/kg/min (or alternatively, 300 to 400ml/kg/min to prevent any rebreathing) during all periods of anesthesia (induction, maintenance, and recovery). Thus the anesthetist could select 500ml/min to 1L/min (100 to 200ml x 5kg), or 1.5 to 2L/min (300 to 400ml x 5kg) if no rebreathing is desired.

66
Q

Given a 25kg dog and a conventional machine with a VOC precision vaporizer, what type of circuit and flow rate would be preferred during the maintenance period?

A

For economic and safety reasons, the type of circuit used would most likely be a semiclosed rebreathing system. The oxygen flow rate during the maintenance period is 20 to 40ml/kg/min. Thus the anesthetist could select between 500ml/min (20ml/kg/min x 25kg) and 1L/min (40ml/kg/min x 25kg).
If a closed rebreathing system were used, the flow rate would be 5 to 10ml/kg/min with a minimum flow of 250ml/min. For this animal the flow rate would therefore be about 250ml of O2 per min (10ml/kg/min x 25kg).

67
Q

Given a 15kg dog and a conventional machine with a VOC precision vaporizer, what would be the recommended flow rate if the patient’s anesthetic depth is inadequate and needs to be increased?

A

For practical and safety reasons, this patient is most likely to be on a semiclosed rebreathing system, and the flow rate can be anywhere from 50 to 100ml/kg/min. For this animal the flow rate therefore would be 750ml to 1.5L/min (50ml/kg/min x 15kg to 100ml/kg/min x 15kg) Although any flow in this range may be used, the higher the flow, the more rapidly the anesthetic depth will change. so if its important that the anesthetic depth changes quickly, it is always preferable to choose a higher rate, even though more gas will be used. If the change can be more gradual, a lower rate (750ml/min) can be used to conserve gases. These rates are appropriate any time the anesthetic depth needs to be changed, including the induction and recovery periods.

Anesthesia (8 decks)

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