Device, Monitoring, and Physics Flashcards
1
Q
Allen’s Test
A
determines collateral blood flow in ulnar and radial arteries before cannulation
2
Q
Amsorb
[contents]
A
calcium hydroxide and calcium chloride
3
Q
Arterial BP Monitoring
[MAP calculation]
A
mean under pressure curve
4
Q
Arterial BP Monitoring
[rate of downstroke]
A
peripheral vascular resistance
5
Q
Arterial BP Monitoring
[rate of upstroke]
A
indicates contractility
6
Q
Baralyme
[absorptive capacity]
A
10-20 L of CO2 per 100g absorbent
7
Q
BIS
[suppression ratio]
A
percentage that an isoelectic condition exists over the prior monitoring time period
8
Q
Blood Pressure Cuff
[ideal fit]
A
bladder should extend halfway around the extremity
width should be 20-50% greater than diameter of extremity
9
Q
Blood Pressure Cuff
[too narrow]
A
large overestimation of systolic pressure
10
Q
Capnography
[mechanism]
A
infrared light
11
Q
Cardiac Index
[normal range]
A
2.8 - 4.2
12
Q
Cardiax Index
[equation]
A
CO / BSA
(L/min/m2)
13
Q
Central Venous Catheter
[risk of left internal jugular]
A
pleural effusion and chylothorax
14
Q
Central Venous Catheter
[ideal placement]
A
right internal jugular
- catheter tip should be just superior to superior vena cava
- just above carina on chest x-ray
15
Q
Central Venous Pressure
[estimation of _____]
A
right atrial pressure
16
Q
Circle components
[in addiion to mapleson circuits]
A
CO2 absorber
unidirectional valves
Y-connector
17
Q
Rank agents in order of carbon monoxide risk
A
des > iso > sevo
18
Q
CO2 Absorbent
[indicator dye]
A
usually ethyl violet
- turns from white to purple with increasing [H+]
19
Q
CO2 waveform
[phase 1]
A
dead space
20
Q
CO2 waveform
[phase 0]
A
inspiratory segment
21
Q
CO2 waveform
[phase II]
A
alveolar gas and dead space
22
Q
CO2 waveform
[alpha angle]
A
related to ventilation-perfusion matching
23
Q
CO2 waveform
[beta angle]
A
assess rebreathing
- should be close to 90o
24
Q
CO2 Waveform
[phase III]
A
“plateau” of alveolar gas
25
**CO2 waveform**
[phase IV]
terminal "upswing" seen in patients with reduced thoracic compliance
* examples: obese and pregnant patients
26
standard compliance in adult breathing circuits
5 mL/cmH2O
* Thus, if PIP is 20cmH2O, about 100mL of tidal volume is lost to the circuit
27
**decreased CVP and blood pressure**
[most likely cause]
decreased venous return
28
**CVP decreases and BP increases**
[most likely cause]
increased cardiac performance
29
At what time is CVP measured?
between A and C waves during end-expiration
30
**CVP measurement**
[a waves]
correspond to atrial contraction
* absent in atrial fibrillation
* exaggerated in junctional rhythms
31
**CVP Measurement**
[c waves]
tricuspid valve during early ventricular contraction
32
**CVP Measurement**
[v waves]
venous return against a closed tricuspid valve
33
Diameter Index Safety System
prevents incorrect pipeline attachements
34
**E-cylinder**
[weight and volume]
63lbs
4.8L
35
Lead I best measures which coronary artery?
left circumflex
36
Lead II best measures which artery?
Right coronary artery (RCA)
37
V5 best represents which coronary artery?
Left anterior descending (LCA)
38
**EKG p-wave**
[normal time span]
0.08 - 0.10 sec
39
**EKG PR interval**
[normal time span]
0.12 - 0.20 sec
40
**EKG QRS complex**
[normal time interval]
0.06 - 0.10 sec
41
**EKG**
[waveform amplitude]
1 mV
42
**EKG**
[Lead II]
connects right arm to left leg
* parallel to electrical axis of atria
* results in largest p-wave
* enhances diagnosis of arrhythmias and detection of inferior wall ishcemia
43
**EKG**
[myocardial ischemia detection]
ST depression exceeding 1mm
* recorded 80 msec after the J point
* best seen in "diagnostic mode"
* may be seen with t-wave inversion
44
**EKG**
[V5 lead]
anterior axillary line at 5th intercostal
* detect anterior and lateral wall ischemia
45
**Fractional Concentration of Agent at Vaporizer**
(FA)
[equation]
* QV = flow of carrier gas
* QT = total flow of gas
* PA = vapor pressure of agent
* PB = barometric pressure
46
Fresh Gas Coupling
[definition]
increased tidal volume and PIP with increasing fresh gas flow
* O2 flush should be avoided during inspiratory phase
47
Recommended gas exposure according to NIOSH
25 ppm N2O
2 ppm agent (0.2 if N2O also present)
48
Link-25
maintains [O2] by increasing the flow of oxygen
49
Mapleson A
50
Mapleson A
[uses]
spontaneous ventilation
51
Mapleson B
52
Mapleson C
53
Mapleson D
54
Mapleson E
55
Mapleson F
56
Mapleson F
[uses]
neonates and small infants
57
**Methemoglobin**
[pulse oximetry reading]
85%
* same absorption coefficient at both red and infrared wavelengths, resulting in a 1:1 ratio
58
Myer Overton Rule
anesthetic potency of inhalational agent correlates directly with their lipid solubility
59
**N2O**
[liters in full tank]
1,590
60
**N2O**
[tank pressure]
745 psig
61
**O2 Tank**
[liters and psig]
660L at 2200 psig
62
**ORMC**
[acronym]
Oxygen Ratio Monitor Controller
63
**Oxygen Analyzers**
[3 types]
polarographic (Clark electrode)
galvanic (fuel cell)
paramagnetic
64
Oxygen Ratio Monitor Controller
reduces [N2O]
* Drager
65
**Oxygen**
[1L of liquid oxygen equals \_\_\_\_L in gas]
862L
66
**PA Catheter**
[contraindications]
left bundle branch block and conditions with increased risk of arrhythmias
* Example: Wolff-Parkinson-White
67
**PA Catheter**
[insertion tips and tricks]
* have patient inhale deeply
* head-up, right lateral tilt position
* injet cold saline through proximal lumen
* inotropic agent to increase CO
68
**PA Catheter**
[placement distance]
35-45 cm
* should see a sudden increase in *diastolic* pressure
69
**PA waveform**
[causes of large A waves]
a-fib
left ventricular hypertropy
70
**PA waveform**
[large V wave]
mitral regurge
71
**Passy-Muir Valve**
[definition]
redirects air flow through the vocal folds to enable speaking
72
**Passy-Muir Valve**
[errors to avoid]
remove before ventilation
* if left on, will cause repeated inflation of pateint's lungs without ability to exhale
73
Peak Inspriatory Pressure
highest circuit pressure generated during inspiration
* *dynamic* compliance
74
Pin Index Safety System
prevents incorrect cylinder attachments
75
**Piston Ventilators**
[advantages]
delivers accurate tidal volumes
* good for patients with poor lung compliance and infants
76
Plateau Pressure
pressure measured during inspiratory pause
(time of no gas flow)
* *static* compliance
77
**Pressure Sensory Shut-off Valve**
"fail safe" in Datex
* shuts off other gases when O2 falls below 26psig
* upstream of 2nd regulator
* based on *threshold*
78
**Pulmonary Artery Catheter**
[distance to PAWP]
50 cm
79
**Pulmonary Artery Catheter**
[distance to pulmonary artery]
40 cm
80
**Pulmonary Artery Catheter**
[distance to right atrium]
20 cm
81
**Pulmonary Artery Catheter**
[distance to right ventricle]
30 cm
82
**pulmonary artery measurement**
[predictors of pulmonary embolism]
increased PAP, but no change in PAWP
83
**Pulmonary Artery Wedge Pressure**
[estimation of \_\_\_\_\_]
left ventricular end-diastolic pressure
84
**Pulmonary Vasular Resistance**
[equation]
| (dynes\*sec\*cm-5)
85
**Pulmonary Vascular Resistance**
[normal range]
100 - 250
dynes \* sec \* cm-5
86
**Pulse Ox**
[wavelength absorption]
660 and 940 nm
87
"any increase in dead space must be accompanied by a corresponding increase in \_\_\_\_\_, if alveolar ventilation is to remain unchanged"
tidal volume
88
"An increase in PIP and plateau pressure implies _____ or \_\_\_\_\_"
increase in tidal volume
or
decrease in pulmonary compliance
89
"For each mmHg rise in PaCO22, normal awake patients increase their minute ventilaiton by ____ L/min"
2 - 3
* general anesthesia decreases this response, paralysis eliminates it
90
"an increase in PIP without any change in plateau pressure corresponds to \_\_\_\_\_"
an incrase in airway resistance or inspiratory gas flow rate
91
**Resuscitation Bags**
[disadvantages]
* FiO2 is directly proportional to [O2] and flow rate while inversely proportional to MV
* requires high fresh gas flow
92
**Resuscitation Bag**
[key difference compared to other systems]
contains a non-rebreathing valve
93
**Soda Lime**
[contents]
calcium-, sodium-, and potassium hydroxide
94
**Soda Lime**
[absorptive capacity]
15 - 25 L of CO2 per 100g absorbant
95
**Somatosensory Evoked Potentials (SSEPs)**
[purpose]
evaluates ascending sensory tracts
| (primarily dorsal spinal column)
96
**Somatosensory Evoked Potentials (SSEPs)**
[significant changes]
50% amplitude decrease
and
10% latency prolongation
97
**Somatosensory Evoked Potentials**
[commonly monitored peripheral nerves]
ulnar
median
posterior tibial
98
**Stroke Volume**
| (normal range)
60 - 90
99
**Stroke Volume**
[equation]
(CO/HR) \* 1000
| (mL/beat)
100
**Systemic Vasular Resistance**
[equation]
(dynes\*sec\*cm-5)
* same as total peripheral resistance
101
**Systemic Vasular Resistance**
[normal range]
900 - 1400
dynes\*sec\*cm-5
102
**Thermodilution**
[correlation with change]
degree of change is inversely proportional to CO
* temperature change is minimal during high clow
103
**transmural pressure**
[equation/definition]
atrial pressure - extracardiac pressure
104
**Baralyme**
[contents]
20% barium hydroxide and 80% calcium hydroxide
105
**Oxygen Failure Protection Device**
gradually reduces other gases until oxygen supply is lower than 12 psig
* Draeger
* base on *proportioning*
106
**Primary Pressure Regulator**
[change in psi]
2200 psi from cylinder to 45-50 psi
107
**Secondary Regulator**
[change in psi of O2 and N2O]
lowers O2 to 14 psi
lowers N2O to 26 psi
108
**Visual Evoked Potentials**
[uses]
monitor optic nerve and occipital cortex during resection of large pituitary tumors
109
