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Board Exam > Device, Monitoring, and Physics > Flashcards

Device, Monitoring, and Physics Flashcards

1
Q

Allen’s Test

A

determines collateral blood flow in ulnar and radial arteries before cannulation

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2
Q

Amsorb

[contents]

A

calcium hydroxide and calcium chloride

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3
Q

Arterial BP Monitoring

[MAP calculation]

A

mean under pressure curve

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4
Q

Arterial BP Monitoring

[rate of downstroke]

A

peripheral vascular resistance

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5
Q

Arterial BP Monitoring

[rate of upstroke]

A

indicates contractility

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6
Q

Baralyme

[absorptive capacity]

A

10-20 L of CO2 per 100g absorbent

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7
Q

BIS

[suppression ratio]

A

percentage that an isoelectic condition exists over the prior monitoring time period

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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

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9
Q

Blood Pressure Cuff

[too narrow]

A

large overestimation of systolic pressure

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10
Q

Capnography

[mechanism]

A

infrared light

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11
Q

Cardiac Index

[normal range]

A

2.8 - 4.2

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12
Q

Cardiax Index

[equation]

A

CO / BSA

(L/min/m2)

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13
Q

Central Venous Catheter

[risk of left internal jugular]

A

pleural effusion and chylothorax

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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
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15
Q

Central Venous Pressure

[estimation of _____]

A

right atrial pressure

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16
Q

Circle components

[in addiion to mapleson circuits]

A

CO2 absorber

unidirectional valves

Y-connector

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17
Q

Rank agents in order of carbon monoxide risk

A

des > iso > sevo

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18
Q

CO2 Absorbent

[indicator dye]

A

usually ethyl violet

  • turns from white to purple with increasing [H+]
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19
Q

CO2 waveform

[phase 1]

A

dead space

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20
Q

CO2 waveform

[phase 0]

A

inspiratory segment

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21
Q

CO2 waveform

[phase II]

A

alveolar gas and dead space

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22
Q

CO2 waveform

[alpha angle]

A

related to ventilation-perfusion matching

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23
Q

CO2 waveform

[beta angle]

A

assess rebreathing

  • should be close to 90o
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24
Q

CO2 Waveform

[phase III]

A

“plateau” of alveolar gas

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25
Q

CO2 waveform

[phase IV]

A

terminal “upswing” seen in patients with reduced thoracic compliance

  • examples: obese and pregnant patients
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26
Q

standard compliance in adult breathing circuits

A

5 mL/cmH<span>2</span>O

  • Thus, if PIP is 20cmH2O, about 100mL of tidal volume is lost to the circuit
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27
Q

decreased CVP and blood pressure

[most likely cause]

A

decreased venous return

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28
Q

CVP decreases and BP increases

[most likely cause]

A

increased cardiac performance

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29
Q

At what time is CVP measured?

A

between A and C waves during end-expiration

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30
Q

CVP measurement

[a waves]

A

correspond to atrial contraction

  • absent in atrial fibrillation
  • exaggerated in junctional rhythms
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31
Q

CVP Measurement

[c waves]

A

tricuspid valve during early ventricular contraction

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32
Q

CVP Measurement

[v waves]

A

venous return against a closed tricuspid valve

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33
Q

Diameter Index Safety System

A

prevents incorrect pipeline attachements

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34
Q

E-cylinder

[weight and volume]

A

63lbs

4.8L

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35
Q

Lead I best measures which coronary artery?

A

left circumflex

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36
Q

Lead II best measures which artery?

A

Right coronary artery (RCA)

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37
Q

V5 best represents which coronary artery?

A

Left anterior descending (LCA)

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38
Q

EKG p-wave

[normal time span]

A

0.08 - 0.10 sec

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39
Q

EKG PR interval

[normal time span]

A

0.12 - 0.20 sec

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40
Q

EKG QRS complex

[normal time interval]

A

0.06 - 0.10 sec

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41
Q

EKG

[waveform amplitude]

A

1 mV

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42
Q

EKG

[Lead II]

A

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
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43
Q

EKG

[myocardial ischemia detection]

A

ST depression exceeding 1mm

  • recorded 80 msec after the J point
  • best seen in “diagnostic mode”
  • may be seen with t-wave inversion
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44
Q

EKG

[V5 lead]

A

anterior axillary line at 5th intercostal

  • detect anterior and lateral wall ischemia
45
Q

Fractional Concentration of Agent at Vaporizer

(FA)

[equation]

A
  • QV = flow of carrier gas
  • QT = total flow of gas
  • PA = vapor pressure of agent
  • PB = barometric pressure
46
Q

Fresh Gas Coupling

[definition]

A

increased tidal volume and PIP with increasing fresh gas flow

  • O2 flush should be avoided during inspiratory phase
47
Q

Recommended gas exposure according to NIOSH

A

25 ppm N2O

2 ppm agent (0.2 if N2O also present)

48
Q

Link-25

A

maintains [O2] by increasing the flow of oxygen

49
Q
A

Mapleson A

50
Q

Mapleson A

[uses]

A

spontaneous ventilation

51
Q
A

Mapleson B

52
Q
A

Mapleson C

53
Q
A

Mapleson D

54
Q
A

Mapleson E

55
Q
A

Mapleson F

56
Q

Mapleson F

[uses]

A

neonates and small infants

57
Q

Methemoglobin

[pulse oximetry reading]

A

85%

  • same absorption coefficient at both red and infrared wavelengths, resulting in a 1:1 ratio
58
Q

Myer Overton Rule

A

anesthetic potency of inhalational agent correlates directly with their lipid solubility

59
Q

N2O

[liters in full tank]

A

1,590

60
Q

N2O

[tank pressure]

A

745 psig

61
Q

O2 Tank

[liters and psig]

A

660L at 2200 psig

62
Q

ORMC

[acronym]

A

Oxygen Ratio Monitor Controller

63
Q

Oxygen Analyzers

[3 types]

A

polarographic (Clark electrode)

galvanic (fuel cell)

paramagnetic

64
Q

Oxygen Ratio Monitor Controller

A

reduces [N2O]

  • Drager
65
Q

Oxygen

[1L of liquid oxygen equals ____L in gas]

A

862L

66
Q

PA Catheter

[contraindications]

A

left bundle branch block and conditions with increased risk of arrhythmias

  • Example: Wolff-Parkinson-White
67
Q

PA Catheter

[insertion tips and tricks]

A
  • have patient inhale deeply
  • head-up, right lateral tilt position
  • injet cold saline through proximal lumen
  • inotropic agent to increase CO
68
Q

PA Catheter

[placement distance]

A

35-45 cm

  • should see a sudden increase in diastolic pressure
69
Q

PA waveform

[causes of large A waves]

A

a-fib

left ventricular hypertropy

70
Q

PA waveform

[large V wave]

A

mitral regurge

71
Q

Passy-Muir Valve

[definition]

A

redirects air flow through the vocal folds to enable speaking

72
Q

Passy-Muir Valve

[errors to avoid]

A

remove before ventilation

  • if left on, will cause repeated inflation of pateint’s lungs without ability to exhale
73
Q

Peak Inspriatory Pressure

A

highest circuit pressure generated during inspiration

  • dynamic compliance
74
Q

Pin Index Safety System

A

prevents incorrect cylinder attachments

75
Q

Piston Ventilators

[advantages]

A

delivers accurate tidal volumes

  • good for patients with poor lung compliance and infants
76
Q

Plateau Pressure

A

pressure measured during inspiratory pause

(time of no gas flow)

  • static compliance
77
Q

Pressure Sensory Shut-off Valve

A

“fail safe” in Datex

  • shuts off other gases when O2 falls below 26psig
  • upstream of 2nd regulator
  • based on threshold
78
Q

Pulmonary Artery Catheter

[distance to PAWP]

A

50 cm

79
Q

Pulmonary Artery Catheter

[distance to pulmonary artery]

A

40 cm

80
Q

Pulmonary Artery Catheter

[distance to right atrium]

A

20 cm

81
Q

Pulmonary Artery Catheter

[distance to right ventricle]

A

30 cm

82
Q

pulmonary artery measurement

[predictors of pulmonary embolism]

A

increased PAP, but no change in PAWP

83
Q

Pulmonary Artery Wedge Pressure

[estimation of _____]

A

left ventricular end-diastolic pressure

84
Q

Pulmonary Vasular Resistance

[equation]

A

(dynes*sec*cm-5)

85
Q

Pulmonary Vascular Resistance

[normal range]

A

100 - 250

dynes * sec * cm-5

86
Q

Pulse Ox

[wavelength absorption]

A

660 and 940 nm

87
Q

“any increase in dead space must be accompanied by a corresponding increase in _____, if alveolar ventilation is to remain unchanged”

A

tidal volume

88
Q

“An increase in PIP and plateau pressure implies _____ or _____”

A

increase in tidal volume

or

decrease in pulmonary compliance

89
Q

“For each mmHg rise in PaCO22, normal awake patients increase their minute ventilaiton by ____ L/min”

A

2 - 3

  • general anesthesia decreases this response, paralysis eliminates it
90
Q

“an increase in PIP without any change in plateau pressure corresponds to _____”

A

an incrase in airway resistance or inspiratory gas flow rate

91
Q

Resuscitation Bags

[disadvantages]

A
  • FiO2 is directly proportional to [O2] and flow rate while inversely proportional to MV
  • requires high fresh gas flow
92
Q

Resuscitation Bag

[key difference compared to other systems]

A

contains a non-rebreathing valve

93
Q

Soda Lime

[contents]

A

calcium-, sodium-, and potassium hydroxide

94
Q

Soda Lime

[absorptive capacity]

A

15 - 25 L of CO2 per 100g absorbant

95
Q

Somatosensory Evoked Potentials (SSEPs)

[purpose]

A

evaluates ascending sensory tracts

(primarily dorsal spinal column)

96
Q

Somatosensory Evoked Potentials (SSEPs)

[significant changes]

A

50% amplitude decrease

and

10% latency prolongation

97
Q

Somatosensory Evoked Potentials

[commonly monitored peripheral nerves]

A

ulnar

median

posterior tibial

98
Q

Stroke Volume

(normal range)

A

60 - 90

99
Q

Stroke Volume

[equation]

A

(CO/HR) * 1000

(mL/beat)

100
Q

Systemic Vasular Resistance

[equation]

A

(dynes*sec*cm-5)

  • same as total peripheral resistance
101
Q

Systemic Vasular Resistance

[normal range]

A

900 - 1400

dynes*sec*cm-5

102
Q

Thermodilution

[correlation with change]

A

degree of change is inversely proportional to CO

  • temperature change is minimal during high clow
103
Q

transmural pressure

[equation/definition]

A

atrial pressure - extracardiac pressure

104
Q

Baralyme

[contents]

A

20% barium hydroxide and 80% calcium hydroxide

105
Q

Oxygen Failure Protection Device

A

gradually reduces other gases until oxygen supply is lower than 12 psig

  • Draeger
  • base on proportioning
106
Q

Primary Pressure Regulator

[change in psi]

A

2200 psi from cylinder to 45-50 psi

107
Q

Secondary Regulator

[change in psi of O2 and N2O]

A

lowers O2 to 14 psi

lowers N2O to 26 psi

108
Q

Visual Evoked Potentials

[uses]

A

monitor optic nerve and occipital cortex during resection of large pituitary tumors

109
Q
A

Board Exam (5 decks)

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