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Anesthesia Machine > Final > Flashcards

Final Flashcards

1
Q

Vaporizers are included in this part of the gas distribution system?

A

Low pressure

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2
Q

List the vaporizer functions

A

–Change liquid anesthetic into vapor

–Deliver set dosage

–Deliver consistent concentration of agent vapor into anesthetic gas mixture

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3
Q

A __________ is an instrument designed to change a liquid anesthetic agent into its vapor and add a controlled amount of this vapor to the fresh gas flow

A

Vaporizer

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4
Q

What is the partial pressure of an agent in vapor phase?

A

Vapor pressure

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5
Q

The boiling point of a liquid is what?

A

The temperature at which vapor pressure equals atmospheric pressure

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6
Q

What is the amount of heat (calories) required to convert 1 g of liquid agent to a vapor?

A

Heat of vaporization

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7
Q

The speed at which heat flows through a substance is what?

A

Thermal conductivity

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8
Q

Vapor pressure is dependent on what 2 factors?

A

Temperature and liquid (substance)

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9
Q

True or False: Currently there are no ideal inhalational anesthetics

A

TRUE

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10
Q

For a blood/gas partition coefficient, the higher the number means ________

A

It is more potent because it wants to stay in the blood

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11
Q

For a oil/gas partition coeffecient, the _______ the number means more of the agent wants to stay in the tissue

A

higher

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12
Q

What is isoflurane’s VP, Blood/gas coefficient, and MAC values?

A

238 vp

  1. 36 blood/gas
  2. 15 MAC
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13
Q

What is sevoflurane VP, Blood/gas coefficient, and MAC values?

A

157 vp

  1. 6 blood/gas
  2. 05 MAC
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14
Q

What is desflurane VP, Blood/gas coefficient, and MAC values?

A

669 vp

0.45 blood/gas

6 MAC

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15
Q

Which anesthetic agent is the most potent?

A

Isoflurane

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16
Q

Which anesthetic agent is least potent?

A

Desflurane

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17
Q

T or F: More potent means the agent has slower onset and means slower it comes off

A

TRUE

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18
Q

What are the 2 effects of intermittent back pressure?

A

Pumping effect– increases vaporizer output

Pressuring effect– decreases vaporizer output

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19
Q

What is vaporizer formula?

A

Fa = Qv x Pa / (Pb - Pa) x Qt

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20
Q

What is percent of Isoflurane when fresh gas flow is 2L (Carrier gas flow is 100mL)

A

Pb= 760 Pa=240 Qt=2000 Qv= 100

Fa= 100 x 240 / (760-240) 2000

Fa= 0.023

2.3%

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21
Q

What device on vaporizer ensures that only one vaporizer can be used at a time.

A

vaporizer interlock

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22
Q

What are the 2 main purposes of the vaporizer manifold

A

–Provides places where vaporizers are mounted on the machine

–Provides passageway for fresh gas flow

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23
Q

The first vaporizer was?

A

Ether inhalation–rag soaked in ether and then placed over patients nose and mouth

Done by Dr. Crawford Long in 1842

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24
Q

T or F: Do you have to dilute a copper kettle?

A

TRUE

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25
Q

T or F: All the gas passes through a copper kettle

A

FALSE

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26
Q

Are modern vaporizer’s part of the breathing circuit (in circuit) or are they not part of the actual breathing circuit (out of circuit)

A

Out of circuit

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27
Q

Classification of modern vaporizers.

A
  1. Variable bypass
  2. Flow over
  3. Temperature compensated
  4. Agent specific
  5. Out of circuit
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28
Q

Tec 5 vaporizers can hold approximately how much liquid anesthetic and how often do they need to be recallibrated?

A

~300 ml

Every 3 years

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29
Q

How do Tec 6 vaporizers differ from the rest of the vaporizers?

A

Injection

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30
Q

What is main difference from Tec 5 to the Tec 7 vaporizers?

A

Filling configurations include agent specific funnels or Easy-fil adapters

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31
Q

Which anesthesia machine uses the aladin cassette vaporizers?

A

Aisys

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32
Q

What color is associated with isoflurane?

A

purple

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33
Q

What color is associated with sevoflurane?

A

Yellow

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34
Q

What color is associated with desflurane?

A

Blue

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35
Q

Why is it that the Tidal Volume you set is never what is actually delivered to the patient?

A

The circuit itself holds compliance

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36
Q

What are the circle system components?

A

CO2 Absorbent, Reservoir Bag, Bag/Vent Switch, Ventilator, Pressure Gauge, Gas monitor sensor

airway pressure monitor, CO2 Absorbers, respirometer, Unidirectional Valve

Inspiratory / Expiratory Ports, Breathing Tubes

Y-piece, Fresh Gas inlet, APL Valve

37
Q

What is the function of the CO2 absorbent and what are the main types?

A

Neutralize carbonic acid

Soda lime (primary) and barium hydroxide lime

38
Q

What are 3 CO2 absorbent properties?

A

Granule size (smaller granules have high absorptive surface area)

Hard (prevents dust formation)

Moistness (Dry granules will absorb and degrade volatile anesthetics more)

39
Q

When do you need to change the CO2 absorbent?

A

When you see FiCO2 in the inspired gas

Color change from white to purple

Heat in the cannisters (reaction with CO2 produces heat)

40
Q

T or F: Tube length doesn’t affect dead space because of unidirectional gas flow

A

TRUE

41
Q

On the Y-piece what size connectors lead to the breathing tubes?

A

22 mm

42
Q

On the Y-piece, what size connector leads to the ETT tube?

A

Female 15 mm

43
Q

Name 2 functions of the APL valve

A

Controls pressure in breathing system

Releases gases to scavenging system

44
Q

Explain fresh gas flow when using low flows

A

Require CO2 absorber

Vary O2 & anesthetic concentrations

Prolong induction & recovery

45
Q

Explain fresh gas flow when using high flows

A

> 5 L/min don’t require CO2 absorber

Accelerate induction & recovery

Compensate for circuit leaks

Decrease unanticipated gas mixture risk

46
Q

Resistance is increased in the circuit by what?

A

Unidirectional valves

CO2 absorber

Coaxial tubings

47
Q

No matter how long the circuit is, the dead space remains the same as long as you have __________ flow

A

unidirectional

48
Q

T or F: When flow becomes bidirectional, then dead space will increase

A

TRUE

49
Q

What gases is in the reservoir bag?

A

Expired gas including CO2 because hasn’t been scrubbed yet by CO2 absorber

50
Q

When does CO2 get absorbed?

A

Just before inhalation, just prior to mixture with fresh gas flow

51
Q

Define scavenging

A

Collection of excess gases from equipment used to administer anesthesia or exhaled by the patient & the removal of these gases to an appropriate place of discharge outside the work environment

52
Q

What are the parts of the scavenging system?

A
  • Gas-collecting assembly (collects excess gases)
  • Transfer tubing (carries collected gas to interface)
  • Interface (Provides positive and negative pressure relief)
  • Gas-disposal tubing (carries gas from interface to disposal system)
  • Gas-disposal system (discharges gases)
53
Q

The gas collecting assembly uses what size outlet connection?

A

30 mm

54
Q

Transfer tubing uses what size connection fittings?

A

19 mm inlet

30 mm outlet

55
Q

What is the main function of the interface?

A

Prevents pressure increases/decreases in scavenging system from being transmitted to breathing system or ventilator

56
Q

Features of an open interface

A

Has 1 or more openings to the atmosphere

Contains no valves

Used only with active disposal

Reservoir needed to hold gas surges

57
Q

What is the design of an open interface scavenging system?

A
  • Parallel tubes inside canister (1 carries waste gases to bottom of canister, 1 carries gases from bottom to disposal system)
  • Open ports at top of canister provide positive and negative pressure relief
  • Flow control valve regulates scavenging flow
58
Q

What are the features of the closed interface system?

A

Connects to atmosphere through valves

Positive pressure valve required

Negative pressure valve required only if active scavenging

Reservoir not required

59
Q

T or F: Passive disposal systems have piping directly to the atmosphere

A

TRUE

60
Q

What is the gas that cannot be absorbed by passive disposal systems?

A

N2O (nitrous oxide)

61
Q

An open interface should only be used with what type of gas disposal?

A

Active

62
Q

What is always required with a closed interface?

A

Positive pressure relief valve

63
Q

What gas can not be absorbed?

A

Nitrous

64
Q

What is always required with an active duct system?

A

Negative pressure relief valve

Positive pressure relief valve

65
Q

What colors are associated with scavenging?

A

Purple and yellow

66
Q

Which CO2 cannister will you change out first, the top or the bottom?

A

TOP

67
Q

Why do you change out top cannister first?

A

Because flow starts are top and distributes down

68
Q

What is the fresh gas inlet?

A

Where fresh gases with/without anesthetics enter the breathing circuit

69
Q

Name some functions of the reservoir bag?

A

Allows gas to accumulate during exhalation

Provides method for generating positive-pressure vent

Provides way to monitor spontaneous respiration

Protects pt from excessive pressure in breathing system

70
Q

What is the gas called that pushes the bellows down during __________?

A

Drive gas

Inspiration

71
Q

What is the primary gas that pushes the bellows up during __________?

A

Patients expiratory breath

Expiration

72
Q

What does the repirometer measure?

A

Ventilatory volumes

73
Q

What are the circle system design objectives?

A

Maximize inclusion of fresh gas

Maximize venting of alveolar gases

Minimize absorbent dessication

Minimize absorbent consumption

Provide accurate repirometer readings

74
Q

List the order of the circuit system from patient expiration to when the gas gets the inspiratory limb (spontaneous breathing)

A

Pt lungs, Y-piece, Expiratory limb, expiratroy check valve, reservoir bag until full, excess flows out APL valve

AT START OF INSPIRATION

Reservoir bag, CO2 canister, fresh gas inlet, inhalation check valve, inspiratory limb, Y piece, Pt lung

75
Q

List the order of the circuit system from fresh gas inlet to fresh gas inlet when on mechanical ventilation

A

Fresh gas inlet, inhalation check valve, Inspiratory limb, Y-piece, pt

During expiration

Y-piece, expiratory limb, exhalation check valve, Ventilator (bellows), CO2 canister, Fresh gas inlet

76
Q

What is the difference in the drager circle system and datex circle system?

A

Drager has piston ventilation, so patients expiration does not push bellows up during mechanical ventilation. FRESH GAS FLOW FILLS THE PISTON IN DRAGER

77
Q

Name the advantages of the circle system

A

Economy

Reduced OR pollution / reduced environmental pollution

Good estimation of anesthetic agent uptake / O2 consumption

Heat and humidity conservation

Reduced barotrauma risk

78
Q

What are the disadvantages to the circle system?

A

Larger overall circuit size / increased complexity

Less portable

Increased resistance

Canot predict inspired gas concentrations with low FGF

Faster absorbent exhaustion

Hypercarcbia risk

79
Q

What are the main locations for gas collecting assemblies?

A

Breathing systems

Ventilators

Respirtory gas monitor

Leak sites

80
Q

What organization is responsible for the standards associated with scavenging?

A

ASTM

American society of testing and materials

81
Q

Open interface can only be used with what type of disposal?

A

Active disposal

82
Q

All of the following are true about closed interface except:

A) Positive pressure relief valve always required

B) Negative pressure required only with active disposal

C) Reservoir not required

D) All are true

A

D) all are true

83
Q

With a passive disposal system, what type of interface should be used?

A

A closed interface with only positive pressure relief

84
Q

T or F : With passive disposal system, the negative pressure relief valve is always closed

A

TRUE

85
Q

What are the advantages of passive disposal ?

A

Simpler

Less expensive

86
Q

What are some disadvantages to passive disposal?

A

Not as effective in lower trace gas levels because positive pressure promotes outward leaks

87
Q

What are some advantages to active disposal?

A

More effective at keeping pollution levels low

Allows small bore tubing

No excessive resistance

Aid in room air exchange

88
Q

What are some disadvantages to active disposal?

A

Expensive

Not automatic

More complex

Requires interface to have negative pressure relief

89
Q

What is the size of the waste gas reservoir bag?

A

3 L

Anesthesia Machine (5 decks)

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