Instrumentation Flashcards
All information that was taught to me while attending Vanier College's "Animal Health Technology" Program, located in St-Laurent Montreal.
What is a stethoscope
An acoustical diagnostic instrument especially useful in the evaluation of heart and pulmonary sounds
What are the stethoscope ear tips made out of
Plastic, rubber, soft or hard. Many types and sizes available
What should ear tips do
Be cleanable, replaceable and comfortable. Seal the outer ear canal without entering the canal
In which direction should ear tips curve
Forwards
Describe the ear tube or binaural headpiece
Distributes the sound to each ear, should hold ear tips at a comfortable distance apart. Tension should be adjustable to accommodate a variety of head sizes
Describe the stethoscope tubing
Tubing should be flexible, smooth and thick walled to decreased ambient noise and improve sound transmission.
What is the variety of lengths that stethoscope tubing comes in
14-18 and 25-30
What are the two sound transmitted devices in the chest piece of a stethoscope
The diaphragm and the bell
Describe the role of a diaphragm in the chest piece of a stethoscope
Detects mainly high-frequency sounds and attenuates low-frequency sounds when diaphragm is applied firmly to the skin of the thoracic cage. Breath sounds, normal heart sounds, and some murmurs.
Describe the role of the bell in the chest piece of the stethoscope
Detects mainly low-frequency sounds, diastolic heart murmurs and bowel sounds. Apply lightly to skin if you press with too much pressure the underlying skin acts as a diaphragm that can mask low-frequency sounds
Describe the relationship between capacity of the Bell and diaphragm to register sounds and diameter
Larger equals better. Size dictated by practical means and patient size.
What are the two different arrangements that the bell and diaphragm can have
Two separate pieces, with one on either side of the chest-piece Combined into a single sided chest-piece
Describe how to use a one sided chest piece to pick up low and high frequency sounds
For the one sided chest piece a light pressure on the chest piece against the thoracic wall gives the effect of a bell and a firmer pressure converts it to a diaphragm
How many heart sounds do hear when you listen to a normal heartbeat
2 heart sounds
What is S one
Onset of ventricular Systole. Mitral and tricuspid valve’s close
What is S 2
Termination of ventricular systole. Aortic and pulmonary valves close
What is S3
Early diastole. Rapid ventricular filling
What is S4
Just after atrial contraction and just before ventricular systole. Large amount of blood entering quickly
What can you hear on the left side of the heart
Mitral valve, aortic valve, pulmonary valve
What can you hear on the right side of the heart
Tricuspid valve
How do you maintain the stethoscope
Can use soapy water or alcohol to wipe down surfaces. No steam sterilization. Ear tips can be removed for cleaning. Diaphragm can be removed to clean the chest piece
What possible reason we have for not hearing anything through the stethoscope
It’s been turned to the other side, not in the right area, obstruction of ear tip
What does the refractometer do
Measures protein concentration in a liquid, measures fluid specific gravity
How does the refractometer work
By refraction: bending of light rays as they pass from a medium into another with a different optical density
What fluid types can you measure protein concentration from in the refractometer
Plasma, body fluids, cerebrospinal fluid, liquids accumulating in body cavities
What is the unit for protein concentration
In grams per 100 mL
What is the specific gravity based off of
Weight of a substance compared to water.
What are exudate
Fluids containing a high amount of protein and cellular debris escaped from blood vessels. Usually a result of inflammation
What are transUdates
Fluids escaped from tissues or blood vessels. Contain small amount of proteins or solids
What is the built-in prisim used for in the refractometer
Deviation and dispersion of light
What is special about the scale of the refractometer
It needs to be calibrated and tested. Measures specific gravity of urine and protein concentration in grams per 100 mL
What are the four components of the refractometer
Eyepiece, cover plate, prism, calibration screw
Describe the AO TS refractometer
Plasma protein and urine specific gravity. Measures refractive index, protein concentration of plasma, urine specific gravity.
What does a uricon refractometer measure
Urine specific gravity, refractive index scale
What does the Leica vet 360 refractometer measure
Urine specific gravity for dogs and cats as well as serum or plasma protein in grams per 100 mL
How do you use the refractometer
Please drop of sample on prison plus gently close cover plate. Look at scale through eyepiece. Read result.
How do you clean the refractometer
Wipe clean with tissue paper and distilled water
Why do you avoid any gritty material on the prism
So that it doesn’t scratch the lens
How often should you calibrate the refractometer
Weekly
With what fluid should you calibrate the refractometer
Distilled water. Scale should read zero
How do you calibrate the refractometer
With the adjusting screw.
Can you immerse the refractometer and water
No
What do we do blood testing for
Complete blood, biochemistry, coagulation profile, immunology testing, blood bank testing, DNA testing
When you do a biochem what are the components
Protein, glucose, lipids, electrolytes, enzymes, hormones
What is plasma and what is it used for
Plasma is obtained after centrifugation of blood with a tube containing an anticoagulant such as EDTA, sodium site trait, heparin. Can be used for biochemistry analysis and total protein
What are EDTA tubes used for
Plasma collection after centrifugation. Hematocrit determination by microhematocrit Capillary tube and a blood smear
What is serum and what is it used for
Obtained after centrifugation of blood that has been allowed to coagulate. The clot composition is red blood cells white blood cells platelets fibrin and coagulation factors. Serum is used for blood biochemistry, red top tubes, tiger top tubes
What are the uses of the centrifuge
To separate cells and particulates from liquid part by centrifugal force
What is the supernatant
The lighter part of the fluid
What is the sediment
To heavier part of the fluid
What is the G Force
Acceleration to be applied to a sample
If we use the same rpm but different centrifuge with a bigger radius what happens to the G force applied to the sample
It is bigger. Take-home message is that the bigger the radius the bigger the G Force
What happens if you centrifuge something for too fast or too long
Cells can rupture or morphology is altered
What happens if you centrifuge something for too slow and too short of a time
Incomplete separation of the elements
What are the different types of centrifuges based on design
Swinging bucket, fixed angle centrifuge, horizontal micro hematocrit
What are the different types of centrifuges based on speed
Benchtop, micro centrifuge, high-speed, ultra centrifuges (for research)
What is a swinging bucket centrifuge used for
For urine or blood samples.
What are the hanging specimen cups called in the centrifuge
Trunnions
What are the disadvantages of the swinging bucket centrifuge
Remixing of sediment or supernatant, at a very high speed there is heat buildup
What is a fixed angle centrifuge used for
Higher speeds and horizontal centrifuge without the heat buildup. For rapid sedimentation of small particles
What is the microhematocrit centrifuge used for
Used to separate blood from plasma using a very small sample. Separates packed cell volume, Buffy coat, plasma (containing clotting factor)
What is the timer used for on the centrifuge
Sets required time for spinning samples. Automatically turn centrifuge off after preset time
What is the tachometer
Dial setting the speed. Absent in some centrifuges run at preset speeds
How do you care and maintain the centrifuge
Should always be used on a level surface. Always balance samples in the centrifuge. Close lids. Clean spills immediately. Clean with mild detergents. Maintenance schedule as per manufacture
What are the safety musts with a centrifuge
Check power supply and cord, only operate with closed cover
What is special about the Triax centrifuge
Blood, urine, microhematocrit, break
What do you have to do to the triac when you want to run a microhematocrit tube test
Take out the trunnions. Position micro capillary hematocrit to correctly with the clay towards the outside. Use metal lid cover
What are some reasons that the Triax centrifuge will not work correctly
Poor balancing, instrument not level, forgot cover, wrong setting for time or speed, placed micro capillary hematocrit tube clay the wrong way
What are calibration and quality control needed for
Together ensure the accuracy of results. Complement each other and both are necessary
Define calibration
Establishes an initial point of measurement or data point. Think of scale that is zeroed. Think of refractometer who specific gravity is adjusted with the screw to read 0 when distilled water is used
Why is quality control necessary
It checks that the calibration is correct. This is the exam for the equipment.
How can you test a scale to make sure this reliably weighing your patient
Use a standard to verify, weight or concentration
What do calibration and quality control together determine
The accuracy of the method. Accuracy and precision equals reliability
What can you say if you analyze a sample And get the correct result
The instrument does demonstrates good accuracy
What can you say about an instrument if you repeat the same analysis on the same sample a few times and get results with little variation
It has good precision
When does something have good accuracy and good precision
Correct results and acceptable variation. The only good option
When can something have poor accuracy And good precision
Incorrect results but An acceptable degree of variation
When can something have good accuracy but poor precision
Correct results but unacceptable degree of variation
When does something have poor accuracy and poor precision
Incorrect results with unacceptable degree of variation
What are errors in scale measurements due to
Displacing, tare, surface, location on scale, care and maintenance
What is an otoscope used for
Observation of ear structures
What are the components of the otoscope
Handle, head, bulb, speculum
What is the ophthalmoscope used for
Observation of eye structures. Dilation of pupils.
What are the components of the ophthalmoscope
Handle, head, bulb
What is the woods lamp used for
Dermatological conditions, ocular conditions, ethylene glycol poisoning in humans
What are the two types of tattoo devices for small animals
Clamp or tattoo gun
What do microchips do
They use RFID technology it goes under the skin in dogs and cats. Intramuscular in avians. Ear tags in farm animals.
Describe the schiotz tonometer for measuring intraocular pressure
Use weight and gravity. Must be used vertically. Requires local anesthetic
Describe the tonopen
Weight measured to produce a specific amount of flattening the cornea. Can be used in any position. Requires local anesthetic. much less contact surface then Schiotz.
What can the laser cyte hematology analyzer do
Check red blood cells, Reticulocytes, white blood cells, platelet count
What species can lasercyte hematology analyzer analyze samples from
Cat dog equine
Which white blood cells are granulocytes
All the Phils
Which white blood cells are agranulocyte’s
All the cytes
How does the lasercyte hematology analyzer work
Each cell goes through a laser beam. Light is scattered by the cell and measured by four detectors based on size, complexity, granularity, light absorption. The time of flight through the laser beam is also recorded
What are the main components of the lasersight hematology analyzer
Reagent compartment containing sheath reagent bottle and waste bottle. Air filter, status light, loading tray
In the CBC5R kit which tubes are contained
Purple top tubes, gray top tube, red top tubes, yellow top tubes
What is inside the purple top tube
EDTA
What’s inside the grey top tube
Quality beads, and new methylene blue stain to stain reticulocytes.
What is inside the red top tube
Discard tube
What is inside the yellow top tube
Automated enzymatic cleaner
What does the sheath reagent do
Lyses red blood cells to isolate the white blood cells for analysis
Go through the steps of analyzing a sample with the lasercyte
Collect a sample, Fill purple top that collect tubes with 0.5 to 1.5 mL. Invert eight times before collecting and running. Put sample and gray top tube in the analyzer. Enter patient info and run it.
What are the different ways you can verify results from the laser sight analyzer
Dot Plot, blood smear
How do you calibrate the laser sight analyzer
It’s done at the factory
How is quality control run on the lasersight analyzer
Quality beads in reagent tubes and two different hemoglobin readings are done
How does maintenance on the lasersight analyzer work
It’s automated. After every sample, every four hours, and every 24 hours it flushes and rinses. After every 20 samples the extensive enzymatic clean happens. Weekly the air filter must be cleaned, the system is rebooted and backed up, sheath reagent amount is checked, waste bottle is emptied
What does the catalyst DX analyzer do
Chemistry analysis, electrolytes, UPC fructosamine phenobarbital.
How does the catalyst DX analyzer work
By chemical reaction
What are the main components of the catalyst DX analyzer
Touchscreen interface, sample drawer, waste drawer, maintenance access doors, tip and diluent drawer
What are the pre-loaded clips you can put into the catalyst DX on a laser
Chem: 17 for canine, chem: 15 feline, Chem: 10 Preanesthetic, Lyte 4: electrolytes
What are some other main components of the catalyst DX analyzer
lithium Heprin whole blood separator, pipettes, sample cups
How do you prepare a whole blood sample for the catalyst DX analyzer
.7 mL in lithium heparin separator. Swirl five times
How do you prepare a plasma sample for the catalyst DX analyzer
Whole blood in lithium heparin tube, mix, centrifuge. 300 µL in sample cup with no bubbles
How do you prepare a serum sample for the catalyst DX analyzer
Dry or SST tube, allowed to Claude, centrifuge, 300 µL in sample cup with no bubbles
How do you prepare a urine sample for the catalyst DX analyzer
Centrifuge, 300 µL of supernatant in sample cup
How do you analyze the sample in the catalyst DX analyzer
Select patient data, load sample, load clip or slides with the Lyte 4 first, run, view results on catalyst or vet lab machine.
How do you maintain the catalyst DX analyzer
Empty the waste drawer, clean the internal components
How do you clean the internal components of the catalyst DX analyzer
Do it monthly and before quality control, lint free wipes with 70% alcohol
When do you do the quality control
Monthly,after the analyzer has been movedto verify system performance
How do you do a quality control sample
Client equals QC, patient equals lot number of QC clip, sample equals 300 µL vettrol solution, load QC clip and lyte 4 clip, compare results to pass fail values on QC log
What does the vet lab station do
Integrates results into a single report, organizes results, reduces manual data entry, integrates with clinics computer system
Why do we use an endotracheal tube
Protecting in maintaining a patient airway helps minimize anesthetic risk
What are the different types of material that endotracheal tubes are made out of
Red rubber, PVC, silicone
What are some different types of endotracheal tubes
Murphy, McGill, Cole
What is the purpose of endotracheal tube
Deliver anesthetic gas from breathing circuit to trachea and into patient’s lungs. To keep an open airway when in a critical condition
Describe the patient and of a endotracheal tube
The slanted end of tube that’s passed through the mouth and into the trachea
Describe the machine or circuit end of the tube
That end up or truths from the mouth and connects to the breathing circuit
Describe some general qualities of red rubber endotracheal tubes
Common, flexible, may collapse, difficult to detect occlusions due too solid colors, may absorb disinfectant solutions, short longevity.
Give some general characteristics of PVC tubes
Transparent, stiffer, higher risk of tissue trauma, less porous, has a radio opaque line
Describe some general qualities of silicone rubber tube
Expensive, strong and pliable, less irritating, resistant to cleaning
What are two special types of endotracheal tubes
Metal coiled tubes, fire resistant metal tubes
What is a stylet
Guides and facilitates insertion of small or flexible endotracheal tubes into the trachea
Describe the difference between the Murphy and McGill endotracheal tube
The Murphy has an eye
Describe the cole endotracheal tube
Short, uncuffed, for very small patients
Describe the sizing of tubes
French scale system. Pick three sizes of tube, one that will fit perfectly one that is one size larger, one that is one size smaller
How do you select the correct size of tube
Through gentle palpation of trachea, widest tube that will fit comfortably past larynx and into trachea without excessive force
What happens if you have increased mechanical dead space
You have decreased ventilation
How do you tell the length of an ET tube
Tip of nose to the thoracic inlet
What happens if the endotracheal tube goes beyond the thoracic Inlet
Risk of ventilation of only one lung.
What are the advantages of using cuffed endotracheal tubes
Decreased risk of aspiration, prevents leak of waste gas, prevents inspiration of room air
What are the disadvantages of cuffed tubes
Damage to trick your wall, compression of endotracheal tube lumen
Why is it important to attach the endotracheal tube properly to the patient
To prevent movement of the tube which can cause trauma to the trachea
How do you check the cuff prior to intubation
Fill it up with air and leave it for five minutes
What are some important points to remember about endotracheal tubes
Endotracheal tubes should be lubricated to avoid trauma to the trachea, never move or turn the patient while the endotracheal tube is connected to anesthesia machine, do not over inflate a cuff, deflate the cuff before extubating
How do you clean endotracheal tubes
So can mild soap detergent, scrub insides with a brush, and fleet cough slightly to clean fold, rinse well, air dry
How do you disinfect endotracheal tubes
Chlorhexidine, Excel, glutaraldehyde which is unstable
Which tubes can you autoclave
Silicone tube
Describe some general characteristics of endotracheal tubes
Allows control of airway, oxygen and inhalant delivered closer to lungs, lower oxygen flow required, allows for positive pressure ventilation if apnea, decreases anatomical dead space, prevent aspiration
Describe some general characteristics of facemasks
Relies on patient to maintain respiratory rate, uptake of oxygen and inhalant depends on patient respiration, higher oxygen flow required, cannot assist with ventilation
What is a laryngoscope used for
Increases visibility of pharynx larynx and the tracheal opening.
What are the five components of the laryngoscope
Handle, Blade, slip groove, light source, light pipe
What is a Macintosh blade
A curved laryngoscope Blade
What is a miller blade
A Straight laryngoscope Blade
How do you maintain and clean laryngoscope’s
Gently scrub blade in soapy H2O, Renton clean top water. Disinfect handle with alcohol.
What do you check if the unit fails to light or flickers
Check the lamp, batteries, replace parts
What are hair clippers used for
Used for hair removal. Surgical prep, around wounds, aesthetic procedures. Either electric or battery operated. Interchangeable blades.
How do you shave an open wound with the clipper
Put lube in the wound and shave around it
How do you hold the razor
With a pencil grip.
How do you know how much to shave for surgical prep
Minimum 10 cm in all directions from planned incision
How do you care in maintaining the clipper
Apply lubricating oil to blades and brush off organic material
What does the electrosurgery unit get used for
Uses high-frequency electric current to cut or coagulate tissue in a controlled manner
Describe the components of an electro surgery unit
Electrode, electrosurgical unit, ground plate, footpad
What happens when the footpedal of the electrosurgery unit is pressed
Current runs through the active electrode then runs through the tissue being incised through the patient into the ground plate. The ground plate brings the current from the patient back to the generator. A complete circuit is needed for the current to flow
Describe the active electrode in the electrosurgery unit
In contact with a very small area of the patient. High current density at that point. Maximizes the effects on the tissue.
Describe the ground electrode in the electrosurgery unit
In contact with a large area of patient. Low current density. Minimizes damage to tissues which are not in surgical site
What are some safety concerns with the electrosurgery unit
Risk of Burns to patient, current leakage
What are the advantages of the electrosurgery unit
Reduced blood loss, reduced foreign material, ease of hemostasis, reduced surgical time, small cutting element
What are some disadvantages of the electrosurgery unit
Greater tissue damage, reduced resistance to infection, can burn patient, fire and explosion hazard
How do you care and maintain the electrosurgery unit
White electrodes with alcohol moistened gauze pad while operating, sterilize electrodes. Clean the unit with mild soap or water
Why is proper surgical instrument care important
Patient safety, longevity of instruments
What can spotting, staining and corrosion do
Impaired function of surgical instruments, interfere with sterilization, shortening instrument life
How does spotting staining and corrosion impair function of surgical instruments
Rust in box lock area impair opening of instruments. Rusted scissor blades become doll
How can spotting staining and corrosion interfere with sterilization
Spores are protected from distruction by layers of iron oxide
Describe characteristics of spots on surgical instruments
Loose or semi adherent deposits on instruments surface. Usually wiped off with a cloth with minimal friction. Don’t physically or chemically effect instruments if they are removed
What can cause spots on surgical instruments
Mineral water deposits, chemical residues, steam residue, poor soil removal
Give some general characteristics of stains on surgical instruments
Tightly adhered deposits on instrument surface, can be an integral part of the surface, don’t physically or chemically effect instruments if they removed
What can cause stains on surgical instruments
Replating of metals, impure steam
What are surgical residues and what do they cause
Blood, tissue, pus. Contain chloride ions that cause corrosion. Primary cause of pitting, staining and discoloration of surgical instruments
How do you resolve surgical residues
Clean and dry instruments immediately after surgery, open hinged instruments
What can cause corrosion
Tapwater, harsh cleaners, residual detergent on surgery drapes
How can you test for rust
Taking an eraser and if there’s a pit mark under the stain then it is rust
What does an orange brown stain usually mean
Phosphate deposit. Caused by autoclave water, dirty autoclave, bleach, surgical wrappings
What does a dark brown stain mean
Caused by dry blood missed at cleaning stage, acidic solutions
What is a bluish black stains caused by
Plating which is contact between dissimilar metals
What is a multicolor or rainbow color caused by
Excessive heat during autoclaving
What are the steps for basic cleaning
Presoaking, manual cleaning, ultrasonic cleaning, inspection and repair, lubrication
What is Sterility
State of being free of viable micro organisms
What is sterilization
Process of killing micro organisms that remain on a clean instrument
What are four important conditions for the autoclave
Adequate contact between steam and micro organisms, sufficient moisture, exposure to temperatures lethal to heat resistant micro organisms, adequate time
What are four important parameters for ethylene oxide gas sterilization
Concentration of gas, exposure time, temperature, relative humidity
Is there any difference in the specific gravity of urine pre-versus post centrifugation
No because it measures the dissolved solute not the supersaturated particles
Do you use fresh or centrifuge sample of urine on the Chemstrip
Fresh
What does the laser cyte machine measure
Total number of red blood cells, hematocrit value, hemoglobin, erythrocyte
How does the laser cyte machine works
Using a laser it shines to the cells and registers size absorption granularity
What type of changes in blood can interfere with the analysis from the catalyst DX analyzer
Hemo lysis, coagulation of blood, agglutination
State three causes of hemolysis
Shake too hard, stressed Cat or dog, the needle is too small
Can you run a Chem 15 test while there is a phenobarbital test in progress
No
Name 5 objects used in the analyzer
PipetteClipsSample cupLithium heparin whole blood separator Pipette tips
In what type of tube should you collect your blood sample if you want to use plasma for your analysis and how much do you need
300 µL and a lithium heparin top
Which clip is always placed first in the catalyst dx analyze
Lyte 4 clip
Which components of the catalyst DX idolizer should be filled and emptied regularly
The diluent drawer is filled and the waste drawer is emptied
What are the two types of woods lamp
White light and black light
What is the order of lamp removal when bulbs need to be replaced in the Woods lamp
The Inner lamp first and then the second lamp
What is the order of lamp installation when a bulb is being replaced in the woods lamp
Install the two ultraviolet lamp first
Which microchip type is accepted at the international level and in Canada
RFID/ISO
What are the correct steps to clean disinfect and sterilize surgical instruments
Rinse in pH neutral water, immerse in soapy water, brush, ultrasonic for 10 minutes, rinse in tapwater, distilled bath, dry
What are the three functions of the instrument milk
Lubricant, rusted inhibitor, anti microbial
What do exposure tape indicators show
You’ve been exposed to gas
What do you do dosimeter tape indicators show
Have you been exposed to correct concentration, correct time, correct temperature
How frequently should you use a biological test indicator
Once a week
What are the two types of anesthetic systems
Bain and circle
List some components of the anesthetic machine
Compressed carrier gas supply, oxygen flow meter and anesthetic vaporizer, breathing circuit, scavenging system
Describe the oxygen flow meter and anaesthetic vaporizer
Flowmeter allows oxygen carrier gas to flow at a rate of liters per minute. The oxygen gas picks up gas and anesthetic from the vaporizer.
Describe the breathing circuit
Conveys carrier gases and inhalant anesthetic to the patient and removes exhaled carbon dioxide.
What are the two types of breathing circuits
Re-breathing circuits a non-rebreathing circuits
Describe the gas scavenging system
Disposes of excess and waste anesthetic gases
What are the two types of anesthetic vaporizers
Percision and non Percision vaporizers
How much oxygen does a healthy conscious animal receive in the air
21%
How much oxygen does an animal received in the anesthetic system
Up to 100%
Why is the oxygen percentage so high in the anesthetic system
Due to the fact that anesthetized patients have a decrease respiratory rate and tidal volume which causes a risk of hypoxia with normal air.
Describe the compressed gas cylinders
Contain a large volume of courier gases in the highly pressurized compressed state.
What are the two types of compressed gas cylinders
The E cylinder and the K cylinder
Describe the E cylinder
Small and directly attached to a machine by the yoke
Describe the K cylinder
Large and freestanding. Connected to the machine via the gas line
What is the function of the anesthetic machine
To deliver oxygen and volatile anesthetic gas to and from patient and to deliver oxygen gas to critical patients. The carrier gas oxygen transport vaporized anesthetic gas to patient at a controlled flow rate.
What happens if a cylinder is dropped
It will cause it to fly at a high velocity in the opposite direction of released gas.
How do you calculate the liters of oxygen by the psi for the E cylinder
Times by .3
How do you calculate the liters of oxygen by the psi
Times by 3.1
When should oxygen tanks be changed
When pressure drops below 100 or 200 psi
When should Oxymed be called
When pressure drops below 500
Describe the pressure reducing valve
Reduces the pressure of the gas to a constant and safe operating pressure of 40 to 50 psi
What is the flowmeter
Dial attached to a graduated glass cylinder and a moving indicator that indicates gas flow rate in liters per minute
How do you read the ball indicator in the flowmeter
At the center of the ball
How do you read the rotor indicator in a flowmeter
At the top of the rotor
What happens if the flowmeters opened
Allows oxygen gas to flow through the machine if the dial is open and sets the gas flow in liters per minute
What does the flowmeter reduce oxygen pressure to
15 psi
What is the oxygen flush valve used for
Used to rapidly deliver a large volume of pure oxygen gas. Delivers oxygen gas directly into the circuit on bypasses oxygen flow meter and anesthetic vaporizer
What is the uses for the oxygen flush valve
Rapidly delivers oxygen to critically ill patient. Rapidly fills depleted reservoir bag. Dilutes anesthetic gas remaining in the circuit
What is the vaporizer used for
Convert liquid anesthetic to vapor anesthetic
How do you know when to refill the vaporizer
If over half of the anesthetic has evaporated
What is a Percision vaporizer
Delivers exact concentrations of anesthetic.
What are some components to the circle rebreathing system
Fresh gas inlet, Unidirectional valve, pop off valve, reservoir bag, carbon dioxide absorber, pressure manometer, breathing tubes
What is the fresh gas inlet
The point at which the carrier gas on the anesthetic gas enter the system
How is the fresh gas inlet connected to the circle system
By the vaporizer outlet port
What is a Uni directional valve
Located inside a clear housing that allows the anesthetist to observe the action of the valves. Can be used to monitor respiratory rate
What happens when a patient enhales in the Uni directional valve
Inspiratory Uni directional valve will open to allow passage of fresh gas to the patient
What happens to the Uni directional valve when the patient exhales
Carbon dioxide and anesthetic gas is released from the bloodstream and exhaled.
What is the use of the pop off valve
Allows excess gas to exit the system and enter the scavenger. Prevents build up of excessive pressure within the circuit
What position should the pop off valve always been when connected to the animal
Open
Describe the reservoir bag
Rubber bag that gradually inflates as gases enter the circuit or patient exhales. Deflates one patient inhales.
What are some uses of the reservoir bag
Flexible storage reservoir. Respiratory monitoring tool. Aids in confirming proper ET tube placement, allows delivery of oxygen and anesthetic gases to patient
Why is bagging beneficial
Helps reinflate collapsed alveoli. can normalize respiratory rate
How do you calculate which of reservoir bag you need
Minimum of 60 mL per kilogram
What happens if your reservoir bag is too small
Reservoir may not be large enough for patient to breathe easily. May over inflate during expiration increasing the pressure in the patient’s airways
What is the optimum size for reservoir bug
Three quarters full at peak inspiration
What is the use of the carbon dioxide absorber
Absorb carbon dioxide
How do you know when you need to change the carbon dioxide absorbing soda lime
The pH indicator causes granules to change color when saturated
After how many hours of use is it recommended to change soda lime granules
14 to 18 hours of use
What is the function of the pressure manometer
Indicates the pressure of gases within the breathing system
What is the negative pressure relief valve used for
Admits room air into the breathing circuit if negative pressure is detected
What are the breathing tubes used for
Carries anesthetic gas to and from the patient
What are the three types of breathing systems
Total rebreathing (closed)Partial rebreathing (semi closed)Non rebreathing
Describe the total rebreathing system
Closed Pop off valveAll gasses are recirculated Slow turnover of gasesOnly for animals over 7-10kg
What are three concerns with total rebreathing
Co2 accumulationDifficult to exhaleO2 depletion
Describe a semi closed system
Pop off left open All exhale gases escape to scavenger, requires high oxygen flow rate. For animals less than 10kg
Describe the brain system
Tubing allows incoming gases to be warmed by the surrounding exhaled gases. Lighter and less cumbersome system. No CO2 canister
Describe the induction flowrate
High oxygen flow rate to saturate circuit with carrier gas and static
Describe maintence flowrate
Oxygen flow rate reduced
Describe the recovery flow rate
Hi oxygen flow rate
What is the unit for waste anesthetic gas concentration
Ppm
What are the two categories of health hazards induced by long-term effects of anesthetic gas
Short-term problems and long-term problems
What are some short-term problems of anesthetic gas
Fatigue, headache, drowsiness, depression, irritability
What are some long-term effects of anesthetic gas
Reproductive disorders, liver and kidney damage, bone marrow abnormalities
What is the list of gas toxicity in order
IsofluraneSevofluraneHalotaneMethoxyflurane
What are two types of scavenging systems
Active system Passive system
What does the active system do
Suction created by vacuum pump draws gas in the scavenger
Describe passive systems
Positive pressure of gas in the machine pushes gas in the scavenger
What is a risk in active and passive scavenging systems
Obstruction
What are the two types of leak test
High pressure leak test at 50 psi low pressure leak test at 15 psi
Why do you do a high pressure leak test
To check for leaks between gas tanks and flowmeters
Why do you do low-pressure leak test
To test for leaks from anesthetic machine to breathing circuit
How do you do a high-pressure system leak test
Turn the tank on. Note tank pressure reading. Turn tank off. Recheck tank pressure gauge one hour later
Describe doing a low-pressure system leak test
Close pop off valve and occlude patient port. Set flowmeter to 2 L per minute. Turn off flowmeter when bag fully inflated
When is a high pressure leak test done
Every week
When is a low pressure leak test done
Every time machine is assembled for you
What are seven ways to minimize gas release
Minimize use of anesthetic chambers. Avoid using masks to induce or maintain anesthesia.Used cuffed eT tubes for adequate size when possible. Ensure reservoir bag is synchronized with patients respiration. Avoid turning vaporizer and flowmeter on until machine is connected to ET tube.Do not release contents of reservoir bike into room area. Leave patient attached until extubation to allow expired gasses to enter the scavenging system
What are the hazards of ionizing radiation
Harmful to immature and rapidly dividing cells
What is a millisievert
Unit for measuring amounts of low-level radiation received
What is the acceptable exposure limit of radiation per year
50 mSv’s per year
What is the exposure limit for five years of radiation
100 mSv
What is the limit of radiation for a declared pregnant worker
4 millisievert’s
Which patients are at risk for x-rays
Breeding animal
What are three sources of exposure to radiation for personnel
Primary beam, scatter radiation, x-ray tube hosting
Do lead gloves protect from the primary beam
No just from scatter radiation
How do you expose large animals to the primary beam
Use a cassette holder instead of holding the cassette with your hands
What is scatter radiation
It is produced when x-rays from the primary beam change direction after colliding with objects in their path. Large portion travels in an upward path towards chest and head of restrainer.
What is a personal radiation monitoring device called
Dosimeter
What does a dosimeter do
Registers amount of radiation received
What are the two dosimeter types
Film badge dosimeter, thermoluminescent dosimeter
How often is the dosimeter sent to the lab for analysis
Every three months or every two weeks during pregnancy
How do you shield yourself from radiation
Using protective apparel, a portable lead wall, collimation.
What are four examples of protective apparel for radiation
Aprons, thyroid shield, gloves, lead-based glasses
How do you clean lead apparel
With a soapy water and a soft brush
What is a portable led wall used for
Preventing radiation.
What does an aluminum filter do
Absorbs soft x-rays
What does collimation do
Reduces exposure to primary beam and scatter radiation
What is fluoroscopy
Special imaging modality that uses x-rays to produce a real time moving image. Used for evaluation of dynamic processes and to facilitate surgical treatment
What is digital radiography
Uses digital sensors instead of traditional film
What are the two types of digital radiography
Computer radiographyDigital radiography
What is computer radiography
Image receptor screen is phosphor crystals that become energized during exposition. Latent image is read by a laser and sent to the computer
What is digital radiography
The image sent directly to the computer
What are the advantages to digital radiography
Reduced need for retakes, time efficiency, easier storage, can be sent to specialists
What is a cat scan
X-ray generating tube that makes a continuous circular movement around the patient. X-rays are picked up by a row of detectors and table moves in sync with x-ray tube. A computer is used to mathematically reconstruct a cross-sectional images of a body area
Why do we do CAT scans
Visualize internal organs, bones, soft tissue, blood vessels
What is an MRI
Does not use ionizing radiation. Uses strong magnetic field and radio waves to form images of the body. Provides better imaging then CAT scan for soft tissues
What is an ultrasound
Does not use ionizing radiation. Uses soundwaves with a higher frequency than the upper limit of the human hearing range. Gives a dynamic image. Allows for better soft tissue differentiation then x Rays
What is ionizing radiation
Radiation composed of particles that carry enough Kinetic Energy to liberate an electron from an atom.
What is radiation
Energy that comes from a source and travels through media or space.
What are the two forms of radiation use the medical imagery
Corpuscular an electromagnetic
What are x-rays considered
A form of electromagnetic radiation
Describe electromagnetic radiation
Has no Mass, no charge, can travel in a vacuum, constant speed, travels in a straight line, its wavelength is inversely proportional to its energy
What is wavelength
Distance between two consecutive corresponding points. Measured in nanometers
What is frequency
The number of cycles per second. Inversely proportional to the wavelength
What is energy
Proportional to the frequency and inversely proportional to the wavelength
Describe a shorter wavelength
High frequency and high energy
Describe a long wavelength
Low-frequency and low energy
What are four basic properties of x-rays
Can penetrate through materials that absorb or reflect visible light. Can make certain substances fluoresce. Can produce Latent images on film. Can cause biological changes in living tissue
Describe x-ray production
Produced in an x-ray tube that is a glass tube with a vacuum
What is the Cathode
Produces the electrons
What is the anode
Attracts electrons and creates X-rays
What are the two components of the cathode
Coiled wire filaments and focusing cups
What is the cathode controlled by
The mA
What are the two components of the anode
The tungsten target and copper casing
What are the two types of anodes
Stationary and rotating
Where is a stationary anode usually found
In dental or small portable x-ray units
Where is the rotating anode generally found
And large x-ray units
Describe the logic behind the focal spot
The smaller the focal spot the more heat at the spot and the clear the image
Describe the angle of the anode target
Smaller angle makes a smaller focal point and better detail
What is a penumbra
The loss of detail
What happens if the focal spot is bigger than the pinpoint
Causes a penumbra
On which side is the primary X-ray beams intensity stronger
On the cathode side
What is a transformer necessary for
Necessary to multiply the incoming voltage to the necessary kilovolt a
What are step down transformers used for
Provides electricity to heat the filament and creates mA
What do step up transformers do
Creates the KVP
Which type of current is necessary to generate X-rays
Direct current
What does monophasic direct current needs to be changed to
Triphasic
What is the KVP
The difference between the cathode on the anode. Determines the speed and energy of electrons. Causes a high penetrating power
What is the MA
Determines the quality of x-rays in the beam
What is MAS
Total quantity of x-rays produced in a certain amount of time
What do x-rays due to the film
Make the radiographic film go black
How do you reduce scatter radiation
Collimate and use an anti-diffusion grid
What is the collimator used for
Nerves the atomic region to x-ray. Decreases scatter radiation. Increases quality of image
What is the anti-diffusion grid
Thin vertical lead strips that absorb x-rays which travel at abnormal angles
What does the potter Bucky diaphragm do
Prevents the outline of the grid from appearing on the film by moving the grade during the exposure
Describe the cassette
Lightproof, rigid, has two intensifying screens, contains foam padding. Lead blocker for patient ID
Describe the back of the Cassette
Lead lined to absorb back scatter radiation
What crystals are located in the intensifying screen
Phosphor crystals that expose the film an account for more than 95% of film exposure
Describe a slow screen
High definition when exposure time is not critical
Describe a medium speed
Good resolution with relatively low exposure time
Describe a fast speed
Reduce exposure time and lower MAS needed
What are five factors that affect screen speed
Phosphor type, crystal size, layer thickness of phosphors, reflective later efficiency, dyes in phosphor layer
Describe the emulsion layer of the x-ray film
Has silver halid crystals
What are the four steps to manual developing
Developer five minutes. Fix or 10 minutes. Final wash 30 minutes. Drying
Where does the waves of electrical activity start in the electro cardiogram
The waves of electrical activity starts in the sinoatrial node and travels to the internodal tracks through atrial contraction. Then it travels to the atrioventricular node where the purkinje fibers cause ventricular contraction
What does the P wave represent
Electrical depolarization of atrial myocardium prior to contraction
What does the QRS complex
Depolarization of ventricle myocardium prior to contraction
What does the T wave represent
Ventricular re polarization
What does the electrocardiograph do
Sensitive voltage metering instrument that amplifies hearts electrical impulses
What position does the animal need to be placed for an electro cardiogram
Right lateral recumbent sea on a non-conductive surface. Limbs need to be perpendicular and parallel to each other
What is a pair of electrodes called
A lead
What is the principal lead used to assess arrhythmias
Lead to placement
What is blood pressure
Pressure exerted by circulating blood on arterial walls
What is the systolic pressure
Highest pressure of the cardiac cycle
What is diastolic pressure
Lowest pressure of cardiac cycle
What is map
Mean arterial pressure
What is blood pressure an indicator of
Anesthetic depth Cardiac functionOrgan perfusion
What are two indirect blood pressure monitors
Doppler bpOscillometer bp
What is a Doppler bp monitor
Continuously monitor hr and heart rhythm
What are the 4 arteries where yu can place the Doppler
Median palmar arteryDorsal pedal artery Coccygeal arteryFemoral artery
What is pao2
Oxygen partial pressure in the arteries
What is sao2
Arterial hemoglobin saturated with O2
What light is used by the pulse oximeter
Oxygenated hemoglobin absorbs red light Deoxygenated hemoglobin absorbs infrared light
What are two factors affecting accuracy of the pulse oximetry device
External light sourcesElectro cautery Tissue thicknessDarkly pigmented tissuesWell perfused areaArea with no hairExcessive movementHypothermiaAnemiaDrug effects
What does a capnograph do
Measures amount of co2 in patients inhaled and exhaled air.
What is an electrocardiogram
Graphic representation of the hearts electrical activity as it travels to the cardiac conduction system
What are some endoscopic evaluations of the respiratory tract
RhinoscopyTracheoscopyBronchoscope
What are some endoscopic evaluations of upper GI tract
EosophagoscopyGastroscopyDuodenoscopy
What are some endoscopic evaluations of lower gi tract
Colonoscopy, ileoscopy
What are some endoscopic evaluations of urinary and genital tract
Cystoscopy,UrethroscopyColposcopy
What is abdominal endoscopy by surgical incision called
Laparoscopy
What is interventional endoscopically used for
Foreign body removal, surgical interventions
What are components of the endoscope
Insertion tube, light delivery, air/water pipes, instrument channel and suction and control cables
What is the illumination lens used for
Light source
What is the objective lens used for
Focus adjustment
What is water flushing used for
Cleaning lens and clearing view
Why do we do a leak test and when does it happen
Be performed every time the endoscope is used to ensure no damage has been caused during the use of the instrument. Needs to be performed prior to cleaning and disinfecting
How should the endoscope be cleaned
Washed and cleaned of all visible organic debris in the neutral pH detergent. Use a special brush to clean the device
What is endoscopic
Looking inside the body for medical reasons. Allows a valuation of areas within the body in the minimally invasive manner
What are two types of ultrasonic scaler’s
Magnetostrictive ultrasonic scaler and Piezoelectric ultrasonic scaler
What are the two types of scalars available
Ultrasonic scaler’s, sonic scalars
Describe ultrasonic scaler’s
Most commonly used in Veterinary practice. Driven by an electric micromotor. Can cause cavitation and implosion of water to help disrupt the calculus
Describe a magnetostrictive ultrasonic scaler
Tip vibration generated by magnetostrictive mechanism
Describe a piezoelectric ultrasonic scaler
Tip vibration generated by piezoelectric mechanism in hand piece.
Describe sonic scalers
Air driven Tip vibrates at sonic frequencies
What are the two pieces to the magnetostrictive ultrasonic cleaner
The tip and the stack
Describe how you use the magnetostrictive ultrasonic cleaner
Light sweeping strokes using a modified pencil grip across a tooth surface
What happens if the stack or tip is inefficient
Thermal damage to teeth
Can the stack and tip be placed in the ultrasonic cleaner
No. It is okay to autoclave the stack and the tip though
What is a sonic scaler used for
Supragingival scaling
What is the maximum amount of time when using a scaler on teeth
Three consecutive seconds
At what point should you replace the tip
When it is 2 mm down
What water can be used with a mechanical scaler
Distilled or filter water
What is the sharp tip manual scaler usd for
Supragingival use
What is the curette used for
Subgingival use.
What is the function of polishers
Polishing helps prevent pocket errands by removing microinches
What type of handpiece is ideal for polishing teeth
Low-speed hand pieces
What are mechanical scalars used for
Allow rapid and easy removal of tartar.
What is the function of the lead blocker and what do you have to keep in mind when taking X-rays
The function is for identification of children and do not place any relevant patient body part in the corner
What is the function of the foam pressure pads in the cassette
Ensure close contact of film screens
What are two ways to break cassette
Physical damage, leakage of fluid into cassette
What is the function of the intensifying screens and what are they contain
Convert x-ray it’s a photons that are responsible for most of the film exposure 95%. Contain phosphor crystals that is responsible for this conversion
How do we clean and care for the cassettes or screens
Keep closed, free of dust hair or artifacts. Avoid scratching when inserted or removing filmed. Clean with mild soap and water
What is important to know when selecting an appropriate screen
decision based on speed and efficiency
What is the direct exposure film used for
Used if needed better detail better quality image. No cassette required
How should film be stored and handled
In a box in vertical position
What is KV P in which transformer does it require
Kilovoltage peak and a step up transformer
What is mA and which transformer does it need
Milliamperage and step down transformer
What is the function of the x-ray tube height adjustment lock
To prevent The tube from moving and allows you to convert from table top to cassette
What is S I D
Source image distance
How do you place the body in relation to the anode and cathode
Thicker portion of the body towards the cathode
What are the three things that happens when an x-ray strikes an object
Transmission, scatter, absorption
How many intensifying screens do you have per cassette
Two
What do the intensifying Screens contain
Phosphor crystals
What happens when phosphor crystals are hit by x-rays
They fluoresce
What are the advantages of the automatic developer
Shorter time than manual development. Standardized so it is a consistent quality
How do you keep the Rock rollers and guides clean in an automatic processor
Send a scout through to started. Use cleaning film to cover all rollers wait for a beep and then put the next one and
How often do you replace the chemical solutions in an automatic processing
Once a month
What are the four common dental films use and which two are used at Vanier
- We used 2 for small dogs and cats and 4 for dogs
Which side of the film is placed facing the x-ray tube
The white side towards the tube
What is the purpose of the dimple in the film and which direction to place it with respect to the animal
The dimple helps identify where the film was. We place the dimple rostrally
Can the dental X-ray beam be collimated
No it cannot
On the control panel for the dental x-ray unit which buttons control the following settings: film type, time and KV P
Film type: people buttonsTime: film type settings KVP: tooth settings
What are the three steps to the developing process for the dental x-ray unit
Developer water and fix
How long do you develop the film for
30 seconds
How long do you rinse the film for
Three shakes
How long do you fix the film for
60 seconds
Within the protective cover of the film which one is the actual film
The middle one
What are the two reflective sheets around the film
Lead foil backing to reduce scatter radiation
Why do you do quality-control for film
To minimize radiation exposure to patients and personal. To produce good quality radiographs. To decrease number of repeated films
Name three functions of the Cassatt
Rigid lightproof and prevent exposure to light but allow x-rays to penetrate. Film holder. Contains intensifying screens that convert x-rays in the visible light
How do you perform a high pressure leak test
Turn tank on by turning tank outlet valve and note tank pressure reading. Then turn tank off. Check gauge in one hour
At what pressure should we change the tank
100 to 200 psi
At what pressure should we call Oxymed
500psi
What is the purpose of the oxygen cylinder
Compressed gas so large amount stored in small cylinder.
What is the purpose of the tank outlet valve
Allows oxygen to flow into the machine when open
What is the purpose of the tank pressure gauge
Pressure of gas remaining when opened
What is the purpose of the pressure reducing valve
Almost constant flow of gas into machine and reduces pressure to 40 to 50 psi
What is the purpose of the oxygen line
For freestanding cylinders it transports oxygen to anesthetic machine
Why do we do a high pressure leak test
To check for leaks between the gas tank and the flowmeter
What is the purpose of the flow meter
Turns on or shuts off oxygen flow through machine. Decreases gas pressure to 15 psi
What is the purpose of the vaporizer
Vaporizes liquid anesthetic to gas
What is the purpose of the indicator window
Allows viewing of liquid anesthetic levels
What is the purpose of the oxygen flush valve
To dilute the line with oxygen
What is the purpose of the fresh gas inlet
Mix of oxygen and anesthetic has
What is the purpose of the reservoir bag
Stores gas, ensures ET tube is in trachea, allows delivery of oxygen
What is the function of the pop off valve
Allows access gas to exit the system
What is the function of the scavenger
Collects and disposes waste gas
What is the function of CO2 absorber
Absorbs co2 from rebreathed air
What is the function of the pressure manometer
Measures gas pressures in breathing system
What is the purpose for a low pressure leak test
Checks for leaks from the anesthetic machine to breathing circuit at 15 psi
What is the induction rate for the circle system
100-200 ml/kg/min
What is the induction rate for the Bain system
130-300ml/kg/min
What is the maintence rate for the circle system
25-50ml/kg/min
What is the maintenance rate for the Bain system
140-200ml/kg/min
Why do we use keyed filler devices
Prevent introduction of incorrect anesthetic
What habits can minimize exposure to Anesthetic gas
Refill vaporizer at the end of the day. Recap bottles before discarding. Store vaporizer filling devices in sealed bag.
How do you clean flutter valves
Mild soap and water
What is the purpose of the manual mode of the ecg
To control the lead used
Why do we adjust the pen temperature and damping
Adjust to get optimum thickness at the lowest possible temperature
How do we identify leads on paper
The event marker button
How is spo2 measured
With both red and infrared light
What does a pulse oximeter measure
Pulse oximetry saturation, functional oxygen saturation of arterial hemoglobin, pulse rate
Can you use a ecg and a Mri at the same time
Nope
What must you do if the EKG is stored for more than one month
Remove the batteries
What does the capnograph measure
Inspired and expired co2, rr, spo2 and pulse rate
What is the normal systolic bp in a cat or dog
120mm Hg
What is the minimum systolic bp
80mm Hg
How often should the hand piece be charged
After each days use
How long should the hand piece and footpedal be charged for
At least 90 mins
What is the function of the dental probe
For locating some gingival plaque and to evaluate enamel
What is the function of the dental mouth mirror
Good for visualizing lesions
What is the function of the MOuth speculum
For maintaining mouth open
What is the function of the dental scaler
Removing supragingival calculus only
What is the dental curette used for
Remove subgingival calculus
What is the function of the periosteal elevator
For lifting gingiva
What happens if foot pedal is depressed half way
Tip is activated and h20 flows
What happens if foot pedal is completely pressed
Activated boost
Which three parts can be steam sterilized in the cordless dental polisher
Outer sheath, color ring, handpiece cradle
