Lab Exam Flashcards
1
Q
describe a basic anesthetic machine setup
A
oxygen cylinder→pressure reduction valve→ flowmeter→vaporizer→fresh gas inlet →breathing circuit
2
Q
what is the metabolc requirement/ minimum O2 flow required
A
5-10ml/kg/min
3
Q
E-cylinders
A
usually single
attached directly to anesthesia machine via yoke
4
Q
H- cylinder
A
often in banks
supply central O2
5
Q
pressure in the O2 tank is measured in _______
A
psi
6
Q
breathing system pressure is measured in _______
A
cmH20
7
Q
what is the capacity of most commonly used E-cylinders
A
660 L
8
Q
what pressure are O2 tanks filled to?
A
2200 psi
9
Q
what are some safety systems in place for different tanks
A
color-coded tanks
labellig
diameter index safety system
pin index safety system
quick connectors
10
Q
what is a regulator
A
pressure-reducing valve
decreases tank pressure (approx 50 psi) which is supplied to flowmeter
11
Q
what is a flowmeter
A
controls rate of gas flow through vaporizer (L/min)
enters at 50 psi leaves at 15 psi
12
Q
T/F flowmeters are gas specific
A
True
O2 flowmeter is not accurate if used for N20
13
Q
what is the minimum % O2 that should be delivered to patient
A
35%
14
Q
T/F the quick flush bypasses the vaporizer
A
true
15
Q
what is a possible complication of the quick flush
A
pneumothorax
16
Q
anesthetic vaporizers
A
changes liquid into vapor
deliver selected % of anesthesitic vapour to fresh gas outlet
17
Q
types of re-breathing systems
A
circle
universal F
18
Q
types of non-rebreathing system
A
mapleson A-F
most common- bain/modified mapelsonD, mapelson F
19
Q
how can you calculate bag size for small animal
A
body weight (in kgs) X 90
20
Q
O2 flow rate for small animal induction and recovery
A
50-100 mL/kg/min
21
Q
maintenance O2 flow rate for small animals
A
20-50 mL/kg/min
22
Q
O2 flow rate for large animal induction and recovery
A
20-50 mL/kg/min
23
Q
maintenance O2 flow rate for large animal
A
10-20 mL/kg/min
24
Q
when are non-rebreathing systems used
A
< 3kg
25
how high should th eO2 flow rate be with non-rebreathing
2-3x tidal volume
~300 mL/kg/min
26
types of ET tubes
PCV, rubber, silicone
cuffed or uncuffed
27
murphy ETT
cuffed or uncuffed
has "murphy eye" - allows gas flow if end in obstructed
28
cole ETT
uncuffed
commonly used in avian patients - has shoulder that seals agaisnt the glottis
29
T/F ETT can be inflated without checking for leaks in ruminants
**True**
high risk of regurgitation
30
types of passive scavenging
exhaust directly into atmosphere - window/hole in wall
F air canister
31
ventilation is defined by \_\_\_\_
**PaCO2**
normal ≈ 35-45 mmHg
32
ventilation is monitored via \_\_\_\_
arterial blood gas
capnography
33
oxygenation is defined by \_\_\_\_\_
**PaO2** or **SpO2**
monitored with arterial blood gas or pulse ox
hypoxemia: PaO2 \< 60 mmHg, SpO2 \< 90%
34
types of ventilation
**spontaneous** - patient determines, when and how
**assisted** - patient determines when and ventilator determines how
**manditory** - ventilator determines when and how
35
IPPV
intermittent positive pressure ventilation
positive pressure maintaned only during inspiration
36
IMV
intermittent manditory ventilation
predetermined number of positive breaths but patient can breath freely between mechanical breaths
37
CPAP
continuous positive airway pressure
spontaneous breathing with positive pressure during both inspiration and expiration
38
PIP
peak inspiratory pressure
inflates alveoli, opens atelactasis, causes barotrauma
39
indicationd for mechanical ventilation under anesthesia
decreased PaCO2
hypoxemia - breathing air
40
hypercapnia may be acceptable \_\_\_\_
up to 60-70 mmHg fr purpose to improve circulation
41
tidal volume, resp rate, and inspiratory time in healthy lungs
**TV:** 10-15 ml/kg
**RR:** 6-10 breaths/min
**IT:** 1-2 sec
42
2 modes of mechanical ventilation
volume controlled
pressure controlled
43
blood gas analysis measures:
pH
PaCO2
PaO2
44
normal pH of blood
7.35-7.45
45
normal HCO3 value
**24 +/- 4 mEq/L**
cats tend to be lower
herbivores tend to be higher
46
normal PaCO2 value
35-45 mmHg
47
normal base excess (BE)
0 +/- 4 mEq/L
positive = metabolic alkalosis
negative = metabolic acidosis
48
what can effect PaCO2 value
resp rate, tidal volume, breathing effort
49
PaO2 is interpreted in light of ...
**FiO2**
ambient pressure
PaCO2
50
if breathing 100% O2, PaO2 should be...
**\> 500 mmHg**
51
A-a difference if breathing 100% O2
\<110 mmHg
52
causes for a high A-a difference
V/Q mismatch
right to left shunt
diffusion impairment
53
normal PaO2 / FiO2 ratio
\>500 mmHg
54
5 causes for hypoexemia (low PaO2)
Low FiO2
hypoventilation
**diffusion impairment**
**V/Q mismatch**
**right to left shunt**
55
what is the common method for monitoring anesthetic depth
subjective monitoring of subcortical activities/reflexes
56
EEG gives information about
cortical but not subcortical activities
57
cental + dilated pupil can indicate ....
the patient is either too light or too deep
58
T/F CV adverse effects are possible even if iso is not overdosed
**True**
59
most surgeries and intubation are performed at what stage
Stage 3 planes 2-3
60
stage 3 plane 1
light anesthesia
nystagmus
61
stage 3 plane 2
medium plane of anesthesia
weak palpebral, strong corneal reflexes
adequate muscle relaxation
62
stage 3 plane 3
deep anesthesia
some patients may have to be maintained at this stage but ideally should decrease to plane 2
63
T/F HR does not aid in determining anesthetic depth
true
64
spontaneous RR is high (\> 20 br/min) may indicate
too light anesthesia
low lung volume
65
ACVAA monitoring guidelines at least \_\_\_\_, \_\_\_\_\_, \_\_\_\_\_\_, and ______ should be monitored
circulation
oxygenation
ventilation
temperature
66
pulse palpation in small animals
labial, digital, dorsal pedal
67
pulse palpation in large animals
auricular, transverse facial, facial
68
esophageal stethoscope
assess: heart sounds, rate, and rhythm and resp sounds and rate
insert at midline dorsal to ET tube, along palatine raphe
69
T/F ECG indicated that the heart is contracting
False
70
conduction system of small animals
**mammalian type A** - base to apex current flow
positive R wave
71
conduction system of large animals
**mammalian B type** - apex to base
negative R wave
72
normal HR and strong pulses indicate \_\_\_\_\_
adequate CO
73
common arrhythmias under anesthesia
sinus bradycardia and tachycardia
AV blocks (1st & 2nd degree)
74
hypotension in small animals
mean \<60
systolic \< 80
75
hypotnesion in large animals
mean \< 70
systolic \< 90
76
BP changes with respiration indicates
hypovolemia
77
crucial elements of CV function
HR (and rhythm)
contractility
circulating volume
vasconstriction
78
invasive BP
continuously via arterial catheter
**gold standard**- most accurate
79
non-invasive BP
intermittently using a pressure cuff
oscillometric and doppler
80
IBP should be used in horses if they are anesthetized longer than \_\_\_\_\_
45 min
81
arteries used for IBP in K9
dorsal pedal
metatarsal
82
artery used in IBP in sheep and goats
**median**
auricular
83
oscillometric cuff's width should be about
40% of the circumference of the limb
84
advantages of oscillometry
provides systolic, mean and diastolic BP
85
placement of doppler sensor in sheep and goats
over median artery
86
if you can only afford a single anesthesia monitor, you should choose a \_\_\_\_\_\_
doppler
87
SaO2 if breathing pure O2
\> 98%
88
pulse ox readings are affected by
hypoperfusion
pigmentation
movement
abnormal Hb species
89
when is it important to use a pulse ox
breathing room air
V/Q mismatch
resp disease
90
capnograph
continuously displays ETCO2 vs time on a graph
91
how can core body temp be measured
esophageal temp probe entered into mid thorax
92
normal temp for all species under anesthesia
98 -102.5
93
normal resp rate for all species
10-20 br/min
94
normal HR for K9 under anesthesia
50-160 bpm
95
normal HR for sheep under anesthesia
60-150 bpm
96
which dog breed has prolonged recovery with thiobarbituates, propfol, and alfaxalone
sighthounds
97
what premeds are typically used in K9 anesthesia
opioid + sedative IM before catheter placement
98
which species is the easiest to intubate
dogs
99
blood volume of K9
~90 ml/kg
100
how can aspiration be prevented under anesthesia
proper ETT cuff lube and inflation
101
what should be done if reguritation occurs in K9
postural drainage while anesthestized
swab or suction caudal oropharynx before extubation
keep cuff inflated or partially inflated for extubation
place in sternal recumbency ASAP
102
how long should sheep and goats be fasted
NPO 12-18 hrs
no water for 4 hours
103
common problems with ruminant anesthesia
reguritation and aspiration
ruminal tympany
salivation
cardio-resp effects
104
catheter size for sheep and goats
16-18 gauge
105
because of its pulmonary effects, _________ are not recommended in sheep and goats
**alpha 2 agonists**
bronchoconstriction, increase pulmonary vascular resistance, pulmonary edema
106
T/F atropine can be used to reduce production of saliva
**False**
does not reduce saliva production but makes it more viscid
107
T/F intubation of small ruminants can be blind or by direct visualization with a laryngoscope
**True**
108
what can effect the accuracy of the capnograph readings with ruminants
exhaled methane
109
how should ruminants be recovered
ETT removed with cuff inflated - regurge & aspiration
support in sternal - tympany
check temp & use heating blankets in small ruminants/calves
110
acepromazine duration of action
long acting
4-8hrs, 48 for liver patients
111
phenothiazines act on which receptor(s)
dopamine
serotonin
alpha 1
histamine
112
main indications for phenothiazines
sedatiion (++)
antiemetic effect
antiarrhythmic
no analgesia
113
CV & resp effects of phenothiazines
vasodilation
hypotension
114
phenothiazine: contraindications
hypovolemia, hemodynamically instable
boxers - sensitive (bradycardia)
breeding stallions- penile prolapse
115
butorphanol is what class of opioid
mixed agonist antagonist
116
butorphanol acts on which receptor(s)
kappa - agonist
mu - antagonist
117
CV & resp effects of opioids
minimal bradycardia
118
main indication for propofol
injectable anesthestic
status epilepticus
119
propofol acts on which receptor(s)
GABA agonist
120
CV and resp effects with propofol
hypotension
vasodilation
apnea possible (give slow)
121
main indication for isoflurane
inhalant anesthetic - vapor
122
MAC of isoflurane for a dog
1.3%
123
duration of action for isoflurane
short induction and recovery
124
what is the main muscarinic receptor that acts on the heart
M2
bradycardia
125
T/F atropine crosses the BBB and placenta but glycopyrrolate does not
**True**
126
T/F glycopyrrolate can be used during emergency cases
**False**
slow onset (1-5 min, compared to ~1min with atropine)
127
common class 1B anti-arrhythmic
lidocaine
128
MOA of lidocaine
Na channel blocker
129
Main indication for lidocaine as an anti-arrhythmic
hypotension/ inadequate perfusion
R on T phenomenon
multiple VPCs
HR \>180
130
what are the mixed inotropes and pressors
dopamine
ephedrine
norepi
epi
131
adverse effects for ephedrine
reflex bradycardia - vasconstriction
CNS stimulation
increases MAC
132
indications for epi
CPR or anaphylactic shock
133
vasopressin
aka ADH
non-adrenergic sympathomimetic - vasoconstriction via V1 receptor
indicated for refractory shock or non-responsive hypotension as CRI
134
blood volume of dogs
90 mL/kg
135
blood volume of sheep
60 mL/kg
136
maintenance fluid rate under anesthesia
10mL/kg/hr
137
10mL/kg fluid boluses (within 15min) can be given in cases of \_\_\_\_\_
hypotension
138
what would be the fluid rate for a 45kg sheep (drops/sec) if using a 15 d/mL administration set
**≈2 drops/sec**
* 45kg X 10mL/kg/hr = 450mL/hr*
* (450mL/hr)/(60min/hr) = 7.5mL/min*
* (7.5mL/min)/(60 sec/min) = 0.125 mL/sec*
* 0.125 mL/sec x 15 drops/mL = 1.875 drops/sec ≈ 2 drops/sec*
