Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Apex > Miscellaneous Monitors and Equipment > Flashcards

Miscellaneous Monitors and Equipment Flashcards

1
Q

How does the TOF deliver twitches?

A

4 twitches at 2 Hz at 0.5 second intervals for 2 seconds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

When does fade occur?

A

T4/T1 ration is < 1.0 (usually caused by a NMB or a phase II block by a depolarizing NMB

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

When is clinical recovery from a NMB achieved?

A

TOF > 0.9

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the # of receptors blocked when the T4/T1 ratio is 1.0?

A

Total receptor blocked: 25-50%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the # of receptors blocked when the T4/T1 ratio is 0.9?

A

of receptors blocked: 75%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the # of receptors blocked when the T4/T1 ratio is 0.75?

A

of receptors blocked: 75

T4 (75) / T1 (100)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the # of receptors blocked when the T4/T1 ratio is 0.6-0.75? (This includes when T4 is lost)

A

80-85%
T4 (0-75) / T1 (25-95)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the # of receptors blocked when T2 or T3 are lost?

A

of receptors blocked: 85-90%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the # of receptors blocked when T1 is lost?

A

Number of receptors blocked: 90-95%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the # of receptors blocked when the T is 0 (no twitches)?

A

Number of receptors blocked: 100%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is tetanus?

A

It delivers a high frequency of stimulation.

Rapid sequence of 50 Hz for 5 seconds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Is tetany or TOF a more sensitive method of assessing recovery from NM blockade?

A

Tetany

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is double burst stimulation?

A

Delivers two short bursts of 50 Hz tetanus 0.75 seconds apart.

Painful

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is post-tetanus count?

A

A 50 Hz titanic stimulus is delivered for 5 seconds followed by a series of singe twitches ~ these twitches will fade in strength

***we use this to assess the depth of NMB when no twitches are present (deep block) ~ helps plan for recovery and reversal of NMB

> 6 ~ T1 will return very fast

< 3 ~ return of T1 is far away

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How does cerebral oximetry measure cerebral oxygenation?

A

Near infrared spectroscopy (NIRS)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are some traits about cerebral oximetry?

A

Measures venous oxygen saturation
(Decrease O2 delivery, ^ oxygen extraction, decreased venous O2 saturation)

Detects REGIONAL oxygenation

Noninvasive

Two sensors are placed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What % change suggests a reduction in cerebral oxygenation?

A

> 25%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is the range of brain waves from high frequency to low frequency (high to low)

A

Beta > alpha > theta > delta > burst suppression

(Better Always Think Delta Be-Superior)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are beta brain waves?

A

High frequency, low voltage

13-30 cycles/sec

Awake mental stimulation and “light anesthesia”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are alpha brain waves?

A

8-12 cycles/sec

**associated with awake but restful state with eyes closed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are Theta waves?

A

4-7 cycles/sec

General anesthesia and children during normal sleep

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What are delta waves?

A

<4 cycles/sec

Associated with general anesthesia, deep sleep, and/or brain ischemia or injury

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is burst suppression?

A

Associated with general anesthesia, hypothermia, CPB, and cerebral ischemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is Isoelectricity?

A

Absence of electrical activity

(Associated with very deep anesthesia or death)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

How does Ketamine affect the EEG?

A

Increases high frequency cortical activity and May confused the EEG interpretation ~ patient may be deeper

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Which volatile agent affect beta wave activity?

A

Nitrous oxide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What is the target number for general anesthesia when considering the BIS monitor?

A

40-60

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

As the level of anesthesia becomes deeper, what do the EEG waveforms exhibit?

A

Lower frequency (they become slower)
Higher amplitude (they become taller)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What are some limitations of the BIS?

A

20-30 second lag

Less accurate in children

BIS < 40 for more than 5 mins correlates with an increased 5-year mortality (supposedly)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What is the Patient Safety Index Monitor?

A

Similar to BIS, but target range is 25-30

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What is a Macroshock?

A

Larger amount of current is applied to the EXTERNAL surface of the body

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What is a Microshock?

A

Smaller amount of current is applied directly to the myocardium (think PA cath, central line, pacing wires)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What is the maximum allowable current leak in the OR?

A

(Part of the microshock voltage)

10 micro amps (uA)

100 uA to cause vfib

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What is 1mA?

A

Macroshock

Threshold for touch perception of electric shock

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What is 5 mA?

A

Macroshock

Max current for a harmless electrical shock

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What happens at 10-20 mA?

A

Macroshock
“Let go” current occurs before sustained contraction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

What happens at 50 mA?

A

Macroshock
Loss of consciousness

38
Q

What happens at 100 mA?

A

Macroshock
Ventricular fibrillation

39
Q

Is the OR grounded?

A

No! Equipment is grounded

The absence of grounding in the OR provides a second layer of protection against shock.

40
Q

What is a isolation transformer?

A

This is a device that sits b/t the power coming from the power company and the OR (it is required to supply ungrounded power to the OR)

It only works when equipment connected to it are functioning correctly.

41
Q

What is a line isolation monitor?

A

Assesses the integrity of the ungrounded power system in the OR.

It tells you when the OR becomes grounded and how much current could potentially flow through you or a patient.

42
Q

What are some traits about the line isolation monitor?

A

Does not (by itself) protect you or the patient from macro/micro shock.

Purpose is to ALERT OR staff of first fault (aka OR has become grounded)

Alarms at 2-5 mA of leak current

43
Q

What should you do if the line isolation monitor alarms?

A

The last piece of equipment that was plugged in should be unplugged.

44
Q

What frequency does a surgical electrocautery unit deliver?

A

High frequency
(500,000 - 1 million Hz)

**used to cut, coagulate, dissect, and destroy tissue

45
Q

What does the return electrode in a monopolar electrocautery device do?

A

return electrode serves as an EXIT POINT by providing a large surface area for the electric current to exit the body and return to the power generator

46
Q

What does a fault in the return pad mean for the patient?

A

Risk for burns

If the return pad malfunctions, the electrical current will exit from other means (pt EKG stickers, temp probe, or metal components of the table)

47
Q

In what case should all metal jewelry be removed?

A

If a capacitive-couples return electrode is used

(Increased burn risk)

48
Q

Why should metal jewelry be removed prior to surgery?

A

Metal jewelry can cause a “re-concentrating” effect

If a patient refuses, ensure jewelry is not in the direct path of electrical current and return pad AND tape jewelry to the skin

49
Q

At what MAC do volatile agents produce isoelectricity on the EEG?

A

1.5-2.0

50
Q

At what # of receptor blockade does the fourth twitch disappear?

A

80% - 85%

51
Q

What are X-rays and gamma rays called ionizing radiation?

A

Because they can ionize atoms (remove electrons from the outer shells)

52
Q

What are the two effective barriers to X-rays and/or gamma rays?

A

Lead or concrete

53
Q

What is a Roentgen?

A

Unit of radiation exposure

Describe the output of a X-ray machine (some is lost and some is absorbed)

(Think of this as total dose administered)

54
Q

What is Radiation absorbed Dose? (Rad)?

A

Quantity of radiation received by an individual.

Think of rads as “total dose administered at the tissue level”

55
Q

What is radiation equivalent man (REM)?

A

Unit of occupational radiation exposure

Accounts for differences among types of radiation.

Think of Rems as the “effective dose”

56
Q

What is the yearly maximum radiation exposure for adults?

A

5 rem

57
Q

What is the yearly maximum exposure for the fetus of a pregnant worker?

A

0.5 rem or 0.05 rem/month

58
Q

What is the number of electrons used to generate the X-ray beam called?

A

Milliampere-seconds (mAs)

59
Q

What describes the quality of X-rays produced?

A

Kilovolt

60
Q

What tissues have a very high sensitivity to EMR?

A

Bone marrow
Intestinal epithelium
Reproductive cells
Fetal tissue

61
Q

What tissue have a high sensitivity? (Not to be confused with very high)

A

Optic lens
Thyroid epithelium
Mucus membranes

62
Q

What tissue has a medium sensitivity to EMR?

A

Glial cells
Liver
Lung
Pancreas

63
Q

What tissue has a low sensitivity?

A

Mature RBCs
Mature bone
Mature cartilage

64
Q

What are the three ways to limit radiation exposure?

A

Distance
Duration
Shielding

65
Q

What is the easy way to protect yourself from radiation?

A

Distance

66
Q

What is the MINIMUM safe distance from the radiation source?

A

6 feet

67
Q

What equation is used to quantify the amount of exposure at two different locations?

A

Intensity1=Distance2^2 / Intensity2=Distance1^2

68
Q

X-rays penetrate easier via low density and less easily via high density. What is the order of increasing density? (Darkest to lightest on an X-ray)

A
  1. Gas (air)
  2. Fat
  3. Water (soft tissue)
  4. Bone (metal)
69
Q

Why is a X-ray taken on inspiration?

A

Inspiration separates the soft tissue and vessels ~ makes it easier to see on the X-ray

70
Q

What is the most common X-ray view?

A

PA (posterior anterior) rays pass from back to front.

71
Q

In the PA view (on a X-ray), what is the normal width of the heart?

A

< 50% of the width of the thorax

PA view provides the most accurate assessment of heart size

72
Q

In the AP view (in a X-ray), what is the normal width of the heart?

A

< 60% of the width of the thorax

AP provides a less accurate assessment of heart

73
Q

What is the normal position of the diaphragm on an X-ray?

A

Domed

Right is usually higher than the left due to liver

74
Q

What does a unilateral or flattened hemidiaphragm indicate?

A

Tension pneumo

75
Q

What does bilateral flattening of the diaphragm on X-ray indicate?

A

COPD or chronic asthma

76
Q

What do blunted costophrenic angles indicate?

A

Pleural effusions

77
Q

What are air bronchograms?

A

Dark, air-filled bronchi surrounded by opaque white alveoli

If air bronchograms are present, then the opacity is likely atelectasis

78
Q

What is interstitial pulmonary edema (I.e. LV failure) characterized by?

A

Peribronchial cuffing (donuts) and/or linear patterns (Kerley Lines)

79
Q

What does enlargement of the aortic knob indicate?

A

Aortic dissection
Valvular insufficiency
PDA
Severe Tetralogy of Fallot

80
Q

Which lung hilum is normally higher?

A

Left

81
Q

What is the mnemonic for evaluating an X-ray?

A

ABCDEFGHI

A: assess airway
B: bones and soft tissue
C: cardiac
D: diaphragm
E: effusion
F: fields, fissures, foreign bodies
G: great vessels/ gastric bubble
H: hila and mediastinum
I: Impression

82
Q

Where does a properly placed ETT sit?

A

Mid trachea about 4-5 cm above the carina (adults)

** if you can’t see the carina, you can use the T4-T5 vertebral interspace as a surrogate for the carina

The level of the medial ends of the clavicles is another option

83
Q

Where should the distal tip of the central line reside?

A

In the distal 1/3rd of the SVC b/t the right atrium and most proximal venous valves

84
Q

what can happen if the tip of the CVL is in the proximal 1/3rd of the SVC?

A

It is 16-times more likely to thrombose!!

85
Q

What can happen if the CVL is placed too deep?

A

Placing the catheter inside the right atrium can cause arrhythmias and/or cardiac perforation

86
Q

What is the target for a PA cath?

A

West’s zone 3.

87
Q

Where is atelectasis most commonly seen on X-ray?

A

In the posterior segment of the RUL or the superior segment of the RLL

88
Q

What are the 3 stages of cardiogenic pulmonary edema on X-ray?

A

Stage 1: cephalization (vascular redistribution)

Stage 2: peribronchial cuffing (donuts), butterfly pattern around Hila, and Kerley lines

Stage 3: alveolar edema, alveolar consolidation, blunted costophrenic angles, rounded left ventricle

89
Q

What are the three stages ARDs progresses?

A
  1. Exudative (12 hours after insult)
  2. Proliferate (24-48 hours)
  3. Fibrotic
90
Q

The deep sulcus sign represents which abnormality?

A

Pneumothorax

Apex (47 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions