Monitoring During Anesthetic

Question 1

Induction

Answer 1

a systematic process of observing, tracking, and recording data

Question 2

How often should you monitor?

Answer 2

every 5 minutes

Question 3

What are the three stages of anesthesia?

Answer 3

Pre-operative
Intra-operative
Post-operative

Question 4

What are the common methods of monitoring circulation?

Answer 4

Mucus membranes
CRT
Palpation of pulse
Auscultation of heart beat
ECG
Systemic arterial blood pressure

Question 5

ECG

Answer 5

recording of the heart electrical activity from the surface of the body

Question 6

Electromechanical dissociation

Answer 6

When electrical activity is happening but not contracting

Question 7

P wave

Answer 7

atrial depolarization

Question 8

QRS complex

Answer 8

ventricular depolarization

Question 9

T wave

Answer 9

ventricular repolarization

Question 10

Mammalian A type

Answer 10

Purkinje fibers excite the endocardium only and excitement spreads via muscle fibers
Generating base to apex current flow
Seen in humans and small animals

Question 11

Mammalian B Type

Answer 11

Purkinje fibers penetrate the myocardium and most of the myocardium is excited simultaneously
Generating apex to base current flow
Seen in horses, ruminants, pigs

Question 12

Where do you place the white electrode on large animals?

Answer 12

Jugular furrow or withers

Question 13

Where do you place the black electrode on large animals?

Answer 13

Cardiac apex

Question 14

Where do you place the Red electrode on large animals?

Answer 14

anywhere else

Question 15

What are the common arrhythmias under anesthesia?

Answer 15

Sinus bradycardia
tachycardia
AV blocks (1st and 2nd degree)

Question 16

1st degree AV Block

Answer 16

Slow conduction through the AV node

Question 17

2nd degree AV Block

Answer 17

intermittent conduction through the AV node

Question 18

3rd degree AV Block

Answer 18

No conduction through the Av node

Question 19

What is the first line of treatment for ventricular arrhythmias?

Answer 19

Lidocaine IV

Question 20

Systolic pressure

Answer 20

highest point of the BP curve; represents afterload for the left ventricle

Question 21

Mean Pressure

Answer 21

average BP over a full cycle; determinant of tissue perfusion

Question 22

Diastolic Pressure

Answer 22

lowest point of the BP curve; determinant of myocardial perfusion

Question 23

What is the definition of hypotension in small animals?

Answer 23

Mean: less than 60mmHg
Systolic: less than 80mmHg

Question 24

What is the definition of hypotension in large animals?

Answer 24

Mean: less than 70mmHg
Systolic: Less than 90mmHg

Question 25

What are the three treatments of hypotension?

Answer 25

Decrease anesthetic administration Give Fluid bolus Give Drugs

Question 26

What is the equation for BP?

Answer 26

BP = (HR x SV) x SVR

Question 27

SV (Stroke Volume)

Answer 27

depends on preload and contractility

Question 28

What is the equation for Cardiac Output?

Answer 28

HR x SV

Question 29

What are the crucial elements of CV function?

Answer 29

Heart Rate and Rhythm Contractility Circulating volume Vasoconstriction

Question 30

Invasive BP

Answer 30

continuously via arterial catheter

Question 31

Non-invasive BP

Answer 31

intermittently using a pressure cuff

Question 32

What are the most common types of non-invasive BP?

Answer 32

Oscillometric | Doppler

Question 33

Where do you position the transducer in equine?

Answer 33

the level of the base of the heart

Question 34

Oscillometric

Answer 34

arterial blood flowing under an inflated cuff generates pressure fluctuations in the cuff that is detected by the monitor

Question 35

Doppler

Answer 35

An inflated cuff placed over an artery. Blood flow is detected distally from the cuff using a Doppler flow probe. After complete occlusion of flow, cuff pressure is gradually decreased. The pressure where the blood flow appears is systolic BP.

Question 36

Where should the cuff be placed?

Answer 36

at the level of the base of the heart

Question 37

What are the advantages of oscillometry?

Answer 37

Provides systolic, mean, diastolic BP Easy to place Less labor intensive Commonly integrated in complex monitors

Question 38

Disadvantages of oscillometry?

Answer 38

``` May be inaccurate outside of normal BP range Below 10 kg BW Weak pulse During movement or arrhythmias ```

Question 39

Advantages of using Doppler

Answer 39

Can measure BP on smaller animals too Less sensitive for artifacts resulting from movement, arrhythmias and vasoconstriction excellent pulse monitor

Question 40

Disadvantages of using Doppler

Answer 40

Does not measure MAP Noisy Sometimes difficult to place more labor intensive

Question 41

How do you measure oxygenation?

Answer 41

Pulse oximeter | blood gas

Question 42

Hypoxemia

Answer 42

Reduction of oxygenation of arterial blood | PaO2

Question 43

When do you use a pulse oximeter?

Answer 43

patient is breathing room air this is a V/Q mismatch there is respiratory disease

Question 44

Normal PaO2

Answer 44

35-45mmHg

Question 45

PaCO2 greater than 45mmHg

Answer 45

Hypercapnia | Hypoventilation

Question 46

PaCO2 at 35-45mmHg

Answer 46

normocapnia | normoventilation

Question 47

PaCO2 less than 35mmHg

Answer 47

Hypocapnia | hyperventilation

Question 48

Capnometry

Answer 48

Measurement of CO2 partial pressure in the airways

Question 49

Capnometer

Answer 49

only measures the ET CO2

Question 50

Capnograph

Answer 50

continuously displays ET CO2 vs. time on a graph

Question 51

What factors influence ET CO2 values?

Answer 51

CO2 production Circulation Alveolar ventilation Measurement error

Question 52

What are the phases of a capnograph?

Answer 52

I. Baseline II. Expiratory upstroke III. Alveolar plateau IV. Inspiration begins

Question 53

Where do you place the Doppler sensor in a Small Ruminant?

Answer 53

Median Artery

Question 54

Where do you place the Doppler sensor in the Donkey?

Answer 54

Tail