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RUSVM Anesthesiology 2016 > Monitoring During Anesthetic > Flashcards

Monitoring During Anesthetic Flashcards

1
Q

Induction

A

a systematic process of observing, tracking, and recording data

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2
Q

How often should you monitor?

A

every 5 minutes

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3
Q

What are the three stages of anesthesia?

A

Pre-operative
Intra-operative
Post-operative

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4
Q

What are the common methods of monitoring circulation?

A 
Mucus membranes
CRT
Palpation of pulse
Auscultation of heart beat
ECG
Systemic arterial blood pressure
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5
Q

ECG

A

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

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6
Q

Electromechanical dissociation

A

When electrical activity is happening but not contracting

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7
Q

P wave

A

atrial depolarization

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8
Q

QRS complex

A

ventricular depolarization

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9
Q

T wave

A

ventricular repolarization

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10
Q

Mammalian A type

A

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

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11
Q

Mammalian B Type

A

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

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12
Q

Where do you place the white electrode on large animals?

A

Jugular furrow or withers

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13
Q

Where do you place the black electrode on large animals?

A

Cardiac apex

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14
Q

Where do you place the Red electrode on large animals?

A

anywhere else

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15
Q

What are the common arrhythmias under anesthesia?

A

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

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16
Q

1st degree AV Block

A

Slow conduction through the AV node

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17
Q

2nd degree AV Block

A

intermittent conduction through the AV node

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18
Q

3rd degree AV Block

A

No conduction through the Av node

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19
Q

What is the first line of treatment for ventricular arrhythmias?

A

Lidocaine IV

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20
Q

Systolic pressure

A

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

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21
Q

Mean Pressure

A

average BP over a full cycle; determinant of tissue perfusion

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22
Q

Diastolic Pressure

A

lowest point of the BP curve; determinant of myocardial perfusion

23
Q

What is the definition of hypotension in small animals?

A

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

24
Q

What is the definition of hypotension in large animals?

A

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

25
Q

What are the three treatments of hypotension?

A

Decrease anesthetic administration
Give Fluid bolus
Give Drugs

26
Q

What is the equation for BP?

A

BP = (HR x SV) x SVR

27
Q

SV (Stroke Volume)

A

depends on preload and contractility

28
Q

What is the equation for Cardiac Output?

A

HR x SV

29
Q

What are the crucial elements of CV function?

A

Heart Rate and Rhythm
Contractility
Circulating volume
Vasoconstriction

30
Q

Invasive BP

A

continuously via arterial catheter

31
Q

Non-invasive BP

A

intermittently using a pressure cuff

32
Q

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

A

Oscillometric

Doppler

33
Q

Where do you position the transducer in equine?

A

the level of the base of the heart

34
Q

Oscillometric

A

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

35
Q

Doppler

A

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.

36
Q

Where should the cuff be placed?

A

at the level of the base of the heart

37
Q

What are the advantages of oscillometry?

A

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

38
Q

Disadvantages of oscillometry?

A 
May be inaccurate
outside of normal BP range 
Below 10 kg BW
Weak pulse 
During movement or arrhythmias
39
Q

Advantages of using Doppler

A

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

40
Q

Disadvantages of using Doppler

A

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

41
Q

How do you measure oxygenation?

A

Pulse oximeter

blood gas

42
Q

Hypoxemia

A

Reduction of oxygenation of arterial blood

PaO2

43
Q

When do you use a pulse oximeter?

A

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

44
Q

Normal PaO2

A

35-45mmHg

45
Q

PaCO2 greater than 45mmHg

A

Hypercapnia

Hypoventilation

46
Q

PaCO2 at 35-45mmHg

A

normocapnia

normoventilation

47
Q

PaCO2 less than 35mmHg

A

Hypocapnia

hyperventilation

48
Q

Capnometry

A

Measurement of CO2 partial pressure in the airways

49
Q

Capnometer

A

only measures the ET CO2

50
Q

Capnograph

A

continuously displays ET CO2 vs. time on a graph

51
Q

What factors influence ET CO2 values?

A

CO2 production
Circulation
Alveolar ventilation
Measurement error

52
Q

What are the phases of a capnograph?

A

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

53
Q

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

A

Median Artery

54
Q

Where do you place the Doppler sensor in the Donkey?

A

Tail

RUSVM Anesthesiology 2016 (38 decks)

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