Monitors Flashcards
Flow volume loop what’s on top and what’s on bottom
expiration on top, inspirations on bottom
flow volume loop, bottom is blunted
variable extrathoracic obstruction
flow volume loop, top is blunted
variable intrathoracic obsturction
flow volume loop, both blunted
fixed large airway obstruction
peak pressures represents what
maximal resp pressure reached at end-inspiration
Sum of PEEP + Pelastic and Pres
after elimination of resistance, resultant pressure will represent what
plateau pressure
what is plateau pressure
sum of elastic pressure plus Peep
peak alveolar pressure equivalent
what is resistive pressure
pressure required to generate constant laminar flow in the airways at initiation of inspiration , increased in asthma, pulm edema acute, ards, copd
Dynamic effective compliance
= (Peak - PEEP)/tidal volume, compliance and resistance components but measures impedence
Pplat - PEEP = ???
Elastic pressure, pressure necessary to maintain progressive inflation of resp system
Static effective compliance
= (Plateau - PEEP)/tidal volume
what is dynamic effective compliance reduced by
decreased in lung or chest wall compliance or increase in resistance
airway occlusion pressure
measurement of resp NM activity, developed at trachea during first 0.1s of inspiratory effort against occluded airway (normal 90cm)
maximal inspiratory pressure
isometric pressure measured in totally occluded airway after 20 seconds of 10 breathing efforts. more negative is ability to tolerate extubation, less than -20 is contraindication
wavelengths that pulse ox emits
660nm red and 940nm near infrared
oxygenated blood absorbs what from pulse ox
absorbs more IR light, deoxygenated blood absorbs more red light
falsely normal/high SpO2 with leftward shift in dissociation curve
carboxyhemoglobinemia and methemoglobinemia
falsely normal or high SpO2 with rightward shift in diss curve
sulfhemoglobinemia
as a person ages, there’s an expected _____ in PaO2
decrease
A-a gradient in healthy individuals
10
A-a gradient normal in presence of hypoxemia, then hypoxemia is secondary what
hypoventilation or decreased inspired oxygen
A-a gradient increased in presence of hypoxemia then it’s secondary to what
V/Q mismatch, pulmonary shunt, diffusion barrier
If both pH and PaCO2 move in same direction is it resp or metabolic
metabolic
normal anion gap causes
fistulas (pancreatic), saline admin, hyperPTH, diarrhea, carbonic anhydrase inhib, RTA, spironolactone
as temp decreases, solubility of O2 and CO2 ______
increases
as temp decreases, PO2 and PCO2 ______
decrease
for every decrease in temp 1C, pH will increase by _______
0.015
volatile agents effect on EEG
progressive depression at higher doses, burst suppression at 1.5 MAC
IV anesthetic affect on EEG
at higher doses, produce typical EEG anesthetic depression
Nitrous oxide and ketamine effect on EEG
N2O produces fast oscillatory EEG, ketamine increases theta, no burst suppression
Opioids effect on EEG
loss of beta waves, slow alpha waves, increase in delta waves
precedex EEG
slow-wave sleep
hypoglycemia EEG
increased delta and theta
CBF EEG
rapid and progressive changes, loss of high-frequency activity, loss of power and EEG silence
delta (0-4hz)
deep sleep, vague dreams
theta (4-8Hz)
drowsiness
Alpha (12-25Hz)
awake, non-focused, eyes closed
beta (12-25)
awake and alert, focused attention, problem solving, eyes open
Gamma (25-100)
extreme focus, cognitive processing
initial intraop temp drop cause
redistribution
most heat lost in periop setting
radiation
critical velocity =
reynolds numberviscosity / densityradius
fixed-orifice flowmeters
channel gas thorugh narrowed conduit, narrowing increases resistance to flow dropping the pressure of the gas as it exits, velocity and pressure flowmeter
variable orifice flowmeter
use drop in pressure across resistor to calculate flow but contain a flap that opens the diameter of the orifice at high flows and narrows at low flows
Thorpe tube
constant pressure, variable orifice, bobbin stops rising or falling when pressure difference above and below equals weight
Bourdon tube
measure and display high pressure of gas cyclinders, contstnt orifice and variable pressure
high airway pressure alarm
when peak or plateau pressure reaches above set threshold
continuing pressure alarm
when pressure is greater tha 10cm H2O for more than 15 seconds, signals that gas is unable to exit system and pressure is gradually building within, relief valve is stuck, oxygen flush activated, APL closed, scavenging system occluded
low pressure alarm
when circuit doesn’t reach a min threshold within specific period of time
airway fire steps
remove tracheal tube, stop flow of airway gases, remove any flammable material, pour saline
line isolation system
protect people from electrocution in OR by power isolation and continuous monitoring of the isolated power system integrity, designed to detect short circuits or leakage currents and to alert OR personale if peice of equip is no longer isolated from ground
microshock
current applied directly to the heart, LIM will not alarm for these currents
macroshock
occurs when much larger current passes through the body usually skin
_____ the transthoracic impedance against an electrical current can improve successful defibrillation
decreasing
ways to decrease impedance of defibrillation
applying firm pressure (25lb), proper paddle sizes and gel, defibrillation during end-expiration, stacked shock strenghts
when on ekg does synchronized cardioversion take place
R wave of QRS
