Monitors

Question 1

Giving vasodilator affect on map and sbp

Answer 1

The maps would both decrease the same, however the sbp would decrease more distally and less so at the aorta

Question 2

Natural frequency vs dampening

Answer 2

Essentially they are opposites, the more frequency the more points to measure the less dampening

Question 3

Dampening is caused by

Answer 3

Things that affect the monitor
Lengthining the tube, air bubbles, multiple or loose connections and decrease in frequency

Dampening is the oppsoite of frequency so these things all increase dampening and decrease frequency

Question 4

Arterial line thrombus

Answer 4

A larger catheter, propylene glycol, high dose vasopressor, artery size, and puncture attempts and female gender

Question 5

Blood pressure cuff oversized

Answer 5

Oversized: has to have width greater then 40-50% of the circumfrrnce of arm, 20% greater diameter, the bladder length encircling 60% of arm

Less pressure is needed with over sized cuff leading to under estimation

No evidence of inappropriately placed cuffs leads to nerve damage or ischemia

Question 6

Hypothermia

Answer 6

Causes osbourne waves

Question 7

Digitalis

Answer 7

Can cause salvatorndali mustache sign, pvc and av block

Question 8

Wedge pressure

Answer 8

Estimates lvedp

This can be affected by cardiac compliance. If muscle is stiff then pressure will grow disproportionately to volume.

Question 9

Likely site of central line insertion with chylothorax

Answer 9

Left subclsvian

Question 10

Cleanest site of central line insertion

Answer 10

Subclavian, then ij, then femoral

Question 11

Contraindication to pulm artery catheter

Answer 11

Presene of a lbb because the catheter can cause a rbb causing completr heart block

Question 12

Map and sbp aorta vs wrist

Answer 12

The map will be higher at aorta and decrease slightly as you get closer to wrist allowing blood to flow

The wave form exaggerates as you move farther away making systolic blood pressures higher

Question 13

Blocking artert of adamkovicz resembles

Answer 13

Anterior spinal artery so motor gets blocksd

Question 14

Best core

Answer 14

Typanic

Bladder and pulm artery also possibles

Question 15

Hypothermia in or

Answer 15

Phase on is due to vasodilation and redistribution from core to periphery

Phase two is further redis and conduction

Phase three is steady state 4-6 hrs in

Question 16

Anesthetic affect on evoked potentials

Answer 16

Brainstem auditory is least affected then ssep then mep and then visual

Question 17

Minimum o2 needed before i2 pressure sensor valve turns off

Answer 17

25 psi

The second stage of o2 pressure regulator drops o2 down to 16

Question 18

Ohmeda bellows

Answer 18

Use o2

Question 19

Rotatmeter read in middle ofnpin

Answer 19

Ball float

Question 20

Splitting ratio

Answer 20

Depends on anesthetic agent temp chosen vapor conc to be deliveredand saturated vapor pressure

Question 21

Fail safe vs o2 analyzer

Answer 21

Fail safe makes sure there is a 25 psi o2 with n20

Oxygen analyzer avoids hypoxic gas mixtures

Question 22

When n20 is used w vaporizer

Answer 22

Some n20 is absorbed into the vaporizing chamber and so a little less is delivered but then when you shut off n20 the n20 leaves the gas fluid and transiently causes an increase of vaporizor output

Question 23

Capnogran

Answer 23

If co2 doesnt return to zero, patient rebreathing co2. Differential includes incompetent expiratory valve exhausted co2 or gas channeling through co2 absorbent

If inspiratory downstroke is slanted think insp valve problem

Question 24

Most common complication of direct laryngoscopy

Answer 24

Dental trauma, should get xray to see where tooth went and dental consult

Question 25

Piss vs diss

Answer 25

Pin index fkr gas canisters

Diameter index for wall

Question 26

Fail safe vs o2 analyzer

Answer 26

Fail safe makes sure there is a 25 psi o2 with n20

Oxygen analyzer avoids hypoxic gas mixtures

Question 27

When n20 is used w vaporizer

Answer 27

Some n20 is absorbed into the vaporizing chamber and so a little less is delivered but then when you shut off n20 the n20 leaves the gas fluid and transiently causes an increase of vaporizor output

Question 28

Capnogran

Answer 28

If co2 doesnt return to zero, patient rebreathing co2. Differential includes incompetent expiratory valve exhausted co2 or gas channeling through co2 absorbent

If inspiratory downstroke is slanted think insp valve problem

Question 29

Most common complication of direct laryngoscopy

Answer 29

Dental trauma, should get xray to see where tooth went and dental consult