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Respiratory Physiology > pulm intraop monitoring and difficult airway > Flashcards

pulm intraop monitoring and difficult airway Flashcards

1
Q

pulse ox measures a difference between background absorption in ___ and peak absorption in ___.

A

diastole, systole

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2
Q

plethysmography displays as a waveform the differences in absorption during

A

arterial pulsation in systole

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3
Q

infrared nm

A

940

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4
Q

infrared is for

A

oxyhemoglobin

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5
Q

infrared corresponds to ___ saturation

A

100

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6
Q

red light nm

A

660

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7
Q

red is for

A

deoxyhemoglobin

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8
Q

red light corresponds to ___ saturation

A

50

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9
Q

PAO2 ___ ___ __ for Sat ___ ___ ___

A

40 50 60 . 70 80 90

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10
Q

mixed venous blood in PA

A

75, 40

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11
Q

tissue damage by pulse ox caused by

A

heat from light source (rare) or sensor pressure (more common) may cause tissue damage

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12
Q

what happens if you use standard pulse ox in MRI

A

patient gets burned

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13
Q

endobronchial intubation and pulse ox

A

undetected

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14
Q

limitations of pulse ox.

A

HYPO tension, thermia, volemia (shock), perfusion. vasoconstriction. asystole. vfib. BP cuff inflation, tourniquet

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15
Q

carboxyhemoglobin on pulse ox

A

shows spo2 of 100 (overestimates)

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16
Q

methemoglobin on pulse ox

A

absorbs equally at both wavelengths, shows SPO2 of 85% regardless of the true oxygen saturation

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17
Q

what causes methemoglobinemia

A

nitrates, benzocaine spray, nitro, sulfonamides, nitrites, nitroprusside

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18
Q

how to treat methemoglobiema

A

give methylene blue or ascorbic acid

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19
Q

2 things that do not affect pulse ox

A

fetal hemoglobin and bilirubin

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20
Q

poor accuracy at SPO2

A

30

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21
Q

for pulse ox, if Hb __

A

3-4

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22
Q

venous pulsations

A

SPO2 thinks they are arterial. like R heart failure (cor pulmonale) or tricuspid regurg . seen in dependent down limb

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23
Q

malpositioned sensor

A

penumbra effect - shows SPO2 of 90-95

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24
Q

capnography rapidly and reliably indicates ____ intubation but does not reliably detect ____

A

esophageal. endobronchial

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25
Q

gold standard for tracheal intubation

A

ETCO2

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26
Q

capnograph

A

records and displays CO2

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27
Q

CO is depicted graphically as a ___ recorded by a ____ and measured by a

A

capnogram, capnograph, capnometer

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28
Q

aspiration (sidestream) capnograph

A

continual suction of gas from breathing circuit.

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29
Q

aspiration (sidestream) capnograph aspiration rates

A

50-250ml/min

30
Q

aspiration (sidestream) capnograph CO2 concentration is determined by

A

infrared absorption

31
Q

aspiration (sidestream) capnograph is prone to

A

water precipitation and erroneous readings

32
Q

AB

A

beginning exhalation, dead space gas

33
Q

BC

A

exhalation, mixing of gases

34
Q

CD

A

alveolar plateau, alveolar rich gas

35
Q

D

A

highest CO2

36
Q

DE

A

start inspiration

37
Q

early spont breath capnogram

A

muscle relaxant wearing off

38
Q

exp valve failure or depleted CO2 absorber shows

A

elevation of baseline

39
Q

inspiratory valve failure allows you to

A

exhale up the insp limb. causing rebreathing. go up on your flows

40
Q

dCO2 definition

A

normal ETCO2 to arterial CO2 gradient

41
Q

dCO2 normal

A

2-5mmhg

42
Q

carbon dioxide diffusion coefficient: dCO2 reflects

A

alveolar dead space

43
Q

any significant reduction in lung perfusions ___ alveolar dead space and ___ dCO2

A

increases, increases

44
Q

PaCO2 will always be ___ than ETCO2 why?

A

mixing and dilution with the dead space gases

45
Q

what increases dCO2

A

decreased pulm artery pressure, upright posture, PE, COPD, mechanical obstruction of PA, cuff leak, tracheal disruption, bronchopleural fistula, decreased CO or decreased BP

46
Q

hypoventilation causes ____ etco2

A

increased

47
Q

MH causes ___ etco2

A

increased

48
Q

laparoscopy causes ____ etco2

A

increased

49
Q

CO2 inflation causes ____ etco2

A

increased

50
Q

hyperthermia causes ____ etco2

A

increased

51
Q

improved blood flow to lungs after hypotension resuscitation causes ____ etco2

A

increased

52
Q

water in capnograph causes ____ etco2

A

increase

53
Q

tourniquet released causes increased

A

increased

54
Q

CO2 absorber exhausted causes ____ etco2

A

increased

55
Q

inadequate fresh gas flow causes

A

increased

56
Q

faulty valves in circuit causes ____ etco2

A

increased

57
Q

most common cause of decreased ETCO2

A

hyperventilation

58
Q

airway leak, leak around cuff

A

decreased

59
Q

decreased blood flow to lungs causes ___ etco2

A

decreased

60
Q

PE causes ____ etco2

A

decreased (blockage can’t exhale )or increased (increased dead space)

61
Q

arrhythmias causes ___ etco2

A

decreased

62
Q

incipient pulm edema causes ____ etco2

A

decreased

63
Q

hypothermia causes ___ etco2

A

decreased

64
Q

inadequate sample volume causes ____ etco2

A

decreased

65
Q

sample catheter misplaced causes ____ etco2

A

decreased

66
Q

decreased pulm artery pressure causes ____ etco2

A

increased

67
Q

upright posture causes ____ etco2

A

increased

68
Q

COPD causes ____ etco2

A

increased

69
Q

mechanical obstruction of PA causes ____ etco2

A

increased

70
Q

cuff leak, tracheal disruption, bronchopleural fistula causes ____ etco2

A

increased

71
Q

decreased CO or decreased BP causes ____ etco2

A

increased

Respiratory Physiology (11 decks)

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