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Basics of Anesthesia > Quiz 3 > Flashcards

Quiz 3 Flashcards

1
Q

What is vapor pressure?

A

in enclosed space at a constant temperature, with a volatile liquid, there will be an equilibrium between vapor and liquid below vapor- # of molecules exiting liquid for gas phase equals number of molecules returning to the liquid phase

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2
Q

Do you want a vaporizer to have high or low thermal conductivity?

A

high- will minimize temp changes that occur with vaporization to achieve constant flow of gas

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3
Q

Describe variable bypass vaporizers and where it is located

A

splits gas into the vaporizer (above and through the liquid agent); outside circle system

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4
Q

Which gas uses an electronic vaporizer and why?

A

des- has a high vapor pressure

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5
Q

How does the electronic vaporizer work?

A

injects known amount of liquid anesthetic into known volume of gas

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6
Q

What is the electronic vaporizer called?

A

Tec 6

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7
Q

What does the bimetallic strip do?

A

bends depending on temp to alter splitting ratio (sends more flow into vaporizer if cold)

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8
Q

What is the electronic vaporizer called, and what are its two characteristics?

A

Tec 6- heated and pressurized

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9
Q

What way do the control knobs move on the vaporizers?

A

counter-clockwise

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10
Q

What does the wick do in vaporizers?

A

gives the air more time to come up to desired concentration of agents

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11
Q

In the Tec 6, what temp is the gas heated to and pressurized at?

A

39 C, 1300 mmHg (or 2atm)

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12
Q

Will the partial pressure decrease with altitude in the Tec 6?

A

yes- does not compensate

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13
Q

What does the interlock system do?

A

prevents more than one agent being used at a time

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14
Q

The Tec 6 is a ? circuit

A

dual

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15
Q

What is the T setting on the vaporizers?

A

transport setting- prevents liquid from getting into the chamber (must use a new one if it does this)

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16
Q

What happens if you put sevo in an iso vaporizer?

A

You get a lower output (sevo has a lower VP than iso)

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17
Q

What would happen if you put iso in a sevo vaporizer?

A

You would get a higher output (iso has higher VP than sevo)

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18
Q

What would happen if you put halothane in an iso vaporizer?

A

nothing- similar VP

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19
Q

Describe laminar flow and what is the primary factor?

A

smooth, orderly, parallel to walls; flow fastest in the center; viscosity

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20
Q

Describe turbulent flow and what is the primary factor?

A

flow lines are not parallel; density

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21
Q

What are 3 things that change flow from laminar to turbulent?

A

change in gas direction >20 degrees, increased velocity, corrugated tubes

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22
Q

Reynolds number values

A

<2000- laminar >4000- turbulent

23
Q

Mapleson circuits for spontaneous breathing in order of efficiency

A

ADCB (all dogs can bite) *D includes E, F, Bain’s

24
Q

Mapleson circuits for mechanical ventilation in order of efficiency

A

DBCA (dead bodies can’t argue) *D includes E, F, Bain’s

25
Q

In what situation is capnography most accurate?

A

closed/semi-closed system

26
Q

Normal capnography shape is a ? in what type of ventilation?

A

top hat- mechanical

27
Q

Describe phase 1

A

inspiratory baseline- should be near zero (if not, then rebreathing CO2)

28
Q

Describe phase 2

A

expiratory upstroke- emptying of connecting airways and alveoli; mixing of anatomic and alveolar deadspace

29
Q

Describe phase 3

A

expiratory plateu- uneven emptying, end expiration

30
Q

Where is end tidal CO2 read on capnography?

A

end of phase 3 at the beta angle

31
Q

Describe phase 4

A

inhalation; CO2 free gas enters airways

32
Q

What is the normal alpha angle and when does it increase?

A

100-110 degrees; obstructive disease (COPD)

33
Q

What is the normal beta angle and when does it increase?

A

90 degrees; rebreathing

34
Q

What is the normal gradient between arterial and end tidal CO2?

A

2-5 mmHg

35
Q

What is happening here and when is it good and bad?

A

“curare cleft”- pt initiating own breath (good at the end of a case, bad in the middle)

36
Q

What is happening here?

A

COPD

37
Q

What is happening here?

A

obstruction both ways (kinked ETT, bronchospasm)

38
Q

What is happening here?

A

elevated baseline- rebreathing (could be result of exhausted CO2 absorber)

39
Q

What is happening here?

A

cardiac oscillations (not breaths)

40
Q

What happens when there is a leak in the bellows?

A

Can cause high pressure (barotrauma) and increase FiO2

41
Q

Which type of bellows is better and why?

A

ascending- will not rise if patient is disconnected

42
Q

What does the weight of the bellows do?

A

adds PEEP

43
Q

What is fresh gas decoupling?

A

separates FGF from the TV during inspiration

44
Q

What is circuit compliance?

A

the “stretch” in the circuit that may affect the TV delivered to the patient if the machine does not compensate for it

45
Q

How do you calculate the TV if the machine does NOT decouple?

A

TV + FGF (FGF x I:E ratio as fraction/RR)

46
Q

How do you calculate circuit compliance if the machine does not compensate for it?

A

compliance x PIP

47
Q

How do you calculate total TV is the machine does NOT decouple and does not compensate for circuit compliance?

A

(TV + FGF) - circuit compliance

48
Q
A

Mapleson A (APLon patient side)- added expiratory limb

49
Q
A

Mapleson B (both APL and FGF on patient side with corrugation)- long expiratory limb

50
Q
A

Mapleson C (no corrugation)- not efficient

51
Q
A

Mapleson D (distant APL) - good for down lung cases

52
Q
A

Mapleson E (no bag and valve) T piece

53
Q
A

Mapleson F (no valve), attached scavenger

Basics of Anesthesia (8 decks)

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