Surgery Midterm Flashcards
Instrument metal that is harder and stronger, used for thumb forceps, hemostats, retractors, and needle holders.
Martensitic Steel
Instrument metal that is softer, high tensile strength resistant to corrosion, surgical implants, bowls, pans and trays are usually made out of this.
Austenitic Steel
Occasionally used as inserts in tips of instruments especially needle holders, often identified by golden handles.
Tungsten Carbide
Cleans by a process called cavitation, utilizes high frequency vibrations to remove dirt.
Ultrasonic Cleaning
What are three ways to lubricate medical instruments?
Instrument detergents that contain lubricants, lubricant sprays, instrument milk
Common methods of instrument sterilization
Steam autoclave
Ethylene oxide gas
Cold sterilization
Gas cylinders contain _____ or _____ ____ for deilvery to the patient
Oxygen or nitrous oxide
Oxygen is delivered at ____% versus room air which is __-___%
100%, 20-21%
Oxygen cylinders are colorer _____
Green
Volume in any E cylinder can be calculated by multiplying the pressure in pounds per square inch by __
0.3
Full Oxygen tank
2200 PSI / 660 Liters
1/2 full oxygen tank
1100 PSI / 330 Liters
Nitrous Oxide containers are ____
Blue
What is different on nitrous oxide and oxygen to avoid confusion?
Pin number on the yoke
Gas enters at the ___, exits at the ___, displacing the rubber or plastic gauge
bottom, top
What is the minimum oxygen flow rate to a patient?
1/2 Liter (500 mL)
Wick in a glass jar absorbs anesthetic to increase surface area, as oxygen flows past wick it collects the anesthesia to carry to the patient
Non-Precision Vaporizor
Designed for use with one anesthetic only, deliver exact concentration of gas as dialed
Precision Vaporizor
Allows oxygen to bypass vaporizer and enter the breathing circuit, containing no anesthetic gas. Best to depress when patient is not directly attached to the system
Oxygen flush valve
Dilutes the concentration of inhalation agent delivered
Oxygen flush valve
A low pressure hose that carries gas and/or gas mixed with anesthetic to the breathing circuit, preventing return of this gas to other components
Fresh Gas inlet
Minimum volume bag to select for a patient
60 ml/kg
Periodic bagging helps prevent ____
Atelectasis
Flushes the alveoli and airways with fresh gas, necessary when animal is not breathing on its own
Bagging
What occurs when a bag is overinflated?
Back pressure into the lungs and can cause alveoli to break
Maximum amount to bag
15-20 cm H2O (mm HG)
If the scavenger is too strong, what may occur to the bag?
Under inflation
On exhalation, the gas passes through the exhalation hose and either to the ___ ____ ___ or into the ____ _____
Pop off valve, CO2 Canister
Prevents buildup of excessive pressure in the system
Pop Off Valve
What two instances should the pop off valve be closed for?
Bagging a patient, conducting a leak test
Gases that do not exit via the pop off valve go where?
CO2 Canister
___ ___ in canisters cleanses CO2 from the circuit
Soda lime
When should CO2 canisters be changed?
Every 6-8 hours of use
Usually situated on top of the CO2 absorber, measures pressure within the circuit
Pressure manometer
Pressure should not exceed ___ cm H2O or mmHg
20 cm
Rebreathing circuits are available in what sizes?
3: pediatric, large animal, adult
2 types of rebreathing systems
Closed, semi-closed
What breathing circuit is used for animals <5-7 kg?
Non-rebreathing
This breathing circuit has no inhalation flutter valve, allowing gas to flow directly through the fresh gas inlet to the inlet hose for delivery to the patient.
Non-rebreathing system
What breathing circuit reduces resistance associated with breathing
Non-rebreathing
Mask induction level
300 ml/kg/min
Intubation after induction with injectable drugs (level)
200 ml/kg/min
Non-rebreathing flow rates
High, 200 ml/kg/min
Rebreathing flow rates (closed and semiclosed)
Closed: 15 ml/kg/min
Semi-closed: 25-50 ml/kg/min
Flow rates at the end of anesthesia are _____ immediately to the flow rates used during induction
increased
What does inceasing flow rates fo recovery do?
Saturates anesthetic circuit with oxygen
Dilutes the expired concentration of gases, replacing them with pure oxygen
More rapid recovery results
What are some long term effects of anesthetic gas exposure?
Reproductive disorders, liver and kidney damage, nervous system dysfunction
What anesthetics are considered greater hazards?
Methoxyflurane, halothane
Do waste anesthetic gases have cancer causing effects?
No
Whenever possible avoid being closer than ___ feet from the nose of an animal recovering from anesthesia
3 minutes
Hoses, reservoir bags, masks, ET tubes, and other rubber components can be washed with?
Soap and water (minimal soap, usually chorohexadine)
What is available if human exposure to injectable agents?
Narcotic reversing agents
Delivers anesthetic gases directly from the anesthetic machine to the lungs
Endotracheal tubes
ET tubes with beveled end and side holes, possible cuff
Murphy tube
ET tube with no side hole or cuff, abrupt decrease in diameter of tube, used in birds and reptiles
Cole tubes
Clear and stiff material used for ET tubes
Polyvinyl chloride
Flexible, less traumatic, absorbant ET tube material, may kink or collapse
Red rubber
Pliable, strong, less irritating ET tube material, resists collapse
Silicone
ET tubes are measured by ____ diamter
Internal diameter
ET tubes range in size from __ - __ mm
1-30mm
Clear, aquarium like boxes used to induce general anesthesia
Anesthetic chambers
Used in feral, vicious, or intractable animals to reduce stress
anesthetic chamber
Anesthetic chambers are either ____ or ____
Acrylic or Perspex
Disadvantage of anesthetic chambers
Can not monitor patient closely
Carrier gas for anesthetic machines is either _____ or ____ ____
Oxygen or nitrous oxide
Small cylinders attached directly to anesthetic machine
E tanks (small)
Large cylinder attached remotely to anesthetic machine
H Tanks (large)
Reduces outgoing pressure to a usable level
Pressure reducing valve
In Canada, oxygen cylinders are white, in the US they are _____
Green
Nitrous cylinders are what color?
Blue
Carbon dioxide cylinders are what color?
Gray
What color are medical air cylinders?
US- yellow
Canada/Europe- white and black
Pressure reducing valves (pressure regulator) reduce gas pressure to a constant __-__ psi
40-50 psi
Indicated pressure in the gas line between the pressure reducing valve and flowmeter
Line Pressure Gauge
Line pressure gauge should read __-__ psi after the oxygen tank is opened
40-50 psi
Sizes of laryngoscopes for small animals
0-5
Size of laryngoscopes for large animals
18 inch blade
Indicated gas flow in liters per minute
Flowmeter
Where carrier gas enters a vaporizer from the flowmeter
Vaporizer inlet port
Bypasses vaporizer and flowmeter, delivers short, large burst of pure oxygen directly into rebreathing circuit, used to refill rebreathing bag to deilver pure oxygen to a patient
Oxygen Flush Valve
Used to deliver low vapor pressure anesthetics, rarely used
Non-precision Vaporizer
Used to deliver high vapor pressure anesthetics
Precision Vaporizers
Precision vaporizers, high resistance gas flow
VOC (Vaporizer Out of Circuit)
Low resistance gas glow, Non precision vaporizer
VIC (Vaporizer in circuit)
In these vaporizers, oxygen from the flowmeter enters the vaporizer prior to entering the breathing circuit
VOC
In these vaporizers, oxygen enters the breathing circuit from the flowmeter, exhaled gases pass through the vaporizer
VIC
Due to manual ventilation or activation of oxygen flush valve
Back pressure
Color code for Isoflurane
Purple
Color code for Sevoflurane
yellow
Color code for Halothane
red
Color code for Desflurane
blue
Induction rate for Isoflurane
3-5%
