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NURG 7017 > test 3: Anesthesia machine part 1 > Flashcards

test 3: Anesthesia machine part 1 Flashcards

1
Q

what is the systems name that defines the standards for equipment administering anesthetics to patients consisting of the anesthesia gas supply device, the anesthesia ventilator, monitoring device, and protection device.

A

American society for testing and materials.

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2
Q

name the five components of the anesthesia workstation?

A

electrical components
pneumatic system
high pressure system
intermediate pressure system
low pressure system

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3
Q

the master switch activates both the _____ and _____ functions.

A

pneumatic and electrical

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4
Q

when the master switch is in the OFF position, the only electrical components that are active are?

A

the battery charger and the electrical outlets

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5
Q

on some machines the electrical components can be activated without ______ power.

A

pneumatic

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6
Q

the standby position is frequently used on computer controlled machines to allow the system to do what?

A

powered up quickly

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7
Q

most electronic machines have a mean to ______ a checkout in case of an emergency

A

bypass

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8
Q

describe a power failure indicator?

A

a visual and/or audible indicator to alert the anesthesia provider to the loss of main power.

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9
Q

the battery status should be checked when?

A

during the preuse checkout procedure

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10
Q

electricity is crucial for many machine functions so what is necessary in case of a power outage?

A

backup source of power

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11
Q

the electrical outlets on the anesthesia machine are intended for what?

A

to power monitors and other devices

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12
Q

can the power outlets on the back of the anesthesia machine supply power in case of a power outage?

A

no

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13
Q

circuit breakers are present for both the anesthesia machine and the ______.

A

outlets

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14
Q

what is used to communicate between the machine, monitors, and the data management system?

A

data communication ports

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15
Q

the pneumatic system is divided into _____ parts.

A

three

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16
Q

the high pressure system recieves gases from ________ at high _____ pressures and reduces those pressures to lower more constant pressures suitable for use in the machine.

A

cylinders

variable

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17
Q

name the components of the high pressure system?

A

cylinder
hanger yoke
cylinder pressure indicator
pressure regulator (primary)

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18
Q

what is the purpose of the hanger yoke?

A

to orient and support the cylinder, provide a gas tight seal, and ensure unidirectional gas flow.

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19
Q

there must be at least one hanger yoke for what two gases?

A

oxygen and nitrous oxide

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20
Q

name the parts of the hanger yoke?

A

body
retaining screw
nipple
index pins
washer
filter
check valve assembly

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21
Q

describe the purpose of the body of the hanger yoke?

A

framework and support structure for the hanger yoke

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22
Q

describe the purpose of the retaining screw of the hanger yoke?

A

tightens the cylinders in the yoke

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23
Q

describe the purpose of the nipple of the hanger yoke?

A

site where gas enters the machine

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24
Q

describe the purpose fo the index pins of the hanger yoke?

A

prevent attachment of incorrect cylinder

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25
Q

describe the purpose of the washer fo the hanger yoke?

A

helps form a seal between the cylinder and the yoke

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26
Q

describe the purpose of the filter of the hanger yoke?

A

remove particulate matter

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27
Q

describe the pupose of the check valve assembly of the hanger yoke?

A

ensures unidirectional flow of gases through the hanger yoke.

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28
Q

if a circuit breaker is activated on the anesthesia machine what should happen?

A

the electrical load should be reduced and the circuit breaker reset

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29
Q

downstream means?

A

closer to the air source

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30
Q

upstream means?

A

further away from the gas source

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31
Q

the psi on oxygen in the high pressure system is?

A

2000 psi

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32
Q

the psi of nitrous oxide on the high pressure system is?

A

750 psi

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33
Q

you should ensure that the cylinder valves and hanger yoke are free of oil and grease to prevent a?

A

fire hazard

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34
Q

how many washers should be around the nipple on a hanger yoke?

A

one
more than one washer can prevent a tight seal or override the PISS system

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35
Q

the scale on the cylinder pressure indicator in the high pressure system should be at least ____% greater than the maximum filling pressure of the cylinder or the full indication position

A

33%

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36
Q

the most common cause of a leak in the high pressure system is?

A

a defective or missing washer

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37
Q

what is the ASTM standard for the pressure indicator for cylinders?

A

must be a pressure indicator for each gas that is supplied by a cylinder

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38
Q

what is the ASTM standard for the primary pressure regulators?

A

there must be a pressure regulator present for each gas supplied by a cylinder

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39
Q

pressure regulation is performed manually or automatically?

A

automatically

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40
Q

what is the purpose of the cylinder pressure indicator?

A

display the pressure for each gas supplied by a cylinder

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41
Q

what is the purpose of the primary regulator?

A

reduce high and variable pressure of the cylinder to a lower, more constant pressure suitable for the anesthesia machine

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42
Q

where is the two locations for the cylinder pressure indicator?

A

near the cylinder or in the front of the anesthesia machine

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43
Q

what is the main type of pressure indicator?

A

bourdon type

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44
Q

cylinder pressure inicators are required to be calibrated in _________ but ____ may also be used.

A

kilopascals (kPa)

pounds per square inch (PSI)

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45
Q

what is the pressure in the intermediate pressure system?

A

50-55 psi

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46
Q

the intermediate pressure system recieves gases from?

A

the pressure regulators of cylinders or the pipeline inlet

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47
Q

name the components in the intermediate pressure system?

A

master switch

pipeline inlet

pipeline pressure indicators

piping

gas power outlet

oxygen pressure failure devices (oxygen failure safety device and oxygen supply failure alarm)

gas selector switch

second stage regulators

oxygen flush

flow control valves

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48
Q

what is usually independent of the master switch?

A

oxygen flush

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49
Q

the master switch does what?

A

allows oxygen to enter the pneumatic components

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50
Q

if the master switch is off, pressure in the intermediate system will drop to?

A

zero

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51
Q

the master switch is located downstream of what two things?

A

the inlets for the cylinders and the pipeline

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52
Q

what is the ASTM standard for pipeline inlets?

A

there must be a pipeline inlet connection for both oxygen and nitrous oxide

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53
Q

what is the purpose of the pipeline inlet connection?

A

entry point of gases from the pipeline

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54
Q

pipeline gas provide the anesthesia machine with gas at a more constant and low pressure compared to cylinders, usually ___ to ____ psi

A

50 to 55 psi

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55
Q

each pipeline inlet must have a filter with a pore size of ______ or less

A

100 μm

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56
Q

the pipeline Inlets are fitted and threaded, and non-interchangeable creating what?

A

the diameter index safety system fittings (DISS)

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57
Q

Each pipeline inlet must contain what?

A

filter and unidirectional valve

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58
Q

the purpose of the unidirectional valve in the pipeline inlet connection is?

A

prevent backflow from the machine into pipeline or atmosphere

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59
Q

what is the ASTM standard for pipeline pressure indicator?

A

there must be one present for each pipeline gas

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60
Q

the pipeline pressure indicator must be on this side of the?

A

check valve

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61
Q

where are the pipeline pressure indicators usually located?

A

on the front of the anesthesia machine

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62
Q

what is the purpose of piping in the intermediate pressure system?

A

connect the components inside of the machine

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63
Q

what is the ASTM standard for piping in the intermediate pressure system?

A

must be able to withstand four times the intended service pressure without interruption.

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64
Q

leaks between the pipeline inlet or cylinder pressure reducing system and the flow control valve are not to exceed?

A

25 mL/min

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65
Q

if the yoke and pressure reducing system are including with the pipeline inlet and to the flow control valves the leaks are not to exceed?

A

150 mL/min

66
Q

if there is a leak greater than ASTM standards what will happen during the system checkout?

A

the system checkout will fail

67
Q

the intermediate pressure system begins at?

A

the pipeline inlets

68
Q

the intermediate pressure system ends at the?

A

flowmeter control valves

69
Q

what is the purpose of the gas power outlet?

A

may serve a driving gas for ventilator or as the supply gas for the jet ventilator

70
Q

how many gas power outlets are present on the anesthesia machine?

A

one or more may be present

71
Q

what type of gas should be used with the gas power outlet?

A

ox

72
Q

what is a consideration about modern ventilators and the gas power outlet?

A

may not be found on modern anesthesia machines due to the ventilator being integrated inot many anesthesia machines

73
Q

name the two types of oxygen pressure failure devices?

A

oxygen failure safety device and oxygen supply failure alarms

74
Q

without detection, depleted oxygen supply, can result in what being delivered to the patient?

A

100% anesthetic delivery

75
Q

oxygen pressure failure devices aid in preventing hypoxia caused by problems that arise _____ of the machine circuit

A

upstream

76
Q

when the pneumatic system is on, oxygen pressure reaches the oxygen failure safety device, it allows what to happen?

A

other gases to flow (nitrous oxide)

77
Q

if the pneumatic system is turned off, what happens to the oxygen and other gases?

A

oxygen is vented to the atmosphere, the oxygen failure safety device detects a drop in pressure and ceases the flow of other gases.

78
Q

even if the oxygen pressure failure devices are activated does it prevent the delivery of a hypoxic gas?

A

no because a mixture of gas is still present downstream.

79
Q

standards require that oxygen concentration not fall below ____% at the common gas outlet when oxygen pressure is reduced below the manufactures specific minimum which is?

A

19%

20-30 PSIG

80
Q

ASTM standard specifices that a fall in oxygen supply pressure below the manufacturer specified threshold, usually _______ PSIG occurs, at least a medium priority alarm shall occur within ____ seconds.

A

20-30 PSIG

5 seconds

81
Q

other names for the oxygen failure safety devices are?

A

low pressure guardian system

oxygen failure protection system

nitrous oxide shutoff valve

fail safe

pressure sensor

82
Q

what is the purpose of the gas selector switch?

A

prevents nitrous oxide and air from being used together, preventing a hypoxic mixture.

83
Q

is gas selector switch present on all anesthesia machines?

A

no

84
Q

are second stage regulators required?

A

no

85
Q

what is the purpose of a second stage regulator?

A

to eliminate fluctuations caused by pipeline pressure fluctuations in pressure supplied to the flow indicators

86
Q

if a second stage regulator is present they will be just upstream of the ?

A

flow indicators

87
Q

second stage regulators further reduce oxygen pressure to ____ psi

A

14

88
Q

second stage regulators further reduce nitrous oxide to ____ psi

A

26

89
Q

the oxygen flush recieves oxygen from?

A

the pipeline gas inlet or cylinder pressure regulator

90
Q

gas for the oxygen flush is directed at a high _____ flow directly to the?

A

unmetered

common gas outlet

91
Q

the oxygen flush provides a flow?

A

between 35-75 L/min

92
Q

a ASTM Standard is that the connection fo the flush valve delivery line to the common gas outlet must be designed so that activation does not increase or decrease pressure at the vaporizer by _____ or increase vaporizer output by ____

A

> 10 kPA

>20%

93
Q

oxygen flush must be a ______ purpose, self-closing device that is operable with one hand and should not be able to be ________ activated.

A

single

accidently

94
Q

the anesthesia machine has to be on or off to activate the oxygen flush?

A

can usually be activated whether the machine is on or off

95
Q

activating the oxygen flush valve can affect other gases how?

A

Could result in other gases being shut off

96
Q

the oxygen flush valve provides what kind of pressure to the system?

A

positive or negative

97
Q

overuse of the oxygen flush can result in?

A

dilution of the anesthetic mixture

98
Q

what is the purpose of the flow control valves?

A

regulate the flow of oxygen, air, and other gases to the flow indicators

99
Q

what are the two types of the flow control valves?

A

electrical or mechanical

100
Q

what is the ASTM standard for flow control knobs?

A

there should only be one flow control for each gas. it must be identifiable with its associated flowmeter

101
Q

name the components of a flow control valves?

A

body

stem and seat

control knob

102
Q

the flow control valve must be ______ or ______ to its associated flowmeter.

A

adjacent or identable

103
Q

the mechanical flow control valve can also be called the?

A

needle valve

pin valve

fine adjustment valve

104
Q

mechanical control valves are used on _____ and _____ flow control valves

A

electronic and mechanical

105
Q

what does the body of the flow control valve do?

A

screw into the anesthesia machine

106
Q

what does the stem and seat of the flow control valves do?

what does the close position look like?

what does the open position look like?

A

fine threads that allow stem to move only a short distance with complete turns.

closed: pin at the end fits into its seat, occludes opening to prevent gas from passing through
open: turned outward, opening between pin and seal is created.

107
Q

the control knob of the flow control valve is joined to the _____.

A

stem

108
Q

control knob on the flow control valves can be ______ or ________.

A

rotary or electronic

109
Q

electronic flow control valves must be turned _____ to increase flow.

A

clockwise

110
Q

the rotary oxygen control knob on the flow control valve must be?

A

fluted and be large or larger than the other gases

111
Q

the rotary oxygen flow control valve must be turned ______ to increase flow.

A

counterclockwise

112
Q

how can you minimize accidental changes on rotary flow control valves?

A
113
Q

common configurations for electronic flow control devices is?

A

one controls oxygen and one controls total flows

114
Q

the low pressure system is downstream of the?

A

flow control valves

115
Q

Pressure in the low pressure system is only slightly above ______ _______ .

A

atmospheric pressure

116
Q

pressure within the low pressure system depends on what three things?

A

flow from flow control valves

presence of check valves (back pressure devices)

back pressure from the breathing system.

117
Q

what is the purpose of the flowmeters?

A

indicate the rate of flow of the gas passing through them.

118
Q

what is the ASTM standards for flow indicator scales?

A

must be marked on or immediately adjacent to the tube.

119
Q

oxygen flowmeter must be placed on the ______ side of a group of flowmeters

A

right

120
Q

name the components of a flowmeter?

A
121
Q

there is two types of flowmeters, what are they?

A

electronic or mechanical

an electronic one is pictured below

122
Q

the tube on a flowmeter is usually made of _____.

A

glass

123
Q

fine flow tube of the flowmeter goes from _____ to _______.

A

200 mL/min to 1 L/min

124
Q

Dual flow tubes are controlled from ____ _____ valve

A

single flow

125
Q

Indicators with the flowmeter should be _____ moving.

A

free

126
Q

Ball indicators are read where for flowmeters?

A

in the middle

127
Q

nonrotating and rotating indicators readings are taken from where?

A

upper rim

128
Q

what is the purpose of rotating indicators?

A

rotation indicates gas is flowing and indicators is not stuck

129
Q

what is the purpose of the stop on the flowmeter?

A

prevents plugging of outlet by indicator and prevents the indicator from going where it is not visible

130
Q

what is the purpose of lights on the flowmeter?

A

useful in darkened rooms

131
Q

various gas flows meet at the?

A

common manifold (mixing chamber) at the top

132
Q

if two flowmeters are present for the same gas what is their purpose?

A

one is for low flows and one is for high flows

133
Q

if a gas has two flow meters, how do you tell the flow rate?

A

it is not the sum of the two tubes, but the flow shown on the high flow tube.

134
Q

name the two hypoxia prevention safety devices?

A

mandatory minimum oxygen flow

minimum oxygen ratio

135
Q

what is the ASTM Standards for hypoxia prevention?

A

Anesthesia machine must be equipped with a device to protect against an operator selected delivery of a mixture of O2 and nitrous that contains an O2 concentration less than 21% in the fresh gas or inspiratory gas.

136
Q

what is the mandatory minimum oxygen flow?

A

machine may require a minimum of 50 to 250 mL/min of O2 flow before other gases can flow. this will be preset by the manufacturer

137
Q

minimum oxygen flow is activated when what happens?

A

the master switch is turned on

138
Q

does the mandatory minimum oxygen flow prevent hypoxic gas concentration from bein delivered?

A

no

139
Q

what does the minimum oxygen ratio do?

A

inspired gas analyzers prevent O2 concentration administration less than 21%

140
Q

describe the hypoxia safety device in the low pressure system

A

prevents you from setting s a hypoxic mixture with the flow control valves

141
Q

the hypoxia prevention safety device limits nitrous oxide flow to ___ time that of oxygen flow

the nitrous maximum is

the oxygen minimum is

A

3

75%

25%

142
Q

unidirectional valves purpose in the low pressure system?

A

reduce the amount of positive pressure that can backflow into the breathing system

143
Q

with the hypoxia prevention safety device and you increase the oxygen flow two things can happen?

A

the nitrous flow will increase proportionally or remain the same

144
Q

A ___ tooth sproket for nitrous and ____ tooth sprocket for oxygen are linked so that a mixture causing oxygen to drop to 25% causes the oxygen or nitrous levle to adjust as the gases are adjusted to maintain an O2 concentration of ____.

A

14

29

25%

145
Q

the 25% concentration of oxygen at the flowmeter is the concentration required for ______ no the concentration at the _______.

A

flow

common gas outlet (because the the gas will mix with vaporizers)

146
Q
A
147
Q

where is the unidirectional valves are located where?

A

between the vaporizers and the common gas outlet

148
Q

unidirectional valves in the low pressure system are upstream of the ?

A

where the oxygen flush joins the fresh gas flow

149
Q

unidirectional valves reduces _____, but does not prevent it

A

pressure

150
Q

positive pressure during assisted or controlled ventilation and use of the oxygen flush can cause positive pressure to backflow into the system, which would interfere with what?

A

the flowmeter readings and volatile gases delivered from the vaporizers

151
Q

what is the purpose of the pressure relief devices?

A

protects the machine from high pressures

152
Q

where is the pressure relief devices located in the low pressure system?

A

usually near the common gas outlet

153
Q

the pressure relief device valve opens to do what?

A

to release gas to the atmosphere if the preset pressure is exceeded

154
Q

the pressure relief device can limit the use of the ventilator for _____ ventilation when using for a cricothyrotomy?

A

jet

155
Q

what is the purpose the common gas outlet is?

A

recieves all the gases and vapors and delivers the mixture to the breathing system

156
Q

some common gas outlets have a ____ mm female and a ____ mm coaxial male

A

15 mm

22 mm

157
Q

the common gas outlet si a common location for ______

A

disconnections

therefore it must be difficult to accidently disengage the deliver hose from the outlet

158
Q

name the electrical components of the anesthesia machine?

A

master switch

power failure indicator

reserve power

electrical outlets

159
Q

if the machine is likely to be used in locations that do not have piped gases, it is advisable to have?

A

a double yoke especially for oxygen, and a piston driven mechanism

160
Q

the check valve assembly in the high pressure system does what?

A

allows gas from a cylinder to enter the machine but prevents gas from exiting the machine when there is no cylinder in the yoke

161
Q
A

NURG 7017 (7 decks)

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