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Principles > Exam 2 > Flashcards

Exam 2 Flashcards

1
Q

Fixed mass

A

The fixed number of gas molecules the cylinders contain when full

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2
Q

What law do gas molecule in cylinders obey?

A

Boyle’s law- which stats that pressure times volume equals a constant (P1V1=P2V2) provided temp does not change

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3
Q

How can you determine how much gas remains in the cylinder?

A

Because oxygen exists only as a gas at room temp, the tank’s pressure gauge can be used

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4
Q

Who controls such processes as the filling and manufacturing of gas cylinders?

A

The US Department of Transportation

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5
Q

Pin Index Safety System

A

Two 5-mm stainless steel pins on the cylinder yoke connecter just below the fitting for the valve outlet port to ensure the correct cylinder is connected

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6
Q

Pressure alarms built into the main supply line sound when the line pressure varies by ___ in either direction from the normal operating pressure of approx ___ psig.

A

20%; 55

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7
Q

Oxygen concentrations may vary with gas flow and concentrations are most effective at delivering oxygen at flows of less than __ L/min to anesthesia machines

A

4

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8
Q

What is the capacity (L) and pressure (psig) of a full E cylinder of oxygen?

A

1900 psig; 660 L

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9
Q

Diameter Index Safety System

A

The pipeline inlets into the anesthesia machine that are gas specific

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10
Q

Pressing the oxygen flush button results in a flow of ____ L/min of pure oxygen, bypassing any ON/OFF switches, flowmeters, and vaporizers

A

35-75

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11
Q

What do pressure sensor shut-off valves do when the oxygen pressure decreases below a preset threshold?

A

Stop or proportionally decrease the flow of a second gas

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12
Q

The slave nitrous oxide flow control valve limits the ratio of nitrous oxide flow to oxygen so that it does not exceed?

A

3:1

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13
Q

Where should flow be read for a ball or a bobbin?

A

Read at the highest and widest portion of the float (middle of a ball, top of a bobbin)

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14
Q

What type of flow meter uses rotating indicator?

A

Variable orifice flow meters (Rotameters)

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15
Q

What pressure are gases typically supplied to the machine’s pipeline connector inlets?

A

50-55 psig

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16
Q

Gases front eh cylinders at pressures put 2200 psig are regulated to 40-45 psig by what?

A

First-stage regulators

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17
Q

Having entered the machine intermediate-pressure system at ___ psig from the pipelines, or ___ psig from the first-stage regulators, oxygen and other gases take different pathways

A

50-55; 40-45

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18
Q

What is the point of an auxiliary flow meter on the gas machine?

A

Useful for attaching supplemental oxygen delivery devices (nasal cannula) to the gas machine.
Advantage that the breathing circuit and gas delivery hose remain intact while supplemental oxygen Is delivered to a spontaneously breathing pt

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19
Q

What is the most important and overlooked step in the pre-anesthesia check procedure?

A

To ensure immediate availability of a manual means to ventilate lungs

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20
Q

4 components of anesthesia gas machine exposed to high pressures (cylinder pressure)

A

1) hanger yoke
2) yoke block with check valves
3) cylinder pressure gauge
4) cylinder pressure regulators

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21
Q

8 components of anesthesia gas machine exposed to intermediate pressures (pipeline pressure, 50 psi)

A

1) pipeline inlets
2) check valves
3) pressure gauges
4) ventilator power inlet
5) oxygen pressure-failure device
6) flow meter valve
7) oxygen second-stage regulator
8) flush valve

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22
Q

4 components of anesthesia gas machine exposed to low pressures (distal to flow meter needle)

A

1) flow meter tubes
2) vaporizers
3) check valves
4) common gas outlet

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23
Q

What is the name of the cylinder pressure gauge found on cylinder tanks? What does it measure?

A

Bourdon gauge= high cylinder pressure measure. Measures pressure relative to atmosphere

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24
Q

What do second-stage regulators do?

A

Reduce the pressure further to eliminate fluctuations in pressure

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25
Q

Describe the placement of the oxygen flow meter tube in relation to other flow tubes in the side-by-side array

A

Downstream or to the right of tether flow meter tubes nearest the manifold outlet

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26
Q

What is latent heat of vaporization?

A

The amount of heat (calories) required to convert a unit mass (grams) of a liquid into vapor

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27
Q

Contemporary concentration-calibrated variable bypass anesthesia vaporizers are _____ specific

A

Agent

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28
Q

What happens from overfilling or tilting a vaporizer?

A

May result in liquid agent entering parts of the anesthesia delivery system designed for gases and vapor only

29
Q

What do you do if the soda lime canister turns blue during the case and you cannot change it?

A

Increase the fresh gas flow rate to blow CO2 out of the system

30
Q

Where does the fresh gas flow enter the breathing circuit in the circle system?

A

Fresh gas inlet

31
Q

In a circle system, where is the dead space located?

A

Between the Y-piece and the patient

32
Q

What does interchanging the position of the APL valve and the fresh gas inlet do?

A

It transforms a Mapleson A into a Mapleson D circuit

33
Q

The part of a tidal volume that does not undergo alveolar ventilation

A

Dead space

34
Q

The majority of claims involve provider error and a third of the claims were preventable by?

A

Preanesthesia machine check

35
Q

How often should you do a machine check?

A

Every 24 hrs

36
Q

How often should you do a pressure check?

A

B/w each case

37
Q

What 5 features are characteristic of anesthesia workstation vaporizers?

A

Must have an Interlock
Must use a Liquid level to prevent over filling
Must be concentration-Calibrated
Should use a Keyed-filler device
Must not discharge liquid anesthetics from the vaporizer

38
Q

What system prevents filling a vaporizer with the incorrect agent?

A

Key filling port system

39
Q

Which modern gas machine does not have a variable-bypass vaporizer?

A

Tec 6 Desflurane vaporizer

40
Q

Describe functions of the interlock system on the anesthesia machine

A

Prevents simultaneous administration of more than 1 volatile agent/vapor being used at a time

41
Q

What is the main function of the check valves in a gas machine?

A

Prevents back flow of gas to the atmosphere or between cylinders on a machine

42
Q

Describe the purpose of fail-safe valve on anesthesia machine

A

Prevents delivery of hypoxic gas mixtures

43
Q

How frequently does the scavenging system need to be checked

A

Every 24 hrs

44
Q

When is CPAP useful in anesthesia?

A

When pts are intubated but breathing spontaneously, helps maintain FRC and may prevent atelectasis.

To maintain FRC post-op, CPAP to non-dependent lung during OLV to reduce shunt

45
Q

How does PEEP affect CO/ SV/ systemic arterial BP/ ventral venous BP

A

Decreases

CVP may increase

46
Q

Identify components of low pressure system in anesthesia machine

A

Flow meter tubes

Common gas outlet

47
Q

PISS system is used to:

A

Prevent use of the wrong gas cylinder

48
Q

Best practice for handling gas cylinders

A

Laying the cylinder on its side when changing cylinder on anesthesia machine

Removing plastic cover on port when installing the cylinder

49
Q

The O2 pressure failure device activates when:

A

O2 tank is exhausted

O2 pressure in supply line is < 20psi

50
Q

Hypoxia prevention safety device on anesthesia machine will:

A

Limit the N2O flow to 3x O2 flow

51
Q

Which best describes Desflurane Tec 6 vaporizer?

A

It’s output is increased inside a hyperbaric chamber

It is pressurized to 2 atm

52
Q

Which device will be 1st to detect an O2 pipeline crossover?

A

O2 analyzer

53
Q

Identify the MOST critical actions in the event of O2 pipeline crossover

A

Disconnect pipeline supply

Turn on O2 tank

54
Q

O2 flush valve

A

Excessive use can lead to awareness

It will deliver continuous pressure 35-75 psig

55
Q

True statements pneumatic ventilator bellows

A

A leak in the bellows may cause the reading on the O2 analyzer to increase

A hole in the bellows may cause barotrauma

56
Q

Preserves tank O2 in the event of O2 pipeline failure

Allows for more precise delivery of tidal volumes

A

Piston ventilator

57
Q

Pressure control ventilation

A

Gas flow decelerates during inspiration

The risk of ventilator associated lung injury is decreased

58
Q

With VCV the peak airway pressure is directly related to _____ and inversely related to _____

A

Airway resistance; lung compliance

59
Q

For PCV the tidal volume is directly proportional to ______ and inversely proportional to ______

A

Lung compliance; airway resistance

60
Q

Ascending bellows _____ during exhalation and a descending bellows ______

A

Rise; falls

61
Q

Optimal PEEP

A

5-15 cm H2O

62
Q

Tidal volumes

A

6-8 mL/kg with addition of PEEP

63
Q

Common sources of leaks

A

Defective connectors in the N2O central supply line “quick connects”

Defective yokes for the N2O reserve tanks

64
Q

With a leak-proofed anesthesia workstation and breathing system and an effective scavenging system, 94-99% of all OR anesthetic contamination is caused by?

A

Errors in anesthesia technique

65
Q

Number of exchanges per hour

A

15 or more

66
Q

The _____ which typically is weighted, could fill whether a circuit disconnect, leak, or normal exhalation was present

A

Hanging bellows

67
Q

Overpressurization of the airway can occur when:

A

The pt coughs against the ventilator

The ventilator’s settings are excessive for the first breath

The oxygen flush button is depressed during the inspiration phase

68
Q

What is an APL valve

A

Adjustable pressure-limiting valve that permits gas to leave the circuit, matching the excess to the inflow of fresh gas

Principles (4 decks)

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