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Principles of Anesthesia > Breathing Systems Pt. 1 (Exam II) > Flashcards

Breathing Systems Pt. 1 (Exam II) Flashcards

1
Q

This type of circuit is characterized by no reservoir bag and no rebreathing.

A

Open Circuit

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2
Q

This type of circuit is defined by a reservoir bag and complete rebreathing. This circuit is also dependent on fresh gas flow.

A

Closed Circuit

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3
Q

This type of circuit is characterized by a reservoir bag with no rebreathing.

A

Semi-open Circuit

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4
Q

This type of circuit is characterized by a reservoir bag and partial rebreathing.

A

Semi-closed Circuit

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5
Q

What component of the anesthesia machine is indicated by 1 on the figure below?

A

Common (Fresh) gas inlet

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6
Q

What component of the anesthesia machine is indicated by 2 on the figure below?

A

Pressure gauge

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7
Q

What characteristics are necessary for unidirectional valves?

A
  • Must open widely w/ little pressure
  • Must close rapidly w/ no backflow
  • Metal disc w/ low resistance & high competence.
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8
Q

What anesthesia breathing system component directs respiratory gas flow in the correct direction?

A

Inspiratory/Expiratory valves

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9
Q

Which valve opens on inspiration, closes on exhalation, and prevents backflow of exhaled gas?

A

Inspiratory valve

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10
Q

Where is a mask supposed to fit on a patient’s face?

A

Inbetween the interpupillary line and the groove between the mental process and alveolar ridge.

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11
Q

What size is the connection that fits the mask to the Y-piece of the machine.

A

22mm female connector.

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12
Q

What are the general benefits of connectors/adapters on the airway portion of the anesthesia machine?

A
  • extends distance between patient and breathing system
  • change angle of connection
  • allow flexibility
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13
Q

What are the general disadvantages of connectors/adapters on the airway portion of the anesthesia machine?

A
  • increased resistance
  • increased dead space
  • additional points of failure/disconnection
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14
Q

How long is breathing tubing?
How much internal volume does it typically have?

A
  • 1 meter long
  • 400-500 mL/m of length
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15
Q

What type of flow is typically present in corrugated breathing tubing?

A

Turbulent due to corrugation

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16
Q

Does adding longer tubing increase dead space?

A

Interestingly no it does not

Only adds dead space if bidirectional air flow is occurring.

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17
Q

What adds dead space?

A
  • Y-piece attached to patient due to unidirectional gas flow
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18
Q

At what pressure should a circuit pressure check be done?

A

30 cmH₂O

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19
Q

What is required for dead space?

A

Bidirectional gas flow

Includes anatomic dead space, ETT, and Y-piece.

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21
Q

A unidirectional valve is broken. Is the attached inspiratory limb considered dead space?

A

Yes, now bidirectional gas flow is occurring. If valve is fixed then the limb will not be considered dead space again.

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21
Q

Which valve opens on exhalation & prevents rebreathing?

A

Expiratory valve

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22
Q

What shape do breathing/reservoir bags have?

A

Ellipsoidal

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23
Q

What volume do breathing bags have?

A

3L for adults

(0.5 - 6L range)

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24
Q

What is the minimum pressure of a breathing bag?

A

30 cmH₂O

25
Q

What is the max pressure of breathing bags?

A

40 - 60 cmH₂O

26
Q

Plastic bags have ____ the distending pressure of rubber bags.

A

twice

27
Q

What functions does the breathing/reservoir bag serve?

A
  • Reservoir for gasses & O₂
  • Manual ventilation
  • Assistance w/ spontaneous ventilation
  • Protection from excessive positive pressure
  • Visual/tactile monitoring of ventilation
  • Protection from excessive pressure
28
Q

Where is the preferred location for the fresh gas inlet?

A

Between CO₂ absorbent and inspiratory valve

29
Q

What is the purpose of the APL (adjustable pressure limiting) Valve?

A
  • Permits gas to leave the circuit to the scavenging system
  • Controls pressure in the breathing system
30
Q

Turning the APL valve in a clockwise motion will ______ pressure.

A

increase

31
Q

Turning the APL valve in a counterclockwise motion will ______ pressure.

A

decrease

32
Q

How many turn are required to go from fully open to fully closed on the APL valve?

A

1-2 clockwise turns

33
Q

What is the purpose of the side/center tube located in the absorbent cannister?

A

Returns gas to the patient

34
Q

What is the chemical formula for soda lime?

A

Ca(OH)₂

35
Q

What is the chemical reaction that occurs with soda lime in a CO₂ absorbent cannister?

A

CO₂ + Ca(OH)₂ → CaCO₃ + H₂O + heat

36
Q

What are the components of soda lime?

A
  • Calcium hydroxide (80%)
  • Sodium & potassium hydroxide (5%)
  • Water (15%)
37
Q

When does soda lime become exhausted?

A

When all hydroxides become carbonates

38
Q

How much CO₂ can soda lime absorb?

A

19% of its weight

100g can absorb 26L of CO₂

39
Q

What absorbent has greater absorption capacity and is used in submarines and spacecraft?

A

Lithium Hydroxide

40
Q

Which absorbent is responsible for compound A & CO formation?

A

Calcium Hydroxide Lime

41
Q

What is Litholyme?

A

Lithium chloride

42
Q

What are the benefits of Litholyme (Lithium chloride) ?

A
  • No compound A formation
  • No reaction with inhaled anesthetic agents
  • Low exothermic reactivity, and low risk of fire
  • Better for environment
43
Q

What absorbent has no color indicator?

A

Spira-Lith (Anhydrous LiOH)

44
Q

What are the benefits of Spira-Lith?

A
  • Large reaction surface area
  • ↓ temperature production
  • Long duration
  • Cheap
45
Q

At what pH do absorbents undergo color change?

A

10.3

pH > 10.3 (absorbent is colorless & fresh)
pH < 10.3 (exhausted & purple absorbent)

46
Q

What dyes are used in CO₂ absorbents?

A
  • Ethyl Violet
  • Ethyl orange
  • Cresyl yellow
47
Q

What is the purpose of the mesh located in CO₂ absorbents?

A

Maximize absorption and minimize resistance

48
Q

What will excess liquid water do inside a CO₂ absorbent cannister?

A
  • ↓ surface area
  • ↓ absorbent efficiency
49
Q

Approximately how much of a CO₂ absorbent cannister’s volume is gas?

A

½

50
Q

What is channeling and its consequence?

A
  • Small passage ways allowing gas to flow through a defined route
  • Decreases functional absorptive capacity
51
Q

How can channeling be minimized?

A
  • Circular baffles
  • Permanent mounting
  • Prepackaged cylinders
  • Avoiding over packing
52
Q

Which gasses produced the most CO?
The least?

A

Desflurane ≥ Enflurane > Isoflurane > Halothane = Sevo

53
Q

Why should sevoflurane use with dessicated strong base absorbents (baralyme, LiOH) be avoided?

A

High risk of fire

54
Q

What component of the anesthesia machine is indicated by 3 on the figure below?

A

Inspiratory Unidirectional Valve

55
Q

What component of the anesthesia machine is indicated by 4 on the figure below?

A

APL valve

56
Q

What component of the anesthesia machine is indicated by 5 on the figure below?

A

Expiratory Unidirectional Valve

57
Q

What component of the anesthesia machine is indicated by 7 on the figure below?

A

Reservoir Bag

58
Q

What component of the anesthesia machine is indicated by 8 on the figure below?

A

Absorbent Cannisters

Principles of Anesthesia (24 decks)

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