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Y2 Respiratory > Anaesthetic Respiration > Flashcards

Anaesthetic Respiration Flashcards

1
Q

Drugs have a direct affect on which part of the brain?

A

Medulla oblongata

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2
Q

Why can drugs having a direct effect on the medulla oblongata be a problem?

A
  • Reduced response to inputs to the respiratory centre
  • Chemoreceptors
  • Irritant receptors
  • No conscious control
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3
Q

What are the 3 main reasons that respiratory efficiency may decreased during anaesthesia?

A
  • Drugs
  • Recumbency
  • Equipment
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4
Q

What problematic indirect effects may drugs have on respiration during anaesthesia?

A

Over-infusion with IV fluids which may lead to pulmonary oedema

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5
Q

What effect may dorsal recumbency have on respiration during anaesthesia?

A

Abdominal contents compromise the diaphragm so it wont be as functional

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6
Q

What effect can lying in the same position for long period have on respiration?

A

Cause a build up of mucus in airways

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7
Q

Give examples of some equipment that may be used during anaesthesia

A
  • Endotracheal tube
  • Connectors
  • Circuit
  • Anaesthesia machine
  • Monitors
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8
Q

What effects can anaesthetic equipment have on respiration?

A
  • Increase dead space
  • Increased resistance to air flow
  • Potential rebreathing, inadequate oxygen supply
  • Air is not warmed and humidified as it normally would be by the nasal cavity
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9
Q

What would the tidal volume of an 18Kg dog be?

A

180ml per breath

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10
Q

What is the approximate minute volume of an 18kg dog?

A

180ml x 20 (RR) = 3600ml per min

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11
Q

What is the result of drugs, recumbency and equipment on respiration?

A

Ventilation:Perfusion mismatch

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12
Q

What does a ventilation : perfusion mismatch mean for arterial partial pressure of respiratory gases?

A
  • High PaCO2

- Low PaO2

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13
Q

Respiratory acidosis causes a build up of?

A

Hydrogen ions

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14
Q

Metabolic acidosis causes a build up of?

A

Lactic acid

Contributes to an increase in hydrogen ions

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15
Q

What are the serious consequences of prolonged hypoxia?

A

Irreversible brain damage

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16
Q

Hypercapnia has what direct effects?

A

Vasodilation - directly on blood vessels, causing a raised intracranial pressure

17
Q

Where is a pulse oximeter attached?

A

A vascular non-pigmented area e.g. tongue, ear, toe

18
Q

What is measured by the pulse oximeter?

A

Oxygen saturation of haemoglobin

Also measures pulse rate

19
Q

What arterial saturation of Hb would you expect in a normal animal?

A

98-99%

20
Q

At what PaO2 does the level of Hb saturation start to decline significantly in the normal animal?

A

80mmHg

21
Q

What can adversely affect the result of a pulse oximeter?

A
  • Vasoconstriction of the region being measured
  • Abnormal haemoglobin
  • Equipment factors
22
Q

What is measured by capnoraphy?

A

The partial pressure of CO2 in expired air via the breathing system
Also measure respiratory rate

23
Q

What is the main benefit of using a capnography compared to a pulse oximeter?

A

Allows ventilation issues to be spotted faster

24
Q

The capnogram curve gives a measurement of?

A

End tidal CO2

25
Q

What PaCO2 would you expect in expired air from a normal animal?

A

40

26
Q 
On a capnogram what do each of the following stages show?
A-B
B-C
C-D
D-E
A 
A-B = Early expiration
B-C = Expiratory upstroke
C-D = Alveolar plateau
D-E = Inspiratory downstroke
27
Q

If the levels on the capnogram are above 40 what is this showing?

A

More CO2 is being exhaled - more CO2 in blood = hypercapnia

28
Q

If the levels on the capnogram fail to return to 0, what is this showing?

A

Inadequate ventilation
Increased metabolic rate
Increased CO - ventilation:perfusion mismatch
Re-breathing of expired air

29
Q

If the C-D period is short, with the B-C extended, what is this showing?

A

Increased resistance - could be due to equipment

30
Q

What is measured by arterial/venous blood gas measurements?

A

PaO2 and PaCO2 directly

Can also measure pH, bicarbonate ions, lactate

31
Q

From an arterial sample what levels would you expect for the following:

  1. PaO2
  2. PaCO2
  3. pH
A
  1. 100
  2. 40
  3. 7.35 - 7.45
32
Q

At what level of PaO2 would you diagnose hypoxaemia? (room air is 21% oxygen)

A

70-80mmHg

33
Q

What do you need to wait for before you stop monitoring respiratory parameters after anaesthesia?

A

Swallowing/gag reflex has returned

Alert enough to stand

Y2 Respiratory (4 decks)

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