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Monitors & Equipment > Apex- Breathing Circuits > Flashcards

Apex- Breathing Circuits Flashcards

1
Q

Difference b/t semi-open and semi-closed circuits

A

Both have reservoirs
Both can be accomplished with the circle system
> semi open = FGF > MV (no rebreathing)
> semi closed = FGF < MV (partial rebreathing)

semi-open system is also a mapleson circuit

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2
Q

What kind of circuit is a mapleson system : open, semi-open, semi-closed, or closed?

A

semi- open (FGF depends on design)
+resevior
no rebreathing

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3
Q

What 3 ways can the cicle system be configured?

A
  1. Semi-open: FGF > mV
  2. Semi-closed: FGF < mV
  3. Closed: FGF only replaces gas cosnumed by the patient (closed APL)
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4
Q

What does the APL valve determine?

A

how much gas remains in the circuit and how much is directed to the scavenger

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5
Q

What are the 2 most common circle-system related causes of rebreathing

A
  1. exhausted CO2 absorbent
  2. an incompetent unidirectional valve

malfunction of either valve converts the region between the y-piece and the affected valve to apparatus dead space

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6
Q

What happens when the unidirectional valves malfunction in the circle system - stuck open vs stuck closed (airway obstruction vs rebreathing)

A

stuck open = rebreathing
stuck closed = airway obstruction

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7
Q

The American Society for Testing and Materials (ASTM) requires that the pressure inside an adult-sized (3L) reservoir bag does not exceed an internal pressure of what if the bag is inflated up to 4x its size

A

60cm H20

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8
Q

T/f- closing hte APL valve during mask ventilation is useful when theres a leak around the mask

A

True

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9
Q

When the unidirectional valves in the circle system are working properly, dead space begins and ends where?

A

begins at the y- piece (bi-directional flow)
ends at the terminal bronchials (conduit for gas flow, no exhcange)

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10
Q

How does a fault unidirectional valve lead to a high inspired co2?

A

if the inspiratory valve isnt working, when the pt exhales, the exhaled co2 and gases will distribute to both the expiratory AND inspiratory limbs
>the expired gas in the inspirtaory limb now goes back to the patient on the next breath

if the expriatory valve isnt working, then the pt inhales, they will get cleaned gas , as well as excess gas from the expiratory limb that hasn’t been thru the absorbant yet

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11
Q

What is the BEST mapleson circuit for a spontaneously ventilating patient?

A, B, C, or D

which is the worst?

A

A

B

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12
Q

What is hte best mapleson circuit design for controlled ventilation?

which is the worst?

A

D

A

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13
Q

Which Mapleson is the only circuit where the fresh gas inlet is near the bag?

A

A

best for the spontaneously ventilationg pt

worst for controlled

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14
Q

Which mapleson circuit is the only circuit with no corrugated tubing

A

C

C = no Corrugated

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15
Q

Which mapleson circuit is the only circuit with the APL valve away from the patient

A

D

closest to you

well i guess F too - is (Jackson-Rees)

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16
Q

Which is the only mapleson circit without a reservoir bag?

A

E

Ayers T-Piece

No APL valve either

17
Q

Which maplleson doesnt have an APL valve

A

E

ayeres-T-piece

no reservoir mag either

18
Q

List in order form best to worst of mapelsons to use for spontaneous ventilation

mneumonic

A

A > DFE > CB

All Dogs Bite

19
Q

List in order from best to worst of mapelosns to use for controlled ventilation

mneumonic

A

DFE > BC > A

Don’t Be Arrogant

20
Q

The Bain circuit: (Select 2):

-is tested with the Pethick test
-is a modified Mapleson A
- delivers FG through the inner tube
- is best for spontaneous but not controlled ventilation

A

-is tested with the Pethicktest
-delivers fresh gas through the inner tube

Bain is a modification of Mapleson D and can be used for spontaenous and controlled ventilation

21
Q

What is the Bain system a modification of?

A

Mapleson D circuit

coaxial design:

gresh gas is delivered to the pt thru the inner tube
exhaled gas travels through the outer tube (the corrugated tubing)

*Pethick test to check for inner tube kinking and disconnection

22
Q

T/F: the bain circuit can be used for both spontaneous and contolled ventilation

A

True

23
Q

To prevent rebreathing with the bain system, FGF should be what?

A

2.5x minute ventilation

24
Q

What test is used to test the integrity of hte bain circuit during pre-anesthetic checkout ?

A

Pethick test

  1. occlude the elbow at the pt end of the circuit
  2. close the APL valve
  3. use the o2 flush valve to fill the circuit
  4. remove the occusion at the elbow while flushing circuit

-if hte inner tube is patent, the venturi effect will cause the bag to collapse (safe)
-if its kinked or disconnected, the bag will remain inflated and is not safet to use

25
Q

When doing a pethick test on a Bain system, and the occulusion is moved, should the resvior bag stay inflated or fall?

A

fall

venturi effect

26
Q

Which factors affect the extent of reb reathing exhaled gas in the circle system (select 2):

-physiologic deadspace
-arrangement of the components in the circuit
-length of the inspiratory and expiratory limbs
-fresh gas flows

A

-arrangement of the components in the circuit
-FGF

27
Q

Benefits of using a low freswh gas flow in a circle system include a/an (select 2):

-faster Fa/FI equilibration
-slower reduction in body temp
-increased humidity in the system
-reduced risk of barotrauma

A

-slower reduction in body temp
-increased humidity in the system

28
Q

What are the benefits of the Mapleson breathing circuits (select 2):
-allows rebreathing of exhaled gas
-minimal fresh gas requirement
-low airway resistance
-simplicity of design

A

low airway resistance and simplicity of design

29
Q

Which component in the circle system protects the patient from excessive airway pressure during spontaneous ventilation?

-Expiratory valve
-CO2 absorber
-ventilator spill valve
-Reservoir bag

A

Reservoir bag

ATSM requires that the pressure inside an adult-sized bag does not exceed an internal pressure of 60cm H20 if the bag if inflated up to 4x its size.

This menas if you close the APL valve and run fresh gas through the circuit, the pressure inside the circuit wont exceed 60cm H20 until the bag inflate to at least 12L - and hopefully youd figure it out by then

30
Q

Which circuit does not contain deadspace
Open, closed, semi-open, semi-closed

A

Open

An open circuit is open to the atmosphere and does not contain dead space

all of the other circuits are not open to the atmosphere and contain some degree of dead space

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