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Equipment > Module 10 > Flashcards

Module 10 Flashcards

1
Q

What percent of O2 is carried in the plasma

A

2%

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2
Q

How many mL of O2 in 100mL of blood

A

19mL

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3
Q

How much O2 is dissolved in 100mL of plasma

A

.3mL

Plasma dissolved oxygen doesn’t play a significant role in oxygen transport

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4
Q

Arterial oxygen concentration is proportional to

A

HGB saturation

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5
Q

What causes a left shift in the dissociation curve?

A

Decreased: temp
2,3 DPG
H+
CO

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6
Q

What causes a right shift in dissociation curve

A

Increased: temp
2,3 DPG
H+

REDUCED AFFINITY

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7
Q

Oxyhemoglobin dissociation curve is a representation of

A

The relationship between the amount of oxygen bound to the HGB and the partial pressure of oxygen in the blood

Vital tool for comprehending how blood transports & releases oxygen

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8
Q

Saturations greater than 90% are

A

Independent of PAO2

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9
Q

What is the bore effect?

A

Tissues have higher amounts of CO2 & therefore hydrogen, which causes a right shift of the curve & unloading of oxygen from the HGB molecule

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10
Q

Tissue light absorbance

A

Contain pulsations times with HR due to the normal variation in arterial blood volume during each heart beat

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11
Q

Pulse oximetry became standard in

A

1986

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12
Q

Beer Lambert law states

A

The concentration of solutes can be determined by the intensity of light transmitted though a substance

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13
Q

Intensity & absorbance are

A

Inversely related

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14
Q

Of incidence of light intensity & the distance transmitted through a solution is equal, then the

A

Concentration of solutes can be determined in the extinction coefficient for each solute is know

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15
Q

What are the 4 most common hemoglobin species

A

Meth
Oxy
Reduced
Carboxy

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16
Q

The pulse oximeter estimates arterial HGB saturation by

A

Measuring light transmission at 2 wavelengths through a pulsating vascular bed

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17
Q

Light absorbance in tissue can be a

A

Constant component

Pulsating component

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18
Q

The pulsating component is the result of

A

Arterial blood pulsations & therefore by comparing light absorbance of the 2 components, the absorbance of the arterial blood can be determined

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19
Q

Most pulse odometers use 2 wavelengths of light

A

660 (red)
940 (infrared)

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20
Q

The light absorbance of the pulsatilla wavelength is divided by the light absorbance of the non pulse stoke wavelength, yielding

A

The pulse added absorbance which are independent of intensity & incidence

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21
Q

The pulse added absorbance for both wavelengths are calculated & the ratio is related to

A

The arterial HGB saturation

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22
Q

What 3 assumptions are made for pulse oximetry to work?

A

2 light absorbers

Pulsations are all caused by fluctuations in blood volume

One curve is valid for everyone

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23
Q

What are the most common sources of errors with oximetry readings

A

Dyshemoglobins & IV dyes

Wavelength variability

Signal to noise ratio

Motion

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24
Q

Pulse oximetry can only deal with what 2 concentration

A

Oxyhemoglobin & reduced HGB

25
Q

Both carboxy & methe

A

Absorb light at 1 or both of the wavelengths commonly used

Significant concentrations of either will produce erroneous pulse oximetry values

26
Q

At the red wavelength of 660, carboxy

A

Has the same absorbance as oxy

27
Q

Methe absorbs light at

A

Both 660 & 940, which means it adds to both the numerator & denominator of the ratio

28
Q

Rising HGB causes pulse oximetry values to

A

Decrease until reaching a plateau of 85%

29
Q

What has little effect on pulse oximetry

A

Fetal HGB & sickle cell

Nail polish varies—causes low reading

Highly opaque can prevent detection

30
Q

Diodes vary as much as

A

15nm

31
Q

LES light transmission can be corrected by

A

Measuring dioxide wavelength & discarding outside rage

Utilize different algorithms that correspond to different LED Wavelength

Variability doesn’t affect the ability to follow changes in saturation but can produce differences between sensors

32
Q

Pulsations component can be less than

A

1% of the amplitude of the non pulsations component l, which can occur during low profusion states or when the non pulsations component is increased such as with ambient light

33
Q

What can decrease light interference

A

Drape or towel

34
Q

What happens if a pulse is weak

A

The pulse oximetry will use an automatic gain control that adjusts either the LED intensity or the photodetector amplifier gain

35
Q

Amplifying gain will also

A

Amplify background noise

36
Q

Most pulse odometers display

A

A waveform that represents pulsation strength after amplification

37
Q

As ASA physical status increases

A

Pulse oximetry failure rates increase

38
Q

A Mispositioned pulse oximetry can

A

Display correct HR. It an erroneous oxygen value

39
Q

How is loss of signal compensated?

A

Increasing signaling average time & ECG synchronization

Should determine the noise signal and then subtract it from the total signal

40
Q

Difference between earlobe & finger pulse oximetry

A

Earlobe responds quicker

Finger is more reliable

41
Q

Response time is also affected by

A

Signal averaging time

Can range from 1-15 seconds

Longer is more reliable

42
Q

Pulse pressure variation is the

A

Aria took it pulse pressure with respirations

43
Q

Pulses paradox is tied to

A

Fluid responsiveness especially with positive pressure ventilation

44
Q

Higher values of PVI are suggestive of

A

Lower intravascular volume status & stronger probability of hemodynamic response to fluid infusion

45
Q

As intravascular fluid is infused, variability

A

Diminishes greatly

46
Q

PVI is sensitive for any

A

Physiological factor that diminishes CO

47
Q

In non wealth environment,

A

Oxygen or electrical services may/may not be available so equipment must be compact, portable & robust

Cost shouldn’t be a limiting factor, but often is

48
Q

For volatile agents to be vaporized

A

A carrier gas must pass through a vaporizing chamber, driven by positive pressure or drawn thigh utilizing the patients inspiratory effort

49
Q

Drive over is an alternative when

A

Oxygen cylinder isn’t available

50
Q

A draw over system has what 4 components

A

Reservoir tube

Vaporizer

Self inflating bag

Non rebreathing system

51
Q

The self inflating bag is for

A

Controlled or assisted ventilation that’s separated by a 1 way valve

Valves ensure flow is directed towards the patient and cannot be Re-entered into the vaporizer

52
Q

Vaporizer & tubing should be

A

Low resistance so spontaneous breathing can occur

53
Q

This is often used as a source of oxygen

A

Atmospheric air by utilizing a portable oxygen concentrator (inhaled concentration can be increased)

54
Q

Zeolite granules are used to

A

Absorb nitrogen from compressed air & the residual oxygen is send to the patient

By using 2 columns of Zeolite, a continuous supply of 95% oxygen can be produced

Zeolite doesn’t exhaust and doesn’t require changing for many years

55
Q

Oxygen concentrator are able to produce

A

A supply of oxygen at a rate of 5-10L/min

56
Q

Why are mechanical ventilators difficult

A

Due to electrical supply

High gas usage if they are powered by compressed gases

57
Q

Bellows below the beam expand with

A

Exhalation & the adjusted weight above the beam & compressed bellows, delivering tidal volume

58
Q

Important to have monitors that function

A

Under battery & implement safety features that prevent hypoxia gas delivery

59
Q

Elevated alveolar anesthetic gas concentration cause

A

Hypoventilation & decreased intake

Keep I. Mind oxygenation & CO2 removal

Equipment (5 decks)

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