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Module 10 Flashcards

(59 cards)

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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

Study These Flashcards
A

Oxyhemoglobin & reduced HGB

25
Both carboxy & methe
Absorb light at 1 or both of the wavelengths commonly used Significant concentrations of either will produce erroneous pulse oximetry values
26
At the red wavelength of 660, carboxy
Has the same absorbance as oxy
27
Methe absorbs light at
Both 660 & 940, which means it adds to both the numerator & denominator of the ratio
28
Rising HGB causes pulse oximetry values to
Decrease until reaching a plateau of 85%
29
What has little effect on pulse oximetry
Fetal HGB & sickle cell Nail polish varies—causes low reading Highly opaque can prevent detection
30
Diodes vary as much as
15nm
31
LES light transmission can be corrected by
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
Pulsations component can be less than
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
What can decrease light interference
Drape or towel
34
What happens if a pulse is weak
The pulse oximetry will use an automatic gain control that adjusts either the LED intensity or the photodetector amplifier gain
35
Amplifying gain will also
Amplify background noise
36
Most pulse odometers display
A waveform that represents pulsation strength after amplification
37
As ASA physical status increases
Pulse oximetry failure rates increase
38
A Mispositioned pulse oximetry can
Display correct HR. It an erroneous oxygen value
39
How is loss of signal compensated?
Increasing signaling average time & ECG synchronization Should determine the noise signal and then subtract it from the total signal
40
Difference between earlobe & finger pulse oximetry
Earlobe responds quicker Finger is more reliable
41
Response time is also affected by
Signal averaging time Can range from 1-15 seconds Longer is more reliable
42
Pulse pressure variation is the
Aria took it pulse pressure with respirations
43
Pulses paradox is tied to
Fluid responsiveness especially with positive pressure ventilation
44
Higher values of PVI are suggestive of
Lower intravascular volume status & stronger probability of hemodynamic response to fluid infusion
45
As intravascular fluid is infused, variability
Diminishes greatly
46
PVI is sensitive for any
Physiological factor that diminishes CO
47
In non wealth environment,
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
For volatile agents to be vaporized
A carrier gas must pass through a vaporizing chamber, driven by positive pressure or drawn thigh utilizing the patients inspiratory effort
49
Drive over is an alternative when
Oxygen cylinder isn’t available
50
A draw over system has what 4 components
Reservoir tube Vaporizer Self inflating bag Non rebreathing system
51
The self inflating bag is for
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
Vaporizer & tubing should be
Low resistance so spontaneous breathing can occur
53
This is often used as a source of oxygen
Atmospheric air by utilizing a portable oxygen concentrator (inhaled concentration can be increased)
54
Zeolite granules are used to
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
Oxygen concentrator are able to produce
A supply of oxygen at a rate of 5-10L/min
56
Why are mechanical ventilators difficult
Due to electrical supply High gas usage if they are powered by compressed gases
57
Bellows below the beam expand with
Exhalation & the adjusted weight above the beam & compressed bellows, delivering tidal volume
58
Important to have monitors that function
Under battery & implement safety features that prevent hypoxia gas delivery
59
Elevated alveolar anesthetic gas concentration cause
Hypoventilation & decreased intake Keep I. Mind oxygenation & CO2 removal

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