Physics = Measurment Flashcards

(105 cards)

1
Q

emergency oxygen flush?

A

100% oxygen is supplied from the common gas outlet, which has bypassed both flowmeters and vaporisers.

flow of oxygen is usually 45 l/min at a pressure of 400 kPa.

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2
Q

blood gas analysis

A

Heparin is an acid and will lower the pH of the sample

A warmed ABG from a hypothermic patient will show a higher PaO2, higher PaCO2 and a lower pH than that actually present in the patient’s blood in vivo.

standard bicarbonate is measured in a sample titrated to a PCO2 of 5.3, which eliminates the respiratory component, and is a reflection of the metabolic component.

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3
Q

Cardiac Output monitoring modalities

A
Oesophageal Doppler
Transthoracic impedance
PiCCO
NICO
Thermodilution
Lithium dilution. (LIDCO)
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4
Q

Osmolarity solutes?

A

sodium salts (chloride and bicarbonate), glucose, and urea nitrogen

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5
Q

Caudal anaesthesia dose

A

Sacral procedure 0.5 ml/kg
Inguinal procedure 0.75 ml/kg
Lower thoracic 1 ml/kg
Mid-thoracic 1.5 ml/kg

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6
Q

Wright respirometer

A

One way system, exhaled tidal volume and minute volume.

+/- 5 to 10%.

150 revolutions when one litre of gas
minimum flow of 2 litres per minute is required

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7
Q

Humidification

A

Alveoli 43g/m3, @ 37*C

1 micron - ideal

US nebuloser - 2 MHZ

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8
Q

Damping - sine wave

A

Critical damping provides the quickest approach to zero amplitude (damping factor = 1).

With an optimally damped system there is a rapid initial decline in the oscillation to zero amplitude but there is then a small overshoot of about 6-7% of the original amplitude. An optimal damping factor of 0.64 is applied to blood pressure monitoring systems.

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9
Q

Axis deviation

A

If the mean vector is shifted superiorly and leftward (axis of −30° to −90°) left axis deviation (LAD) is present.

I, II, aVF used

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10
Q

Spectrophotometric absorption spectra

A

The isobestic point occurs at a wavelength around 800 nm. The maximum difference in the absorption of the two forms of haemoglobin occurs at a wavelength of about 650 nm.

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11
Q

Bernoulli’s principle

A

an increase in the speed of a fluid occurs simultaneously with a decrease in pressure or a decrease in the fluid’s potential energy

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12
Q

Venturi effect

A

reduction in fluid pressure that results when a fluid flows through a constriction in a tube.

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13
Q

Coanda effect

A

a flow of gas or liquid attaches itself to a nearby surface and remains attached even when the surface curves away from the initial direction of flow.

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14
Q

Charles’s law:

A

At constant pressure the volume of a given mass of gas varies directly with absolute temperature

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15
Q

Boyle’s law

A

At constant temperature the volume of a given mass of gas varies inversely with pressure.

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16
Q

Gay-Lussac’s law

A

for a given amount of gas held at constant volume, the pressure is proportional to the absolute temperature:

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17
Q

Dalton’s law of partial pressure

A

The pressure of a mixture of gases is equal to the sum of the pressures of all of the constituent gases alone.

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18
Q

Henry’s law

A

At a constant temperature, the amount of a given gas dissolved in a given type and volume of liquid is directly proportional to the partial pressure of that gas in equilibrium with that liquid.

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19
Q

joule (J)

A

amount of energy expended if a force of one newton (N) is applied through a distance of one metre (N·m)

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20
Q

Kinetic energy (KE) =

A

½ MV2

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21
Q

potential energy (PE)

A

mass × height attained × acceleration due to gravity

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22
Q

Work done (WD)

A

V (potential difference) × I (current) × t (time)

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23
Q

Soda lime granules

A

94% calcium hydroxide, Ca(OH)2
5% sodium hydroxide, NaOH
1% potassium hydroxide, KOH

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24
Q

Baralyme

A

20% barium octahydrate and 80% calcium hydroxide

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25
Cardiopulmonary exercise testing (CPX, CPEX, CPET)
An AT below 11 ml/kg/min is associated with increased mortality particularly if there is evidence of myocardial ischaemia during the test.
26
average barometric pressure at sea level
``` 1 atmosphere 1000 cm of water 760 mmHg 101.325 kPa 1 Bar 14.7 pounds per square inch. ```
27
Ohm's law
V = I × R
28
Resistors
In series R1 + R2 In parallel 1/R1 + 1/R2
29
Capacitance
V = Q/C In Parallel C1 + C2 In series 1/C1 + 1/C2
30
Lambert's law
each layer of equal thickness of the medium absorbs an equal fraction of the energy traversing it.
31
Beer's law
absorbance being directly related to the concentration of a substance
32
Capnography
Sapphire chamber Filtered infrared light - 4.25 micrometres Collision broadening - other polyatomic moelcules
33
Oxygen Measurement
Oxygen is paramagnetic (attracted) Clark electrode - platinum cathode and silver anode Galvanic fuel cell - gold cathode and a lead anode
34
Lasers
Carbon dioxide - cut tissues and coagulation Argon or krypton - light in the blue-green absorbed by red coloured tissues ophthalmology, photocoagulation and dermatology Nd YAG - infra-red Debulk tumours and for photocoagulation.
35
Sterilisation
Dry heat - Slow 30 mins @ 150*c Autoclave - Time dependent on temp and pressure Ethylene Oxide - For those that cant be heated Long complex, preconditioning, series of cycles Radiation commonly used
36
BIS
B - Aware: Reduced awareness with muscle relaxant B - unaware: No difference BAG - RECALL: Less awareness with ETAC than BIS Currently recommended with TIVA and with muscle relaxant
37
Pulse ox
Wavelengths of 660 nm (red) and 940 nm (infra-red or IR) Isobestic points 660 and 940nm
38
Laryngoscopes
Straight: Miller, Soper, Wisconsin Seward Advanced over epiglottis and lifted (neonates) Curved: Macintosh, Polio, McCoy (Right sided) Placed in Vallecula
39
Seebeck effecrt
Thermocouple Thermoelectric effect The electromotive force at the measuring junction is proportional to temperature.
40
Gas cylinders
02: C (340) - J Size E - Machine 680L Size J - Manifold 6800L (Volumes double with each letter) Filling ratio 15 degrees 0.75 in UK N2O: C - G Size C 450L Size E 1800L
41
Complications
``` 1/10 - Very Common 1/100 - Common 1/1000 - Uncommon 1/10,000 - Rare 1/100,000 -Very Rare ```
42
Diamagnetic
N2 CO2 N2O
43
Epidural Set
Tuohy needle - 16 + 18G 10cm length with 8cm shaft 1cm markings 15cm for obese patients 19G 5cm with 0.5cm markings - Paeds Closed round tip, 2 side ports Cathter - 90cm Filter - 0.22 micron mesh
44
APL valve
Excess gas to exhaust out Inlet, patient, exhaust port (scavening) Hydrophobic dic
45
Ferromagnetic
``` cobalt iron gadolinium (below 20*C) neodymium, and nickel. ```
46
mu opioid (MOP) receptor
Rectangular hyperbola - dose response curve converted to log scle - sigmoid
47
Bain cicruit
Mapleson D (Coaxial) Any age FGF inner tube 1.5 - 2 times alveolar MV is required
48
Arterial Cannulae
Parrellel walls Summation of a series of sine waves 0.5 - 40 Hz Optimal dampening 0.64
49
LMAs
Size 6 50ml cuff Reinforced have small internal diameter
50
Paramagnetic analyzer
Reflected beam of light on 2 photocells Water vapour affects reading
51
ECG
PR - Start of p wave to start of QRS QT - Start of QRS to end of T wave
52
Manley MP3
Minute volume divider FGF drives ventilator 2 x bellows 3 x unidirectional valves Mapleson D type ventilator
53
Innervation of airway
Vagus - Superior laryngeal - Internal/external laryngeal External: cricothyroid muscles Internal: glottid, supraglottis, inferior epiglottis Cadaveric position Vocal cords in intermediate position Vagus nerve - recurrent laryngeal Intrinsics of neck (not cricothyroid) Sensation below vocal cords Glossopharyngeal: Sensory to posterior third of tongue, pharynx,carotid sinus and body Motor fibres as parasympathetic to parotid
54
CO2
Produced from heating calcium carbonate Boiling point -79*C Critical temp 31*C Only forms liquid at 5 atm Solid -> gas sublimation 1.5 density of air Dissociation curve more linear than O2
55
Altitiude
Affects rota meter as density of gas lower
56
CVP trace
A wave: Atrial contraction C wave: Tricuspid valve bulging into the atrium following right ventricle contraction V wave: Represent atrial filling with a closed tricuspid valve X descent: Between C wave and V wave Y descent: Between V and A waves Large A waves: RVH, complete heart block Tricuspid regurge: Giant V waves
57
Equipment safety
I - Outer casing earthed, fault will contact casing melting fuse II - Double insulated III - SELV, low enough that person can contact
58
Subtypes of I and II
B (body) - Maxiumum leakage 500uA, tingling, not to be used with defib BF (Body floating) - Leakage 500uA. Have isolating capacitor or transformer. Secondary circuit from earth. CF - Maximum leakage 50microA, least likely to microshock
59
Osmolality
285 - 295 milliosmole/kg Controlled by ADH - Small change, big response Infusion > 600 - pain and shrinking of RBCs < 150 - haemolysis Colligative property - depends on amount of solute not type - molar conc - dissociation - deviation from norm depression of freezing point, elevation of boiling point and a decrease in vapour pressure.
60
CJD prevention
Autoclave @ 121*C for 30 mins with 1N NaOH
61
Haemorrhage Classes
Class 1 <15% - Minimal change Class II 15 - 30% Tachy, anxious, minimal presure change Class III 30 - 40% Fall in systolics Require transfusion Class IV >40% Preterminal Reduced GCS, cold, narrow pulse pressure Rapid transfusion + surgical
62
BIS
Weighted sum of only 3 EEG parameters Physiological changes can also affects BIS (hypo etc) Agent dependent
63
ETT
Internal diameter in mm Radio opaque line running along length Left facing bevel RAE: cuffed 1 Murphy's eye, 2 in uncuffed ( if the tube is too long) Oxford: L chaped, reinforced, posterior facing bevel
64
ETT
Internal diameter in mm Radio opaque line running along length Left facing bevel RAE: cuffed 1 Murphy's eye, 2 in uncuffed ( if the tube is too long) Oxford: L shaped, reinforced, posterior facing bevel
65
Jet ventilaiton
Through CTM/bronchscope/ETT Pendelluft Cardiogenic mixing Convective streaming Cycles 60 - 600/min TV upto 150mls PEEP 5cmH2O Improves surgical conditions Cannot administer volatile agents
66
Gas Cylinders colours
Oxygen - black body, white shoulders. Nitrous oxide - French blue Air - grey body, black and white quarters on the shoulders Entonox - French blue body, white and blue quarters on the shoulders. Carbon dioxide - grey.
67
PA catheter
5G to 8G Multiple lumens - 10cm intervals from tip Thermistor - 3.7cm from tip Wedge pressure in branch of pulmonary artery
68
Tracheostomy tubes
2nd - 4th tracheal ring Introducer for insertion Standard 15mm connector Square tips Fenestrated - Window on greater curvature Silver tubes - Long term, bactericidal Inner tube for regular cleaning
69
TOE
Made of lead zirconate titanate Inserted nasally or orally T Aorta posterior to probe Heart is anterior
70
Intracellular ions
Potassium + Phosphate
71
Obstructive PFT severity
``` Mild 70-80% Moderate 60-69% Moderately severe 50-59% Severe 35-49% Very severe <35% ```
72
Nitrous oxide cylinder
45kPa 0.75 filling ratio Molybedenum 1/100 tensile tested
73
Pulmonary Vascular resistance
Ohms law MPAP - PCWP/CO
74
Sensitivity/Specificity
The sensitivity of a predictive test = true positives / (true positives + false negatives). The specificity of a test = true negatives / (false positives + true negatives). The negative predictive value of a test is true negatives / (false negatives + true negatives).
75
First order single compartment
Negative exponential curve
76
Penaz Technique
Continuous BP measurement in finger Pressure transducer Also incorporates a photocell, IR light for plethy
77
Vaporiser output
Carrier gas flow x SVP/Ambient pressure - SVP
78
12 Lead ECG
Bandwidth 0.05 - 150Hz Voltage 0.1 - 4 milliV
79
NMB testing
Posterior tibial nerve Facial Ulnar
80
Fick Principle
Uptake or release of a substance by any organ is the product of the arteriovenous (A-V) concentration difference of the substance and the blood flow to that organ CO = VO2/Ca - Cv
81
Vacuum Insulated Evaporator
1500L O2 Liquid @ -150 to - 170*C 5 - 10 atm On a weighing balance Safety valve opens at 1700kPa Pressure regulator maintains piped gas at 400kPa
82
Medical Oxygen Cylinder CD
Transport Flat base 2L internal capacity Nominal pressure 230 bar Nominal contents 460L Integral pressure reducing valve 4 bar outlet Made of aluminium/kevlar
83
Nitrous Oxide
French blue cylinder Pin index 3+5 Filling ratio 0.75 Critical temp 36.5 Antagonises NMDA Green house gas
84
Oxygen
Cylinder: Black body, white shoulders Pin index 1+5 Critical temp - 118.6*C Same % at altitiude PP reduced O2 is oxygen O3 is ozone
85
Scavenging
100ppm N2O 50ppm enfluran, isoflurane (sevo + des recommended) 10ppm halothane Activated charcoal absorbs volatiles Soda lime not involved in scavenging
86
pH
``` pH = -log10[H+] [H+] = 10 ^-pH ```
87
Thermistor
Thermocouple (semiconductor) Resistance falls exponentially with a rise in temp
88
Kinetic energy
1/2mass x velocity^2
89
Bioeffects of US
Thermal | Mechanical - cavitation
90
Absolute humidity
Max water vapour/volume of air Affected by temp only
91
Resistance in a wire
Greatest effect by resistivity | - Material of wire
92
Entonox
50:50 Volume mixture Cylinder blue, with blue and white shoulder Full 137 bar Store horizontally >10*C Pseudocritical temp -5.5*C
93
Larnygospasm
Suction + CPAP Prop Sux to follow Mg2+ and lidocaine for prevention
94
Risk reduction
Absolute risk reduction = Control event rate - Experiment event rate NNT = 1/ARR
95
Pressure in SI
Force/unit area Force = Mass acceleration due to gravity
96
Response of measurment
Zero order (eg thermometer) temp at that time First order Thermometer then placed in mouth, increase in exponential fashion unitl reaches body tmep Second order Place weight on scales Scales will oscillate until true equilibrium reached Drift Gradual loss of accuracy
97
Volatile measurement
IR absorption Mass spectrometry Quartz crystal oscilation UV absorption (halothane)
98
Nerve stimulators for performing nerve block
Stimulus for 1 - 2 milliseconds 2 leads, skin and needle Current of 0.25 - 0.5mA Insulated needle
99
STOP - BANG score
``` Snore? Daytime tiredness Observed stop breathing High blood pressure BMI >35 Age >50 Neck circumference >40 Gender ```
100
Methods for detecting awareness
``` Isolated forearm technique Lower oesphageal contractility Ocular microtremor Skin conductivity R - R beat variability ``` Digital plethysmography Electromuscular monitor Electroencephalogram Evoked potentials
101
Light planes of anaesthesia
``` Caesarean section (1 in 250) Cardiac anaesthesia (1 in 100) Major trauma (1 in 20) Impaired CVS function Bronchoscopy Difficult intubation ```
102
Defibrillator
Capacitor - 5000 - 8000 Volts Discharges in exponential manner Thoracic impedance is reduced by first shock
103
Pressure measurement
Electrical resistance Oscillotonometry Torricellian Vacuun Variable inductance
104
Triple point of water
273.16 K | 612 Pa
105
Energy from laser beam
E = hV E - energy of the photon h - Planck's Constant V - Photon Frequency