Quiz 3 Flashcards

(53 cards)

1
Q

What is vapor pressure?

A

in enclosed space at a constant temperature, with a volatile liquid, there will be an equilibrium between vapor and liquid below vapor- # of molecules exiting liquid for gas phase equals number of molecules returning to the liquid phase

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2
Q

Do you want a vaporizer to have high or low thermal conductivity?

A

high- will minimize temp changes that occur with vaporization to achieve constant flow of gas

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3
Q

Describe variable bypass vaporizers and where it is located

A

splits gas into the vaporizer (above and through the liquid agent); outside circle system

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4
Q

Which gas uses an electronic vaporizer and why?

A

des- has a high vapor pressure

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5
Q

How does the electronic vaporizer work?

A

injects known amount of liquid anesthetic into known volume of gas

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6
Q

What is the electronic vaporizer called?

A

Tec 6

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7
Q

What does the bimetallic strip do?

A

bends depending on temp to alter splitting ratio (sends more flow into vaporizer if cold)

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8
Q

What is the electronic vaporizer called, and what are its two characteristics?

A

Tec 6- heated and pressurized

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9
Q

What way do the control knobs move on the vaporizers?

A

counter-clockwise

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10
Q

What does the wick do in vaporizers?

A

gives the air more time to come up to desired concentration of agents

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11
Q

In the Tec 6, what temp is the gas heated to and pressurized at?

A

39 C, 1300 mmHg (or 2atm)

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12
Q

Will the partial pressure decrease with altitude in the Tec 6?

A

yes- does not compensate

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13
Q

What does the interlock system do?

A

prevents more than one agent being used at a time

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14
Q

The Tec 6 is a ? circuit

A

dual

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15
Q

What is the T setting on the vaporizers?

A

transport setting- prevents liquid from getting into the chamber (must use a new one if it does this)

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16
Q

What happens if you put sevo in an iso vaporizer?

A

You get a lower output (sevo has a lower VP than iso)

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17
Q

What would happen if you put iso in a sevo vaporizer?

A

You would get a higher output (iso has higher VP than sevo)

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18
Q

What would happen if you put halothane in an iso vaporizer?

A

nothing- similar VP

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19
Q

Describe laminar flow and what is the primary factor?

A

smooth, orderly, parallel to walls; flow fastest in the center; viscosity

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20
Q

Describe turbulent flow and what is the primary factor?

A

flow lines are not parallel; density

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21
Q

What are 3 things that change flow from laminar to turbulent?

A

change in gas direction >20 degrees, increased velocity, corrugated tubes

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22
Q

Reynolds number values

A

<2000- laminar >4000- turbulent

23
Q

Mapleson circuits for spontaneous breathing in order of efficiency

A

ADCB (all dogs can bite) *D includes E, F, Bain’s

24
Q

Mapleson circuits for mechanical ventilation in order of efficiency

A

DBCA (dead bodies can’t argue) *D includes E, F, Bain’s

25
In what situation is capnography most accurate?
closed/semi-closed system
26
Normal capnography shape is a ? in what type of ventilation?
top hat- mechanical
27
Describe phase 1
inspiratory baseline- should be near zero (if not, then rebreathing CO2)
28
Describe phase 2
expiratory upstroke- emptying of connecting airways and alveoli; mixing of anatomic and alveolar deadspace
29
Describe phase 3
expiratory plateu- uneven emptying, end expiration
30
Where is end tidal CO2 read on capnography?
end of phase 3 at the beta angle
31
Describe phase 4
inhalation; CO2 free gas enters airways
32
What is the normal alpha angle and when does it increase?
100-110 degrees; obstructive disease (COPD)
33
What is the normal beta angle and when does it increase?
90 degrees; rebreathing
34
What is the normal gradient between arterial and end tidal CO2?
2-5 mmHg
35
What is happening here and when is it good and bad?
"curare cleft"- pt initiating own breath (good at the end of a case, bad in the middle)
36
What is happening here?
COPD
37
What is happening here?
obstruction both ways (kinked ETT, bronchospasm)
38
What is happening here?
elevated baseline- rebreathing (could be result of exhausted CO2 absorber)
39
What is happening here?
cardiac oscillations (not breaths)
40
What happens when there is a leak in the bellows?
Can cause high pressure (barotrauma) and increase FiO2
41
Which type of bellows is better and why?
ascending- will not rise if patient is disconnected
42
What does the weight of the bellows do?
adds PEEP
43
What is fresh gas decoupling?
separates FGF from the TV during inspiration
44
What is circuit compliance?
the "stretch" in the circuit that may affect the TV delivered to the patient if the machine does not compensate for it
45
How do you calculate the TV if the machine does NOT decouple?
TV + FGF (FGF x I:E ratio as fraction/RR)
46
How do you calculate circuit compliance if the machine does not compensate for it?
compliance x PIP
47
How do you calculate total TV is the machine does NOT decouple and does not compensate for circuit compliance?
(TV + FGF) - circuit compliance
48
Mapleson A (APLon patient side)- added expiratory limb
49
Mapleson B (both APL and FGF on patient side with corrugation)- long expiratory limb
50
Mapleson C (no corrugation)- not efficient
51
Mapleson D (distant APL) - good for down lung cases
52
Mapleson E (no bag and valve) T piece
53
Mapleson F (no valve), attached scavenger