Test 3: Breathing System Flashcards
(119 cards)
1
Q
Laminar flow is _______ flow
A
Linear
2
Q
In laminar flow the flow is the highest in the _____ of the tube.
Why?
A
Middle
Because of less friction being present
3
Q
A larger tube for gas to flow through will allow more or less gas to flow?
A
More
4
Q
Wha this Hagen-Posieuille Law for Laminar flow?
A
Change in pressure= (Lx v x V) r4
5
Q
What is turbulent flow?
A
Flow going in multiple directions, not parallel.
6
Q
In turbulent flow, the flow can be ______ or _____.
A
Localized or generalized
7
Q
The more resistance, will do what to gas delivery?
A
Slow it down
8
Q
With turbulent flow, the flow will be _______ throughout.
A
Constant
9
Q
Laminar-turbulent flow will need more ________ to overcome the resistance.
A
Pressure
10
Q
What will increase the resistance on breathing circuits?
A
Bends
Lengthy tubing
Changes in diameter (going smaller)
11
Q
What causes generalized turbulence?
A
exceeding the critical flow rate
12
Q
what causes localized turbulent flow?
A
when gas flow is below the critical flow rate but encounters constrictions, curves, or valves an area of localized turbulence occurs
13
Q
what is the nature of laminar flow? particles move how?
A
the nature of the flow is smooth and orderly,
particles move parallel to the walls of the tube
14
Q
A
15
Q
describe the nature of turbulent flow?
A
flow is going in multiple directions, no longer parallel
16
Q
turbulent flow can be ________ or ________.
A
localized or generalized
17
Q
the more resistance will do what to the flow?
A
slow it down
18
Q
the flow rate of turbulent flow is what across the diameter of the tube?
A
the same
19
Q
describe the flow rate across the diameter of the tube for laminar flow?
A
the flow is the greatest in the middle
20
Q
what is the Hagen-Posieulle Law for Turbulent flow?
A
change in pressure is equal to Lxflow rate (V) x K (constant that includes gavity, friction, and gas density and viscosity)/ r5
21
Q
resistance imposes what on the patient?
A
a strain
22
Q
changes in breathing tend to parallel changes in?
A
work of breathing
23
Q
_______ ________ is typically greater source of resistance compared to the breathing circuit.
A
tracheal tube (smaller diameter and exposed to secretions and could be bite down on and such)
24
Q
list five ways the anesthesia provider could limit resistance?
A
short length
limit turns
limit valves
limit kinks
ensure largest internal diameter
25
when does resistance become excessive?
when the patient cannot overcome it
26
flow volume loops can show changes in?
resistance
27
pressure volume loops can show changes in?
compliance
28
compliance is a change in ________ over a change in \_\_\_\_\_\_\_\_\_\_.
change in volume over a change in pressure
29
in the breathing system what is the most distensible components?
reservoir bag
breathing tube
30
compliance places a role in determination of?
tidal volume
31
compliance is a measure of?
distensiability
32
A higher compliance is equal to what volume and pressure?
larger volume
less pressure
33
lower compliance equals what volume and pressure?
less volume
more pressure
34
the more compliant your system is the less \_\_\_\_\_\_\_\_\_\_
resistance
easier to distend
35
the purpose of all types of anesthesia breathing circuits is to deliver? and eliminate?
oxygen and anesthetic
carbon dioxide
36
what does rebreathing mean?
to inhale previously respired gases from carbon dioxide which may or may not have been removed.
37
rebreathing is ______ as the fresh gas flow is decreased.
increased
38
name the three factors that influence rebreathing?
fresh gas flow
mechanical dead space
breathing system design
39
if the volume of FGF supplied per minute is equal to or greater than the patient's minute volume, is there rebreathing?
no
as long as provision is made for unimpeded exhaust to the atmosphere or to a scavenging system at the point close to the patient respiratory tract
40
what is dead space?
ventilation without perfusion
41
how do you minimize mechanical dead space?
seperate the inspiratory and expiratory gas streams as close to the patient as possible
42
what is mechanical dead space?
the volume in a breathing system occupied by gases that are rebreathed without any change in composition
43
with no rebreathing, the composition of inspired gas is identical to?
fresh gas
44
When rebreathing occurs, the inpsired gas is composed of what?
part fresh gas and part rebreathed gas
45
what is the temperature and moisture content of fresh gas?
room temp and dry
46
what is the temperature and moisture content of exhaled gases?
warm and moist
47
rebreathing reduces what?
heat and moisture loss
cost from decreasing gas supply
48
the effects of rebreathing on inspired gas tensions will depended on?
the part of exhaled gas rebreathed and whether these pass to the alveoli or only to the anatomical dead space
49
oxygen rebreathed alveolar gas will have a \_\_\_\_\_inspired oxygen tension
reduced
50
rebreathing alveolar gas will _______ inductions and emergence.
prolong
51
rebreathing alveolar gas will cause an increased inspired ______ \_\_\_\_\_\_\_\_\_ tension unless the gas passes through an _______ before being rebreathed.
absorbent
52
rebreathing will allow normocarbia to be achieved despite \_\_\_\_\_\_\_\_\_.
hyperventilation
53
name the four rebreathing advantages?
cost reduction
heat retention
moisture retention
decrease occupation exposure to trace gases
54
does a face mask or ETT have more dead space?
face mask
55
list the common components of breathing systems?
connectors
adaptors
breathing tubes
apl valve
peep valve
filters
56
what is the purpose of a connector?
a fitting intended to join together two or more similar components
57
what is the purpose of an adaptor?
a specialized connector that establishes functional continuity between otherwise disparate or incompatible components
58
connector/adaptors can be distinguished by?
shape
component attached to
added features (nipple)
size/type of fitting at either end
59
if positioned between the breathing system and the patient connectors add to?
dead space
60
connector increase the number of locations at which what can occur?
disconnection
61
reservoir bags must have a ______ mm _______ connector
22 mm female connector
62
what is the purpose of the reservoir bag?
allows gas to accumulate during exhalation (permits rebreathing)
help assist or control ventilation
serve as a visual or tactile observation as a monitor of a patient's spontaneous respiration
63
what is the MOST distensible part of the breathing system? it protects the patient from what?
reservior bag
it protects the patient from excessive pressure in the breathing system
64
minimal rise in pressur edespite added volume in the reservior bag occurs untile _______ capacity is reached
nominal
65
once nomial capacity is reached, the pressure rises rapidly to a peak and then reaches a _________ . then as the bag distends further what happens?
plateau
as the bag distends further the pressure falls slightly
66
ASTM for reservoir bags requires that bags of 1.5 L or smaller shall not be less thant ____ cm H20 or over _____ cm H20 when the bag is expanded 4 times its capacity
what is the values for bags larger than 1.5 L
30
50
35 and 60
67
latex free reservior bags may allow _____ pressures to develop
higher
68
new reservior bags develop ________ pressure when first over inflated vs. bags that have been overinflated several times or pre stretched.
higher
69
traditional reservior bag for adults is?
3L
70
when discussing reservior bags a spare bag should always be kept immediately available why?
in case the bag develops a leak or becomes lost
71
what is the purpose of corrugations in the breathing tubes?
increase flexibility, help prevent kinking, and adds distensibility
72
what does the APL valve do?
releases gases to a scavenging system to control pressure in the breathing system
73
what is the STAndard about APL valve?
requires an arrow or marking indicate the direction of movement to close the valve
74
what is the standard motion ot close the APL valve or increase pressure?
clockwise motion
75
PEEP valves can be ______ or \_\_\_\_\_\_\_\_\_.
unidirectional or bidirectional
76
what is the recommended type of PEEP valve for safety? Why?
bidirectional
if placed incorrectly, they will not obstruct flow just not add PEEP
77
what is the major concern with unidirectional PEEP valves?
obstruction of airflow and barotrauma
78
what must a fixed peep valve have on it?
arrow indicating the proper direction of gas flow/ or words inlet and outlet/ and the amount of PEEP that will be applied.
79
after a clinician applied a fixed PEEP valve what should they do?
check for ventilation to ensure no obstructed flow
and check to ensure additional PEEP is being applied.
80
what is the purpose of a filter?
protect the patient from microorganisms and airborne particulate matter and to protect anesthesia equipment and the environment from exhaled contaminants.
81
when a filter is placed between the pt and breathing machine what may the filter do what?
increase inspired humidity
82
however, with a filter resistance increases as what happens?
condensation accumulates or secretions
83
additionally a filter between the patient and ypiece does what?
increases dead space
84
during spontaneous ventilation the APL valve remains closed during ______ and open during \_\_\_\_\_\_\_.
inspiration
expiration
85
during assisted ventilation the APL valve is ______ closed.
partially
86
during mechanical ventilation the APL valve is?
isolated by the bag-ventilator switch
87
minute ventilation is calculated by?
RR x TV
88
name the four classifications of breathing circuits?
open
semi-open
semi-closed
close
89
give examples of open breathing systems?
open drop
insufflation
nasal cannula or face mask
90
give examples of semi-open systems?
mapleson circuits (non breathing circuits)
circle system with high FGF greater than minute ventilation
91
92
semi-closed system examples?
circle system with FGF less than minute ventilation
93
closed circuit system examples?
circle system with extremely low FGF, with APL closed.
94
Does open system have rebreathing or reserviors?
no
95
does a semi open system have rebreathing or reserviors?
rebreathing no
reservior yes
96
does a semi closed system have rebreathing or reserviors?
rebreathing yes (partial)
reservior yes
97
does a closed system have rebreathing or reserviors?
rebreathing Yes (complete)
reservior (yes)
98
describe insufflation?
blowing of gas across a patients face
99
list the advantages of an open system?
easy to use
simple
noninvasive
100
list the disadvantages of a open system
air pollution
unable to ventilate
cannot control amount of gas providing to patient (entrain room air)
cost (high fresh gas flows)
Will not be able to conserve heat or humidity
101
describe draw over?
ambient air is the carrier gas that when the spontaneously breathing patient inspires (negative force) pulls air flow through the vaporizer which pulls some anesthetic to the patients lungs.
102
does a draw over have a reservior bag?
no it is a self inflating bag
103
list the components of the mapleson circuit?
face mask
breathing tubes
fresh gas inlet
adjustable pressure limiting valve
reservior bag
104
what does maplesons lack?
unidirectional valves
CO2 absorbers
both and inspiratory and expiratory limb
105
wha tis the best methods to determine the optimal fresh gas flow?
carbon dioxide monitoring.
106
what determine the amount of rebreathing using a mapleson?
the fresh gas flow
107
why is work of breathing and resistance low with mapleson circuits?
no unidirectional valves
108
with higher FGF you have ______ rebreathing
less
109
with lower FGF you have ________ rebreathing
more
110
what is the breathing tube size on a mapelson circuit?
22 mm
111
if a unidirectional valve gets stuck in a circle system what can happen?
barotrauma d/t obstruction
112
if a unidirectional valve becomes incompetent in a circle system what can happen?
you will get rebreathings
113
what is another name for a check valve?
unidirectional valves
114
the y piece has one _____ mm ___ port and two ____ mm ____ ports
15 female port
22 mm male ports
115
when is the apl suppose to be fully open?
spontaneously breathing
116
compliance of the breathing tube will be reflective of what?
resistance.
117
what are the components of the circle system?
fresh gas inlet
unidirectional valves
y-piece connector
apl valve
reservior bag
canister containing carbon dioxide absorbent
bag/vent selector switch
mechanical anesthesia ventilator
118
a closed breathing system is present with the FGI into the circle system ______ mL/min satisfies the patient's metabolic oxygen requirements _______ mL/min during aneshtesia and replace anesthetic gases lost by virtue of tissue uptake
150-500mL/min
150-250 mL/min
119
