Basics of Anesthesia Test 1

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1. Pulse Ox 1st ON last off 9. What is the cause of Formed with Hgb is exposed to
Carboxyhemoglobin? carbon monoxide
2. Pulse Ox Differentiates between reduced HgB
What will the pulse ox
and oxy-HgB
show? Pulse oximeter will over read
SPO2 by percent of COhb
estimates by using red and IR light
present
The ration between the two signals 10. What causes Caused by metoclopramide and
gives o2 sat Sulfhemoglobin? What sulfonamides
would the pulse ox show?
3. Wave lengths of Reduced HgB absorbs more light in the
Pulse ox will be artificially low
Pulse Ox red band 650-750nm
11. How does Methylene It can lower SPO2 without an
Oxy-HgB absorbs more light in the blue, indocyanine green, actual decrease in saturation
infrared band 900-1000nm and indigo carmine effect but only last a few minutes
SPO2?
4. Beer Lambert Law Relates the concentration of a solute in
solution to the intensity of light 12. What is MAP The point at which the
transmitted through the solution oscillations are maximal
13. A line Zero point R atrium-5cm posterior to the
Pulse Ox fuctions using this...
sternal border
5. Oxyhemoglobin
dissociation curve Mid ear (tragus) when in the
seated position cerebral
pressure around 75% for
perfusion of the brain
14. What is the purpose of an provides information on pts
A-line hemodynamic status
15. What does an A-line- Myocardial contractility
Slope of upstroke
indicate?
16. What does an A-line SVR
Slope of downstroke
Relationship between oxygen binding indicate? slurred/delayed stroke indicates
and oxygen tension increased afterload
6. Methemoglobin Pulse Oximeter 17. What does the dicrotic AV closure
causes inaccuracies notch of an A-line
with what monitor? indicate?
7. What causes Nipride, benzocaine, and prilocaine 18. Components of an arterial Systolic Upstroke
Methemoglobin and waveform Systolic Peak Pressure
what would the Gives false low readings on high sats Systolic Decline
pulse ox show? >85% Dicrotic Notch
Diastolic Runoff
Gives false high readings on low sats End-diastolic Pressure
<85%
19. Lead II Best for diagnosing arrhythmias
8. What is the Tx for Methlyene blue 1mg/kg for immediate Detects inferior wall ischemia
methemoglobinemia reversal Largest P wave
20. Lead V Most sensitive for ischemia
Spontaneous reversal can occur without
(anterior and lateral walls)
tx in 2-3hr following last dose
5th intercostal pace axillary line
True 5 lead when using 5 leads
21. When to get a 12 ST depression of >1mm or 37. Type of anesthesia TIVA without N2O is the
lead ST elevation with peaked T waves performed with MEP preferred technique
-propofol, opiods, precedex
22. Leads II, III and Inferior wall MI or diseased R coronary
aVF reveal what? artery 38. SSEP ...
23. V1, V2 & V3 anteroseptal wall 39. SSEP-Somatosensory evoked Limit Isoflurane to a
potential avoid what meds? concentration of < 0.5 MAC
24. V3, V4 & V5 anteroapical wall
25. V4, V5 & V6 anterolateral wall N2O decreases amplitude
26. How is a modified LA lead is placed in V5 position does not effect latencies
lead V done?
Etomidate and Ketamine
27. Why is the Detect changes in HR, onset of
increase amplitude 200-
precordial dysrhythmias, airway/ventilation
600%
stethoscope used? problems, VAE (venous air embolism)
28. What does CVP preload for the right ventricle (RVEDV) Opioids increase latencies
reflect? if the pt is healthy and decrease amplitude
29. Normal values of 1-15 mmHg 40. MEP-Motor Evoked Potentials MEP are more sensitive to IA
CVP what meds to avoid? What
30. Where is the CVP Just above the junction of the superior meds are preferred TIVA without N2O is the
catheter tip with vena cava and R atrium preferred technique
proper
placement? -Propofol
-Opioid
31. A wave Right atrial contraction occurs just after -Precedex
the P wave on the ECG
41. BAEP-Brain Auditory Evoked 8th cranial nerve-hearing
Absent in afib; may be exaggerated Potentials what nerve is
with junctional rhythms effected? What meds to Can be used with any
avoid? anesthetic type
32. C wave Occurs due to isovolumic ventricular
contraction forcing the tricuspid valve 42. VEP-Visual Evoked Potential Muscle relaxants
to bulge upward into the right atrium What meds to avoid?

33. V wave Reflects venous return against closed 43. How does diverting Uses a pump to aspirate gas
tricuspid valve (sidestream) gas monitoring from the sampling site
work?
Large v waves with tricuspid 44. How does a Nondiverting Measures gas by a sensor
regurgitation (mainstream) gas monitor located in the gas stream
34. BIS Bispectral Analysis work? Only O2 and CO2 can be
measured this way
100-85
Awake; memory intact For non-intubated patients
85-65 45. Raman Scattering Similar to the Beer-Lambert
Sedation law to identify molecules but
65-40 uses weight instead of light
General anesthesia; deep hypnosis
46. Infrared Analyses Can measure multiple gases
<40
CO2, NO2, and all IAs
Cortical suppression
47. Where is the Oxygen On the inspiratory limb
35. Components of Normal waveform consists of three
Analyzer found?
CVP waveform peaks (a,c,v waves) and two descents
(x,y)
36. Complications of Thrombosis, thromboembolism
CVP catheters Infection, sepsis, endocarditis
Arrhythmias
Hydrothorax
48. ASA and AANA Must be present with a low oxygen 58. KNOW A-line
standard concentration alarm in use. Waveform
regarding the
oxygen analyzer The first line of defense against a
hypoxic inspired gas mixture
49. ASA guideline Must be used on all cases!
regarding ETCO2
GOLD STANDARD for ET tube
placement and verification
50. What is measurement of CO2 in a gas mixture
capnometry?
51. What is the device that performs the 1. Systolic Upstroke
capnometer? measurement and displays reading 2. Systolic Peak Pressure
3. Systolic Decline
52. What is the recording of CO2 concentration 4. Dicrotic Notch
capnography? versus time 5. Diastolic Runoff
53. What is the machine that generates the 6. End-diastolic Pressure
Capnograph? waveform 59. Hypocapnea
54. What is actual waveform
Capnogram?
55. Normal ETCO2 ETCO2- 30-43mmHg
values? PaCO2? PaCO2- 35-45mmHg
56. KNOW CO2
Waveform 60. Decreasing
ETCO2

61. Hypercapnea

57. KNOW CVP

Waveform

62. Increasing ETCO2

63. Problems with

expiration
possible
bronchospasms

64. Kinked ET tube

65. Esophageal
intubation
66. Rebreathing 75. What causes Disconnect or leak in the circuit, inadequate
Low peak FGF, bag/ventilator selector valve in wrong
inspiratory position, leaking ETT cuff, disconnected
pressure ventilator, malfunctioning scavenging
alarm? system,
67. Curare cleft
76. What causes a O2 flush activation, an obstructed expiratory
Sustained limb, improperly adjusted APL valve,
elevated scavenging system occlusion,
68. CO2 retention pressure- malfunctioning ventilator, or incorrectly set
HIGH PEEP valve
pressure
alarm? Alarm is activated if the pressure does not
fall below a certain level during the
respiratory cycle
77. What causes a Airway obstruction, reduced compliance, O2
High pressure flush valve is activated during inspiration,
69. Rebreathing alarm? punctured ventilator bellows, occluded
expiratory limb, scavenging system
malfunction, patient coughing or straining
78. What causes a Activated when the pressure falls below
70. Return to subambient atmospheric by a predetermined amount
spontaneous pressure
ventilation alarm? ex. Pt inhales from an collapsed reservoir
bag, malfunctioning scavenging system,
blocked inspiratory limb during the
expiratory phase of the ventilator
71. Cardiac
79. When should ALL peds pts should be monitored at all
Osciallations
pediatrics times.
temp be
monitored? Adults when indicated
80. What is heat Loss of heat through infrared rays from the
loss via warm body to colder objects in the room
radiation? that do not contact the body

Accounts for 65-70% of heat loss

72. Incompetent
81. What is heat Transfer of heat to an air current
inspiratory
loss via Heat lost when body surfaces are exposed
unidirectional
convection? prior to surgical draping
valve
82. What is heat Heat is lost from direct contact between the
loss via patient and colder objects
conduction? OR table, linen, surgical instruments, skin
prep
Major cause of heat loss is skin prep and IV
fluids
73. Leak in the
sampling line of 83. What is heat Heat loss from the skin, respiratory tract,
positive pressure loss via open surgical wounds, pneumoperitonium,
ventilation evaporation? or wet towels and drapes that are in direct
contact with the patient's skin
84. Gradual Inspiratory problems
downstroke of Poss. Kinked ET
ETCO2
74. How can NO2 be By infrared technology only
measured
85. Waveform that is small and gradually decreases to 0 Esphageal intubation