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The hanger youke has pins for E cylinders to fit on
What is the pin index for oxygen?  for nitrous?
Oxygen: 2,5
Nitrous: 3,5
What is the name of the gauge that shows oxygen tank pressure?
Bourdon
In a dual hanger yoke system, what prevents one cylinder from emptying into the other?
there is a "free-floating" valve for each cylinder.  The cylinder with the greatest pressure's valve will open and this pressure will close the vavle of the other cylinder
you have a dual hanger yoke wiht 2 oxygen "E" cylinders.  Both cylinders are turned on, which one will supply the gas machine?
the "E" cylinder withthe highest pressure
What kind of a valve is found in the fisrst and second stage pressure regulators?
Diaphragm valve
when oxygen flows from the cylinder and goes through the pressure regulator, what is the pressure decreased to?
the pressure is decreased to 40-50 psig
When the oxygen flush valve is pushed, what is the rate of oxygen delivery to the patient?
35-75 L/min
What does DISS stand for?
Diameter Index Safety System
have a ball and spring valve
found on the connectors from machine to wall supply
prevents hooking up wrong gas line
What does the pressure have to be at for the oxygen pressure sensor vavle to be open?
20-25 psig
if it falls below this, the vavle shuts and does not allow other gases to go through
prevents a hypoxic mixture
Which gas flow meter is always closest to the patietn?
Oxygen
Gas is delivered to the flow meters at ____psig
16 psig
This is a "free floating" valve:
Cylinder vavle
This vavle has a special diaphragm which identifies the function:
First stage regulator
by adjusting the needle valve on the gas scavenging system, are you altering the flow of waste gases or regulating vacuum/suction?
altering the flow of waste gases
If a vaporizer has been tipped, can you still use it?
no, b/c tipping it causes more liquid vapor to spill into the vaporizer chamber and higher (possibly lethal) concentration of agent will be delivered to the patient
List the components HIGH pressure system of a machine
  • cylinder pressure gauge (Bourdon)
  • Hanger yoke check valves
  • hange yoke index pins
**all related to Cylinders**
all pass throuhg the first stage regulator to bring pressure to 55 psig
List the components of the intermediate pressure system of a machine
  • pressure gages from pipeline
  • DISS
  • flush valve
  • second stage regulator
  • oxygen fail-safe vavle
  • flow control valve from the manifold
*this can be poped in gas (55psig) or cylinder gas that has already passed through the first stage regulator
List the components of the LOW pressure system of hte machine
  • vaporizers
  • common gas outlet
  • manifold
  • check vavles (b/t vaporizer and
    common gas outlet
this is 16 psig and si the pressure after gas has gone through the second stage regulator
Identify the pathway of Oxygen as it moves from an E cylinder to the patient
  • open cylinder valve
  • Hanger yoke system
  • opens free floating vavle of this cylinder and simultaneously shuts free floating valve of the other hanger yoke system and activates Bourdon gage to read cyliner pressure
  • First Stage regulator (decreasing pressure to 55 psig)
the following happens simultaneoously:
  • O2 pressure sensor vavle
  • flush vavle
  • DISS (closes  this free floating and prevents O2 from going into the wall)
  • second stage regulator
from the second stage regulator, the path continues:
  • now at 16 psig
  • gas flow mannifold(flow meters)
  • vaporizer
  • common gas outlet
  • down soda lime canister
  • inspiratory vavle
  • inspiratoyr limb of breathing circiut
  • ETT/pt's lipes
Name the 3 primary valves in the gas machine
1.  "Free Floating" valve:  primary function is to prevent gases from leaking out thoe system
2.  Ball and Spring valve:  function is to permit gas flow once a connection has been made (you supply the energy to make it work)
3.  Diaphragm valve:  function is to reduce pressure (first and second stage regulators)

Your flow meter is read at the _____ and if broken it will______
read at the top
fall if broken
Gas flowing thorugh the oxygen flush valve is:
a.  used to deepen anesthesia level
b.  at a rate fo 3L/min
c.  Intermediate pressure
d.  regulated by a free floating valve
c.  intermediate pressure
the inhalation and expiratory check vavles are what kind of valves?
free floating
What is the standerd marking that must be palced on all anesthetic gas cylinders
ICC3S
All compressed gas cylinders are constructed according to ______
Interstate Commerce Commission (ICC) specifications
What is the most commonly used breathing system today?
Bain circuit, a modification of hte Mapleson D
which Mapelson system is the worst for controlled ventilation?
Mapelson A
best used on spontaneously breathing pt
What mapelson system can be used to ventilate an apneic patient?
All of them
D F E > B C > A
Given an example of an "open" breathing system
pediatric induction
no mask on the face, just hel d close to it, anesthetic is diluted with RA
Give an example of a semi-open breathing system
Ambu bag
give an example of a semi closed system
mapelsons / Bain
List the adverse effects of LMA
  • aspiration
  • sore throat (due to overinflation of cuff)
  • Hypoglossal nerve injury
  • tongue necorsis
  • vocal cord paralysis
what is the maximam # of times an LMA can be reused?
40
once used, an LMA should be washed in_____ and cleaned with______ prior to autoclaving
dilute sodium bicarb solution
Endozime
when autoclaving an LMA, should the cuff be inflated or deflated?
deflated
What is the maximum inlfation volume of an LMA for a neonate (<5 kg)
4 cc
when fully inflated, the LMA rests against the upper _____
esophageal sphincter
what is the max. cuff volume for an LMA in:
infants
children 10 -20 kg
Infants: 7 cc
children: 10
what is the max. cuff volume for an LMA in children 20 - 30 kg
14 cc
what is the max. cuff volume for an LMA in children 30 - 50 kg
20
which nerve when stimulated will cause laryngospams
superior laryngeal nerve
If you think your pt aspirated with LMA, what do you do first?
trendelenburg
Unilateral nerve injury to the superior laryngeal nerve will cause what?
bilatera?
unilateral:  minimal effects
bilateral: hoarseness
**larygnospasm can occur when stimulated
Unilateral nerve injury to the recurrent laryngeal nerve will cause what?
bilateral?
Unilateral: hoarseness
Bilateral: stridor, aphonia, airway obstruction
Unilateral injury to the vagus nerve will cause what?
hoarseness
In a class I airway what can be seen?
  • Pillars
  • Uvula
  • Hard Palate
  • Soft Palate
What does PUSH stand for in airway classification?
Class I: can see Pillars, uvula, hard and soft palate
Class II: can see Uvula, hard and soft palate
Class: III: can see Soft palate and hard
Class IV: can see Hard palate only
Can you see VC in a grade III view
No
What is Endozime?
detergent of choice for cleaning LMAs
Which nerve is involved in glottic sphincter closer and may be stimulated druing LMA insertion?
Superior Laryngeal Nerve
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