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Questions and Answers
Which condition can lead to an erroneously high reading of SpO2?
Which condition can lead to an erroneously high reading of SpO2?
What can cause hypoxaemia due to impaired oxygen transfer?
What can cause hypoxaemia due to impaired oxygen transfer?
Which of the following factors does NOT affect signal detection?
Which of the following factors does NOT affect signal detection?
What is a primary method used for monitoring inhalant agents?
What is a primary method used for monitoring inhalant agents?
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Which monitoring technique is commonly used to estimate core temperature?
Which monitoring technique is commonly used to estimate core temperature?
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What is considered a normal SpO2 level?
What is considered a normal SpO2 level?
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What PaO2 level corresponds to an SpO2 drop indicating a potential problem?
What PaO2 level corresponds to an SpO2 drop indicating a potential problem?
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Which mechanism is used in pulse oximetry to measure the degree of saturation?
Which mechanism is used in pulse oximetry to measure the degree of saturation?
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According to Beer-Lambert law, which of the following factors influences light absorbance?
According to Beer-Lambert law, which of the following factors influences light absorbance?
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What light wavelength is predominantly absorbed by oxyhaemoglobin (OHb)?
What light wavelength is predominantly absorbed by oxyhaemoglobin (OHb)?
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What physiological change occurs immediately after acute hemorrhage?
What physiological change occurs immediately after acute hemorrhage?
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Which type of pulse oximetry technology allows for the distinction of different haemoglobin species?
Which type of pulse oximetry technology allows for the distinction of different haemoglobin species?
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What is the main purpose of measuring Mean Arterial Pressure (MAP)?
What is the main purpose of measuring Mean Arterial Pressure (MAP)?
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In pulse oximetry, what does the receiver measure?
In pulse oximetry, what does the receiver measure?
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Which hormone is primarily affected by low right atrial stretch during hypovolaemia?
Which hormone is primarily affected by low right atrial stretch during hypovolaemia?
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What primary interference affect most pulse oximeters?
What primary interference affect most pulse oximeters?
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In response to acute hypotension, which of the following mechanisms is activated to restore blood volume?
In response to acute hypotension, which of the following mechanisms is activated to restore blood volume?
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What is the estimated time frame for the late response to acute hemorrhage?
What is the estimated time frame for the late response to acute hemorrhage?
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Which method is NOT a form of cardiovascular monitoring?
Which method is NOT a form of cardiovascular monitoring?
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What change occurs in pulse pressure when there is an increase in Systolic Arterial Pressure (SAP)?
What change occurs in pulse pressure when there is an increase in Systolic Arterial Pressure (SAP)?
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What is one of the key reasons for monitoring animals under anaesthesia?
What is one of the key reasons for monitoring animals under anaesthesia?
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Which of the following arteries is NOT typically palpated for assessing peripheral pulse in animals?
Which of the following arteries is NOT typically palpated for assessing peripheral pulse in animals?
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Which of the following physiological aspects should be monitored during anaesthesia?
Which of the following physiological aspects should be monitored during anaesthesia?
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What does the presence of limb withdrawal reflexes indicate in rabbits under anaesthesia?
What does the presence of limb withdrawal reflexes indicate in rabbits under anaesthesia?
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What autonomic response can nociception stimulate during anaesthesia?
What autonomic response can nociception stimulate during anaesthesia?
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What eye movement is an indicator of anaesthesia depth in dogs and cats?
What eye movement is an indicator of anaesthesia depth in dogs and cats?
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Which reflex is crucial for assessing the depth of anaesthesia, especially in horses?
Which reflex is crucial for assessing the depth of anaesthesia, especially in horses?
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What does electrocardiography primarily assess?
What does electrocardiography primarily assess?
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How does the cardiovascular response to nociception differ in horses compared to other animals?
How does the cardiovascular response to nociception differ in horses compared to other animals?
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What is the primary function of a sphygmomanometer?
What is the primary function of a sphygmomanometer?
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Why are complete anaesthesia records important?
Why are complete anaesthesia records important?
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What is the consequence of using a cuff that is too tight during oscillometry?
What is the consequence of using a cuff that is too tight during oscillometry?
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What does the maximal decrease in oscillation size during oscillometry indicate?
What does the maximal decrease in oscillation size during oscillometry indicate?
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In the placement of electrodes for electrocardiography, what shape should they form?
In the placement of electrodes for electrocardiography, what shape should they form?
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What is one limitation of plethysmography?
What is one limitation of plethysmography?
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Which statement accurately describes the purpose of high definition oscillometry?
Which statement accurately describes the purpose of high definition oscillometry?
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What does an inflated cuff during sphygmomanometry aim to accomplish initially?
What does an inflated cuff during sphygmomanometry aim to accomplish initially?
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What does a high Bispectral Index (BIS) value indicate?
What does a high Bispectral Index (BIS) value indicate?
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Which component is primarily associated with determining tissue oxygen delivery (DO2)?
Which component is primarily associated with determining tissue oxygen delivery (DO2)?
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In terms of parasympathetic tone activity (PTA), what does a predominant sympathetic tone reflect?
In terms of parasympathetic tone activity (PTA), what does a predominant sympathetic tone reflect?
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What physiological change is observed in the electroencephalographic (EEG) patterns during anaesthesia?
What physiological change is observed in the electroencephalographic (EEG) patterns during anaesthesia?
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Which wave frequency is primarily characteristic of a conscious state in an EEG recording?
Which wave frequency is primarily characteristic of a conscious state in an EEG recording?
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Which factor can lead to an erroneously low reading of SpO2?
Which factor can lead to an erroneously low reading of SpO2?
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What can cause hypoxaemia through a mismatch in ventilation and perfusion?
What can cause hypoxaemia through a mismatch in ventilation and perfusion?
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Which of the following affects the accuracy of inhalant agent monitoring?
Which of the following affects the accuracy of inhalant agent monitoring?
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What is a common method for monitoring core temperature during anesthesia?
What is a common method for monitoring core temperature during anesthesia?
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Which condition may falsely elevate SpO2 readings in pulse oximetry?
Which condition may falsely elevate SpO2 readings in pulse oximetry?
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What is a direct consequence of decreased Na+/K+ ATPase pump activity?
What is a direct consequence of decreased Na+/K+ ATPase pump activity?
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How is core temperature related to CNS activity during anaesthesia?
How is core temperature related to CNS activity during anaesthesia?
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What effect does hypothermia have on cats during recovery from anaesthesia?
What effect does hypothermia have on cats during recovery from anaesthesia?
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What is an important monitoring aspect when using neuromuscular blocking drugs?
What is an important monitoring aspect when using neuromuscular blocking drugs?
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Which ECG finding indicates myocardial stress or dysfunction?
Which ECG finding indicates myocardial stress or dysfunction?
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What is a primary reason for monitoring animals under anaesthesia?
What is a primary reason for monitoring animals under anaesthesia?
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Which physiological aspect is NOT typically monitored during anaesthesia?
Which physiological aspect is NOT typically monitored during anaesthesia?
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What reflex is crucial for assessing the depth of anaesthesia in horses?
What reflex is crucial for assessing the depth of anaesthesia in horses?
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What response can nociception trigger in the autonomic nervous system during anaesthesia?
What response can nociception trigger in the autonomic nervous system during anaesthesia?
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Which muscle reflex indicates light anaesthesia in rabbits?
Which muscle reflex indicates light anaesthesia in rabbits?
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What is a crucial factor in achieving accurate arterial blood pressure measurements during invasive monitoring?
What is a crucial factor in achieving accurate arterial blood pressure measurements during invasive monitoring?
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Which method is employed to check the autonomic response during anaesthesia?
Which method is employed to check the autonomic response during anaesthesia?
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What is a common characteristic of brain activity during deep anaesthesia?
What is a common characteristic of brain activity during deep anaesthesia?
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Which of the following could lead to inaccurate arterial blood pressure readings?
Which of the following could lead to inaccurate arterial blood pressure readings?
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What is the relationship between blood pressure and organ blood flow outside the range of 60 to 160 mmHg?
What is the relationship between blood pressure and organ blood flow outside the range of 60 to 160 mmHg?
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What determines the adequacy of anaesthesia depth in dogs and cats?
What determines the adequacy of anaesthesia depth in dogs and cats?
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What type of measuring system is preferred for invasive arterial blood pressure monitoring?
What type of measuring system is preferred for invasive arterial blood pressure monitoring?
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During arterial blood pressure monitoring, what important step must be performed to ensure reliability?
During arterial blood pressure monitoring, what important step must be performed to ensure reliability?
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Study Notes
Introduction to Anaesthesia Monitoring
- Essential for maintaining physiological functions during anaesthesia.
- Adequate monitoring improves patient safety, crucial for high-risk species like horses (1 death per 100 cases).
- Complete anaesthesia records serve as legal documentation.
Parameters to Monitor
- Central nervous system (CNS)
- Cardiovascular system (CVS)
- Respiratory system
- Body temperature
- Neuromuscular and renal function
- Metabolic and coagulation status
CNS Monitoring
- Reflexes: Monitor palpebral, corneal, limb withdrawal, perineal, and righting reflexes to assess anaesthesia depth.
- Eye movement: Positions indicate anaesthesia depth; particularly in dogs and cats.
- Autonomic activity: Changes in heart rate and blood pressure reflect nociception, affecting sympathetic and vagal responses.
CVS Monitoring
- Acute haemorrhage leads to decreased venous return, preload, and cardiac output, resulting in hypotension.
- Initial response involves sympathetic activation, increasing heart rate and systemic vascular resistance while redirecting blood flow to vital organs.
- Long-term restoration of blood volume through oral intake and renal functions occurs over hours to days.
Monitoring Techniques
- Heart rate and rhythm assessed through electrocardiography.
- Arterial blood pressure measurement techniques include manual sphygmomanometry, oscillometry, and high-definition oscillometry.
- Mean arterial pressure (MAP) is crucial for assessing organ perfusion: MAP = (SAP + 2 * DAP) / 3.
Electrocardiography and Blood Pressure
- Electrocardiography detects arrhythmias; requires at least three electrodes for correct placement.
- Non-invasive techniques like pulsometry and oscillometry assess arterial blood pressure, with specific guidelines for cuff placement and size.
- MAP as a primary value for organ perfusion over systolic and diastolic pressures.
Pulse Oximetry
- Continuous, non-invasive measurement of hemoglobin oxygen saturation (SpO2) is crucial; normal ranges are 95-100%.
- SpO2 can be a delayed indicator of hypoxaemia, which may not reflect immediate low PaO2 levels.
Respiratory System Monitoring
- Pulse oximetry uses two mechanisms for oxygen saturation evaluation: pulse photoplethysmography and spectrophotometric oximetry.
- Algorithm limitations include issues with hypotension, skin pigmentation, and external light interference.
Hypoxaemia Causes
- Caused by factors like low inspired oxygen, hypoventilation, diffusion impairments, and V/Q mismatch.
Gas and Inhalant Agent Monitoring
- Both inspired and expired gases must be monitored to prevent hypoxic mixtures.
- Inhalant agent concentrations are measured via infrared absorption spectroscopy, mindful of interference from gases such as methane.
Mechanical Ventilation
- Primarily achieved through positive pressure ventilation, which includes volume-controlled and pressure-controlled methods.
Temperature Monitoring
- Core temperature measurement ideally occurs at the pulmonary artery or approximated through the deep oesophagus.
Introduction to Anaesthesia Monitoring
- Monitoring is crucial to maintain physiological functions and ensure appropriate anaesthesia depth.
- Enhances patient safety, especially notable in high-risk species like horses with a mortality rate of 1 in 100 cases.
- Monitoring creates complete anaesthesia records for legal accountability, and also promotes personnel safety through proper analgesia.
Parameters to Monitor
- Central Nervous System (CNS)
- Cardiovascular System (CVS)
- Respiratory System
- Body Temperature
- Neuromuscular Function
- Renal Function
- Metabolic Status (including haematological and biochemical variables)
- Coagulation Status
CNS Monitoring Techniques
-
Reflex Assessment:
- Palpebral reflex evaluated bilaterally; corneal reflex persists until deep anaesthesia.
- Limb withdrawal reflex is crucial in rabbits, indicating anaesthesia depth.
-
Eye Movement and Position:
- Eye position changes can signal anaesthesia depth; notable in dogs, cats, and cattle.
- Horses may show slow palpebral contraction at deep anaesthesia, making globe position unreliable.
-
Autonomic Nervous System Activity:
- Heart rate and arterial blood pressure reflect nociception; can lead to tachycardia/hypertension or bradycardia/hypotension.
- Parasympathetic Tone Activity (PTA) indicates anaesthesia depth and analgesia-nociception balance.
-
Electroencephalography (EEG):
- Measures cortical brain electrical activity, indicating anaesthesia depth through different wave frequencies.
- The Bispectral Index (BIS) ranges from 0 (isoelectric activity) to 100 (awake), with ideal depth around 60%.
Cardiovascular System Monitoring
- Goal to maintain tissue oxygen delivery (DO2) influenced by cardiac output, arterial oxygen content, and oxygen extraction.
-
Arterial Blood Pressure (ABP):
- Invasive monitoring requires catheterization; a non-compliant system connection to pressure transducers ensures accurate readings.
- Mean Arterial Pressure (MAP) is crucial for organ perfusion, needing maintenance within 60-160 mmHg to ensure effective blood flow.
Respiratory System Monitoring
-
Hypoxaemia Causes:
- Low inspired oxygen, hypoventilation, and V/Q mismatch are critical factors affecting oxygenation.
-
Gas Monitoring:
- Inspired and expired gases analyzed to identify hypoxia; inhalant agent monitoring essential for ensuring proper anaesthetic delivery.
- Special filters required to distinguish inhalants from methane interference, which could falsely elevate readings.
Temperature Monitoring
- Core temperature should be managed to prevent CNS depression and maintain metabolic rates, primarily measured at the pulmonary artery or deep oesophagus.
- Hypothermia can lead to cellular edema, acidosis, and decreased organ perfusion, influencing MAC (Minimum Alveolar Concentration).
- Bradycardia and hypotension are common effects of temperature disruptions, affecting ECG readings, and increasing risks during recovery.
Neuromuscular Junction Monitoring
- Important for patients administered neuromuscular blocking agents to assure adequate paralysis and normal recovery.
- Proper electrode placement ensures accurate monitoring; incorrect placement may lead to erroneous interpretations of neuromuscular function.
Renal Function Monitoring
- Maintain MAP during anaesthesia as hypotension can adversely affect renal function and overall patient safety.
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Description
This quiz focuses on the critical aspects of monitoring animals during anaesthesia, emphasizing the importance of maintaining physiological functions and adequate anaesthesia depth. It highlights the safety concerns related to anaesthesia in various species, particularly horses, dogs, and cats. Test your knowledge on best practices and statistics in veterinary anaesthesia monitoring.
