Veterinary Anesthesia Monitoring Quiz
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Questions and Answers

Which characteristic indicates a deep plane of anaesthesia?

  • No jaw tone (correct)
  • Mild respiratory rate
  • Strong palpebral reflex
  • Eyes in a central position

What is the expected respiratory rate when an animal is in a light plane of anaesthesia?

  • Irregular respiratory rate
  • No change in respiratory rate
  • Decreased respiratory rate
  • Increased respiratory rate (correct)

During anaesthesia, what does the lack of a palpebral reflex typically indicate?

  • Ventromedial eye position
  • Light plane of anaesthesia
  • Surgical plane of anaesthesia
  • Deep plane of anaesthesia (correct)

Which method is NOT typically used to monitor the respiratory system during anaesthesia?

<p>Electrocardiogram (D)</p> Signup and view all the answers

What could indicate a change in the depth of anaesthesia based on respiratory patterns?

<p>Change in respiratory rate and pattern (D)</p> Signup and view all the answers

What physiological value indicates hypocapnia?

<p>Less than 35 mmHg (A)</p> Signup and view all the answers

What does a capnograph primarily display?

<p>Pressure versus time plot of expired CO2 (B)</p> Signup and view all the answers

Which of the following statements about capnometry is true?

<p>It involves breath by breath analysis of expired CO2. (C)</p> Signup and view all the answers

During the respiratory cycle, what phase follows expiration in terms of monitoring with capnography?

<p>Inspiration (A)</p> Signup and view all the answers

What is the normal range for end-tidal CO2 (ET CO2) values?

<p>$35 - 45 mmHg$ (C)</p> Signup and view all the answers

What is the primary focus when monitoring the cardiovascular system?

<p>Maintaining adequate tissue oxygen delivery (C)</p> Signup and view all the answers

Which tool is essential for monitoring heart rate and rhythm?

<p>Electrocardiogram (ECG) (B)</p> Signup and view all the answers

What does the amplitude on an ECG measure?

<p>The electrical activity of the heart (A)</p> Signup and view all the answers

What can capnography measure during cardiovascular monitoring?

<p>End-tidal carbon dioxide levels (B)</p> Signup and view all the answers

What does auscultation primarily assess in cardiovascular monitoring?

<p>Heart sound clarity and rhythm (A)</p> Signup and view all the answers

Which of the following is NOT typically monitored in the cardiovascular system?

<p>Respiratory rate (B)</p> Signup and view all the answers

What is the significance of palpation of the apex beat?

<p>It provides information about heart size and position. (C)</p> Signup and view all the answers

In the context of an ECG, what does myocardial hypoxia indicate?

<p>Insufficient oxygen available to heart tissue (A)</p> Signup and view all the answers

What is the most common lead placement for monitoring an ECG?

<p>Right shoulder and left leg (A)</p> Signup and view all the answers

What does a normal QRS complex indicate?

<p>It is tall and narrow (B)</p> Signup and view all the answers

Which of the following components is NOT part of the blood pressure measurement equation?

<p>Elasticity of arterial walls (B)</p> Signup and view all the answers

What does MAP stand for, and why is it important?

<p>Mean Arterial Pressure, an indirect indicator of tissue perfusion (B)</p> Signup and view all the answers

What heart rate change would be classified as 'fast' for most species?

<p>Greater than 100 beats per minute (B)</p> Signup and view all the answers

Which of the following conditions represents a risk regarding blood pressure during anesthesia?

<p>SAP &lt; 50 mmHg (D)</p> Signup and view all the answers

How is systemic vascular resistance related to blood pressure?

<p>It opposes the force of blood flow (A)</p> Signup and view all the answers

What are P waves in an ECG indicative of?

<p>Atrial depolarization (B)</p> Signup and view all the answers

What physiological condition enhances the ability of deoxygenated hemoglobin to carry carbon dioxide?

<p>Haldane effect (D)</p> Signup and view all the answers

What happens to oxygen release from hemoglobin when there is an increase in carbon dioxide concentration?

<p>Oxygen is released more easily. (D)</p> Signup and view all the answers

What does capnography primarily estimate in relation to respiratory function?

<p>Arterial CO2 levels (B)</p> Signup and view all the answers

Which factor primarily leads to hypoxaemia in patients?

<p>SpO2 &lt; 90-95% (C)</p> Signup and view all the answers

Which of the following is NOT a use of capnography?

<p>Analyzing blood pH levels (D)</p> Signup and view all the answers

What is the primary technology used in pulse oximetry to measure oxygen saturation in blood?

<p>Infrared spectroscopy (A)</p> Signup and view all the answers

Which condition is associated with decreased capnography readings due to hypoventilation?

<p>Obesity hypoventilation syndrome (B)</p> Signup and view all the answers

Which physiological effect occurs when oxygen binds to hemoglobin in the lungs?

<p>Decreased ability to carry CO2 (B)</p> Signup and view all the answers

What can cause an increase in end-tidal CO2 (ETCO2) readings?

<p>Severe respiratory acidosis (B)</p> Signup and view all the answers

Which of the following is a known source of interference when using pulse oximetry?

<p>Movement (B)</p> Signup and view all the answers

What is a potential technical error that can affect capnography results?

<p>Disconnected sampling tube (C)</p> Signup and view all the answers

Which of the following conditions is characterized by increased cardiac output and would likely result in elevated ETCO2?

<p>Sepsis (D)</p> Signup and view all the answers

In what condition might pulse oximetry overestimate oxygen saturation?

<p>Pigmentation (A)</p> Signup and view all the answers

What is an essential first action if the quality of the pulse oximetry signal is poor?

<p>Check the plethysmography waveform (A)</p> Signup and view all the answers

In capnography, what does a decrease in ETCO2 typically indicate?

<p>Decreased cardiac output (A)</p> Signup and view all the answers

What is a typical normal range for blood oxygen saturation?

<p>98-99% (D)</p> Signup and view all the answers

What effect does hypothermia have on capnography readings?

<p>Decreases ETCO2 (A)</p> Signup and view all the answers

What physiological change occurs with decreased pH levels in tissues?

<p>Enhanced oxygen release (C)</p> Signup and view all the answers

Which aspect of respiratory monitoring does capnometry NOT provide information about?

<p>Direct lung capacity (A)</p> Signup and view all the answers

What is a potential cause for decreased capnography readings during anesthesia?

<p>Drug-induced respiratory depression (A)</p> Signup and view all the answers

Flashcards

Stage III, Plane 2

The stage of anesthesia where the animal is relaxed and immobile, but still has some reflexes. This is the ideal plane for surgery.

Capnography

A method of monitoring the respiratory system during anesthesia by measuring the carbon dioxide levels in exhaled breath.

Respiratory Rate (RR)

The number of breaths an animal takes per minute.

Mucous Membrane Colour

A change in the color of the mucous membranes can be a sign of low blood oxygen levels, or hypoxia. This can be a sign of problems with breathing or circulation.

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Tidal Volume

The amount of air that is breathed in with each breath. It can help determine if the animal's lungs are functioning properly.

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Capnometry

The measurement of carbon dioxide in expired air. It is a vital tool for monitoring respiratory function.

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What are normal ETCO2 values?

A normal ETCO2 value is usually between 35 and 45 mmHg. Lower than 35 mmHg is considered hypocapnia, while higher than 45 mmHg is considered hypercapnia.

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Normal capnograph trace

The most common waveform seen in capnography, It shows the changes in CO2 pressure over a respiratory cycle.

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Advantages of Capnography?

Capnography is a non-invasive, continuous monitoring method that can detect issues early.

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What is capnography?

Capnography is a method of monitoring carbon dioxide (CO2) levels in exhaled breath. It helps assess the respiratory system and its functions during anesthesia.

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What does PaCO2 represent?

The partial pressure of carbon dioxide in the arterial blood, written as PaCO2, is a key measure in capnography. It reflects the body's ability to eliminate CO2 through breathing.

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What is a ventilation/perfusion mismatch?

A ventilation/perfusion mismatch occurs when the balance between air flow (ventilation) and blood flow (perfusion) in the lungs is disrupted. This can affect how efficiently CO2 is eliminated.

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What information can capnography give us?

Capnography provides insights into the patient's metabolism, cardiac output, and alveolar ventilation. These are all essential aspects of respiratory function.

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What's the difference between sidestream and mainstream capnography?

Sidestream capnography samples a small portion of exhaled breath to measure CO2, while mainstream capnography directly measures CO2 in the exhaled airflow.

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What might a low ETCO2 indicate (decreased CO2 in exhaled breath)?

A decreased ETCO2 can indicate various issues, such as hypothermia, hypothyroidism, drugs affecting breathing, or problems with cardiac output.

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What might a high ETCO2 indicate (increased CO2 in exhaled breath)?

An increased ETCO2 can signal situations like fever, hyperthermia, seizures, or hyperthyroidism. It can also indicate problems with ventilation or CO2 absorption.

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How is capnography useful during CPR?

Capnography is particularly valuable during cardiopulmonary resuscitation (CPR) as it reflects the effectiveness of chest compressions and ventilation.

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What technical errors can affect capnography?

Technical errors in capnography can lead to inaccurate readings. Common errors include disconnection, sampling blockage, ET tube issues, and improper settings.

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Why is it important to monitor changes in ETCO2?

Observing changes in ETCO2 over time is crucial in monitoring the patient's condition and providing appropriate interventions.

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What is ECG?

ECG is a graphic representation of the electrical activity of the heart captured on the skin's surface. It primarily helps monitor heart rate and rhythm but can also detect abnormalities like electrolyte imbalances and myocardial hypoxia.

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Is ECG a measure of the heart's strength?

ECG is not a measure of the heart's pumping strength (contractility). It primarily reflects the electrical signals associated with heartbeats.

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What are artifacts in ECG?

ECG signals can be distorted by external factors, producing misleading results. Ensure the ECG machine setup is stable and avoid sources of interference.

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What is Heart Rate?

Heart rate (HR) is the number of times your heart beats per minute. It can be measured through palpation, auscultation, or an ECG.

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How is ECG used for heart rhythm monitoring?

ECG is used to assess the rhythm of the heart's electrical activity, helping to detect irregular or abnormal heartbeats.

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How does ECG detect electrolyte imbalances?

The electrical impulses in the heart can be affected by electrolyte imbalances, which can be detected through ECG.

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How does ECG detect myocardial hypoxia?

ECG can detect myocardial hypoxia, a lack of oxygen supply to the heart muscle, which can be a sign of heart problems.

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What are auscultation and palpation?

Auscultation involves listening to the heart sounds with a stethoscope, while palpation involves feeling the heartbeat with your fingers.

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What is the Bohr effect?

The tendency of oxygen to be released from hemoglobin in tissues with high CO2 levels and low pH, while it tends to bind to hemoglobin in tissues with low CO2 and high pH (like the lungs).

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What is the Haldane effect?

Deoxygenated hemoglobin has a higher affinity for CO2, while oxygenated hemoglobin has a lower affinity for CO2. This promotes the release of CO2 from the blood in the lungs and its uptake in the tissues.

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What is SpO2?

A measurement of oxygen saturation in the blood, typically expressed as a percentage. It reflects the proportion of the available hemoglobin binding sites that are occupied by oxygen molecules.

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How does pulse oximetry work?

A non-invasive method used to monitor SpO2 by measuring light absorption through a finger or earlobe. It utilizes infrared spectroscopy to detect the differences in light absorption by oxygenated and deoxygenated hemoglobin.

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What are some limitations of pulse oximetry?

Pulse oximetry relies on a pulsatile blood signal, preferably from arterial blood, to calculate oxygen saturation. It can be affected by factors like movement, poor peripheral perfusion, and certain pigments like carboxyhemoglobin.

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What is one key advantage of capnography?

One of the key advantages of capnography is its ability to detect changes in ventilation or respiratory function early, helping to identify potential problems before they become critical.

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What additional information can pulse oximetry provide?

Pulse oximetry can provide additional information beyond just SpO2, including insights into vascular tone, tissue perfusion, and fluid responsiveness. It can be used in conjunction with other monitoring techniques like echocardiography.

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What is a normal SpO2 range and what constitutes hypoxaemia?

A normal SpO2 range is typically considered to be between 98% and 99%. Hypoxaemia, a condition of low oxygen levels in the blood, is often defined as SpO2 below 90% to 95% or a PaO2 below 60 mmHg.

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What are some potential inaccuracies or limitations of pulse oximetry?

Pulse oximetry readings can be influenced by factors like pigmentation, carboxyhemoglobin, and methaemoglobin. These can interfere with the measurement and potentially lead to inaccurate readings.

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Electrocardiogram (ECG)

ECG measures the electrical activity of the heart, providing information about its rhythm and function. It's like a heart's EKG!

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Lead II in ECG

Lead II is a specific placement of electrodes used in ECG monitoring. It provides a clear view of the heart's electrical activity from the right shoulder to the left leg.

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EINTHOVEN'S TRIANGLE

EINTHOVEN'S TRIANGLE is a concept used in ECG to understand the heart's electric activity from various angles. It's a geometric representation of lead placement.

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Blood Pressure

Blood pressure is the force of blood against the arterial walls. It's crucial for blood flow and tissue perfusion.

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Mean Arterial Pressure (MAP)

MAP (Mean Arterial Pressure) is an average blood pressure, indicating tissue perfusion during a cardiac cycle.

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Systolic Blood Pressure (SAP)

Systolic Blood Pressure is the highest pressure during a heartbeat, when the heart contracts.

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Diastolic Blood Pressure (DAP)

Diastolic Blood Pressure is the lowest pressure during a heartbeat, when the heart relaxes.

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Blood pressure values under anaesthesia

Blood pressure values under anaesthesia are significantly lower than those in awake animals; it's important to adjust monitoring and provide appropriate support.

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Study Notes

Monitoring in Veterinary Anaesthesia

  • Monitoring of anaesthetised patients is crucial.
  • Physical examination findings aid in assessing the patient.
  • Clinical signs are used to assess the depth of anaesthesia.
  • Electronic equipment like ECG, pulse oximetry, capnography, and arterial pressure measurement are used.
  • Potential sources of error in physiological monitors and their impact on global patient status are important.
  • The anaesthetic record is a legal document and should be meticulously filled out.
  • Proper monitoring maintains anaesthesia depth, assesses analgesia, and maintains body functions as physiologically normal as possible.
  • Identifying changes and issues, evaluating patient response to treatment, and ensuring safety of patients and staff are vital aspects of monitoring.
  • The 5 human senses (sight, smell, touch, taste, and hearing) are relevant.
  • Monitoring equipment forms a critical component.
  • The anaesthetic record acts as a crucial legal document and should be complete.

Objectives

  • Explain the importance of monitoring anaesthetised patients
  • Describe the use and interpretation of physical examination findings in assessing anaesthetised patients.
  • Identify clinical signs used to assess anaesthetic depth.
  • Describe the use and interpretation of electronic equipment for physiological monitoring, specifically electrocardiography, pulse oximetry, capnography, and arterial pressure measurement.
  • Discuss potential sources of error in physiological monitors and their impact on the interpretation of patient status.
  • Understand the importance of the anaesthetic record as a legal document.

Aim of Monitoring

  • Maintain an adequate depth of anaesthesia.
  • Assess adequacy of analgesia.
  • Maintain the function of different body systems as physiologically normal as possible.
  • Identify changes or issues.
  • Evaluate patient response to treatment.
  • Ensure staff and patient safety.
  • Maintain legal requirements.

Anaesthetic Record

  • Legal document that must be completed in its entirety.
  • Recording should occur at least every 5 minutes (though continuous monitoring is preferred)
  • Any important events during anaesthesia must be recorded.
  • The record serves as a future reference for anaesthetic procedures.

Monitoring of the Central Nervous System

  • Species differences in monitoring are crucial.
  • Eye position, movement, palpebral reflex, lacrimation, and nystagmus are assessed.
  • Jaw tone, laryngeal and pharyngeal reflexes are also evaluated.
  • Physiological parameters (heart rate, respiratory rate, blood pressure), anal tone, pedal reflex, and righting reflex are important indicators to observe.
  • Regular evaluation of trends is essential.
  • Assessing the adequate anaesthetic level.
  • Inconsistent signs in different species.
  • Drug effects (e.g., ketamine).
  • Evaluating the patient during the anaesthetic procedure.

Monitoring the Respiratory System

  • Respiratory rate and rhythm are critical parameters.
  • Capnography and pulse oximetry are necessary for monitoring.
  • Colour of mucous membranes provides insights into oxygenation and perfusion status
  • Tidal volume measurements help in breathing analysis assessment
  • Blood gas analysis provides a comprehensive picture of respiratory function.

Capnography

  • Capnography analyzes expired CO2 (end-tidal CO2).
  • Respiratory rate (RR) is determined by the analyses.
  • Inspired CO2 (FiCO2) levels are assessed.
  • Provides a graphical representation of CO2 throughout the respiratory cycle.
  • Helps determine alveolar ventilation and metabolism, cardiac output, and respiratory rhythm.
  • Identifies issues like ventilation/perfusion mismatch.

Pulse-Oximetry

  • Measures the oxygen saturation of haemoglobin.
  • Calculates the percentage of oxyhaemoglobin.
  • Normal range is between 98-100%.
  • Hypoxaemia is identified if SpO2 is between 90-95%.
  • Continuous and non-invasive monitoring of oxygenation levels.
  • Detects hypoxaemia earlier than observation.
  • Can be used on various body parts.

Monitoring the Cardiovascular System

  • Monitor tissue oxygen delivery.
  • Maintain cardiac output and oxygen saturation.
  • Evaluate heart rate and rhythm.
  • Assess blood pressure.
  • Monitor colour of mucous membranes.
  • Palpate peripheral pulses, noting rate, quality, and synchronicity with heartbeats.
  • Use of pulse oximetry and capnography/capnometry.

ECG

  • 3 leads (+ and - ground leads) are placed for monitoring heart activity.
  • Common placement (most effective): lead II which uses left leg and right shoulder,
  • Evaluate for artefacts (disturbances of the trace )
  • Assess for rhythm and rate

Blood Pressure Measurement

  • Blood pressure is force/area of blood flow.
  • Blood pressure is influenced by cardiac output and systemic vascular resistance.
  • Stroke volume and heart rate affect output
  • Preload, afterload, and contractility impact blood pressure.
  • Non-invasive methods include oscillometry and high-definition oscillometry
  • Invasive methods involve measuring directly in an artery by cannulation
  • Consider the species and breed when interpreting measurements

Temperature Monitoring

  • Measurement are conducted by rectal, nostril, or oesophageal thermometers.
  • Measurement frequency is either continuous or intermittent.
  • High risk for hypothermia and hyperthermia are considerations

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Test your knowledge on anesthesia monitoring techniques in veterinary practice. This quiz covers key concepts such as respiratory rates, reflexes, and the use of capnographs during anesthesia. Perfect for veterinary students or professionals looking to refresh their understanding.

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