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NU 624
Chemistry and Physics of Anesthesia - Exam 1 - Structure of Atom and Elements
| Question | Answer |
|---|---|
| Atoms [can/cannot] be subdivided by ordinary means. | Cannot |
| What has mass and takes up space? | Matter |
| What are the basic building blocks of matter? | Atoms |
| What is the Greek meaning of "atom"? | Indivisible |
| What three things are atoms composed of? | Protons, neutrons, electrons |
| What is the charge of a proton? Neutron? Electron? | Positive, neutral, negative |
| What two types of particles make up the nucleus of an atom? | Protons and neutrons |
| What particles determine the atomic number of an atom? | Protons |
| What part of an atom carries a negative charge? | Electrons |
| Protons are located within the nucleus. Where are electrons located? | Shells or orbits around the nucleus |
| What part of an atom is responsible for its chemical bonding activity? | Electrons |
| The number of electrons depends upon the number of [protons/neutrons] in an atom. | Protons |
| How many protons and electrons make up a hydrogen atom? | 1 proton, 1 electron |
| How many protons and electrons make up a helium atom? | 2 protons, 2 electrons |
| What prevents protons and electrons from coming in contact with one another? | The centrifugal movement of electrons around the nucleus |
| What is the "electronic configuration" of an atom? | The arrangement of electrons around the nucleus |
| What do electrons occupy? | Shells and each shell holds a specific number of electrons |
| What is the maximum number of electrons that the first shell can hold? | 2 |
| Each shell surrounding a nucleus is designated with what? | A specific letter |
| The second electron shell can hold a maximum of _______ electrons. | 8 |
| Which level of electrons is the most important? | The outermost level |
| Why is the outermost level of electrons the most important? | It determines the chemical activity of an atom |
| If the atomic number of sodium is 11, what does this mean in terms of proton content? | There are 11 protons in the nucleus |
| There is a/an [greater/fewer/equal] number of protons to neutrons in an atom that is neutral? | equal |
| What is responsible for the chemical properties of an atom? | Its electron arrangement |
| What condition exists to make an element reactive? | The outermost orbit or shell is not maximally filled with electrons specific for that shell |
| What are the six noble gases? | Helium, neon, argon, Krypton, xenon, radon |
| What 3 noble gases have the ability to form compounds? | Helium, neon, argon |
| Which noble gas contains only 2 electrons in its outermost shell? | Helium |
| What are three ways atoms can form stable electron configurations? | Losing, sharing, gaining |
| What is the formula used to determine the maximum number of electrons in each shell? | 2 x (n)sq |
| What does "n" represent in the electron shell formula? | The number of the shell |
| Sodium has an atomic number of 11. How many electrons are in its outer shell? | 1 |
| Is sodium more likely to donate or accept an electron? Why? | Donate, because it has only 1 out of a maximum of 18 possible electrons in its outer shell. |
| What process occurs with the loss of an electron? | Oxidation |
| Sulfur has an atomic number of 16. How many electrons does it have in its outer shell? | 6 |
| The atomic number of sulfur is 16, is it more likely to donate or accept an electron? | Accept |
| The process of accepting an electron is called __________. | Reduction |
| How many electron rules are there? | 3 |
| Electron rule 1) Atoms with 1, 2, or 3 electrons in their outer shell tend to ... | LOSE their outer-shell electrons to atoms with 5, 6, or 7 electrons in their outer shell. |
| Electron rule 2) Atoms with 5, 6, or 7 electrons in their outer shell tend to ... | GAIN electrons in interactions with atoms that have 1, 2, or 3 electrons in their outer shell. |
| Electron rule 3) Atoms with 4 electrons in the outermost shell tend to ... | SHARE their electrons with other atoms. |
| What is the sharing of electrons known as? | Covalent bonding |
| Give 1 example of an element that covalently bonds with other elements and what is its atomic number? | Carbon, 6 |
| Atoms are inherently [positive/negative/neutral]. | neutral |
| What are the two ways that atoms possess an electrical charge? | Gaining (reduction) or losing (oxidation) electrons. |
| The change of an atom into an ion is done through what process? | The addition of an electron (reduction). |
| An atom that gains an electron becomes a [positive/negative] ion. | negative |
| In an atom that has been reduced, the number of electrons is [greater than/less than/equal to] the number of electrons. | Greater than |
| An atom that loses an electron becomes a [positive/negative] ion. | Positive |
| What are fundamental substances that cannot be chemically broken down? | Elements |
| How many known fundamental substances are there? | 112 |
| How many unknown fundamental substances exist? | 2 |
| How are elements classified? | By their physical property |
| What are the 3 types of physical properties? | Gas, solid, liquid |
| The elements are classified into what 9 categories? | 1) Metals 2) Non-metals 3) Transitional metals 4) Alkali metals 5) Alkali earth metals 6) Halogens 7) Inert elements 8) Lanthanide series 9) Actinide series |
| How are the elements in the periodic table grouped? | Basis of similar properties |
| Who first arranged the periodic table? | Dimitri Mendeleyev |
| What is the 7th group of elements in the periodic table? | Halogens |
| The halogens are a [metal/non-metal] group of elements. | non-metal |
| What are the 5 halogens in the periodic table? | 1)Chlorine 2)Fluorine 3)Bromine 4)Iodine 5)Astatine |
| Halogens [do/do not] dissolve well in water. | Do not |
| What are two properties of halogens in relation to the human senses? | Strong unpleasant odors, burn the flesh |
| Halogens are good [oxidizing/reducing] agents. | Oxidizing |
| What is the strongest halogen? The weakest? | Fluorine=strongest, astatine=weakest |
| How does a volatile anesthetic agent change after combining with a halogen? | 1)Decreased flammability 2)Decreased volatility 3)Increased potency 4)Increased toxicity |
| What portion of diethyl ether constitutes the ether part of this chemical? | The C O C bond |
| Sevoflurane has an ether and hydrogen group in it's structure, making it explosive and flammable. What makes sevoflurane stable for anesthetic use? | Fluorine (halogen) |
| What are the 7 important elements in the body? | 1)Potassium 2)Magnesium 3)Calcium 4)Sodium 5)Lithium 6)Phosphorus 7)Halogen |
| Which element plays a role in the regulation of blood and body fluids? | Sodium |
| Sodium plays a role in what 3 important physiologic processes? | 1)Nerve impulses 2)Cardiac activity 3)Blood pressure |
| What is the normal range for sodium? | 135-145 mEq/L |
| Sodium levels above what amount can result in seizure or death? | 152 |
| What is the primary intracellular ion? | Potassium |
| How much potassium in the body exists in the intracellular space? | 98% |
| Intracellular potassium exists primarily in what areas of the body? | Muscle |
| What is the normal range of serum potassium? | 3.5-5.2 mEq/L |
| What is one feature in the body that buffers extracellular potassium against the large intracellular potassium pool? | Na-K pump |
| The Na-K pump is considered to be an active transport system, what does it need in order to function? | ATP |
| The kidneys help regulate serum potassium levels by excretion. Where in the kidneys is potassium excreted? | Distal tubule |
| What are the 5 physiologic roles of potassium? | 1)Constituent of the Na-K pump 2)Balance the acid-base systems 3)Transmit electrical signals between cells and nerves 4)Affect cardiac automaticity 5)Exchange the potassium ion for hydrogen |
| Explain why the exchange of the potassium ion for hydrogen has important anesthetic implications. | Overventilation blows off hydrogen ions by way of reducing CO2 in the body. As the blood serum becomes more alkalotic, the body compensates for the loss of hydrogen by shuttling serum potassium into the cells. The body then becomes hypokalemic. |
| A crush or tissue injury can lead to the elevation of what element? | Potassium |
| A crush or tissue injury can lead to a hyperkalemic state that can last over how many days? | 40 |
| The destruction of what types of cells can lead to hyperkalemia? | Red blood cells |
| Both metabolic and respiratory acidosis can lead to elevated levels of which element? | Potassium |
| The transfusion of hemolyzed blood can lead to the elevation of which element? | Potassium |
| What are two genetic conditions that can lead to hyperkalemia? | Hyperkalemic Periodic Paralysis and Addison's Disease |
| What are the early ECG changes that occur with hyperkalemia? | Peaked T waves, shortened QT interval, ST depression |
| What ECG changes occur after the early ECG changes in hyperkalemia? | BBB with widened QRS, increased P-R interval, decreased P wave amplitude |
| What are the late ECG changes that occur with hyperkalemia? | P wave disappears, QRS morphology widens to resemble a sine wave, Vfib or asystole |
| What IV combination of drugs should be given with hyperkalemia and what do they promote? | Glucose and insulin. Promotes the transfer of extracellular potassium back into the cells. |
| The administration of IV calcium in the hyperkalemic state protects what organ? | The heart |
| The administration of IV sodium bicarbonate counteracts what condition that occurs with hyperkalemia? | Acidosis |
| How does IV sodium bicarbonate influence the movement of potassium? | Promotes the movement of extracellular potassium back into the cells |
| What types of medications decrease total potassium stores? | Diuretics |
| Cation-exchange resins work to decrease potassium in what area of the body? | Gut |
| Excessive potassium loss can occur secondary to what means and conditions? (3) | Insufficient dietary intake, diuretics, GI disorders (diarrhea, vomiting) |
| What 5 ECG changes occur with hypokalemia? | 1) Shortened PR interval 2) Prominent U waves 3) Biphasic T waves 4) Increased R wave amplitude 5) Increased QRS duration |
| What is the normal range for magnesium? | 1.4-2.2 mEq/L |
| Magnesium is a co-factor for many enzymes involved in what physiologic process? | Energy metabolism |
| Magnesium is important in the synthesis of what 3 products? | Protein, RNA, DNA |
| How does magnesium regulate nervous tissues? | Maintains the electrical potential |
| What cation serves as an exchange ion for K+, which helps regulate potassium fluxes? | Magnesium |
| Magnesium is involved in the metabolism of which element? | Calcium |
| Diseases associated with low magnesium levels are usually accompanied by disturbances of what nature? | Nutritional |
| Hypomagnesemia occurs below what level? | 1.4 mEq/L |
| Low concentrations of magnesium are factors in what 4 conditions? | 1)Malabsorption syndromes 2)Protein calorie malnutrition (Kwashiorkor's) 3)Parathyroid disease 4)Chronic diarrhea |
| Hypermagnesemia occurs above what level? | 2.1 mEq/L |
| Hypermagnesemia does not usually lend itself to creating ____________. | Symptoms |
| Patients with what conditions are susceptible to hypermagnesemia? | Renal failure, pre-eclampsia |
| What ECG changes occur with elevated magnesium levels? | Lengthened P-R interval, widened QRS, increased T wave amplitude |
| How does hypermagnesemia affect NMBs? | Prolongs their effects |
| High levels of magnesium interferes with which element? | Calcium |
| Magnesium interferes with the action of calcium involving the release of what chemical and at what site? | Acetylcholine, pre-synapses |
| Normal calcium ranges between what levels? | 9-10 mg/dL |
| How are calcium levels regulated in the body? | GI absorption, bone reabsorption, Vitamin D ingestion |
| What is the most abundant mineral in the body? | Calcium |
| Calcium plays a role in what 4 processes related to movement? | 1)Neuromuscular transmission 2)Smooth and skeletal muscle contraction 3)Cardiac automaticity 4)Nerve conduction |
| Cell division and movement depends in large part on what element? | Calcium |
| What element is a co-factor for many steps during blood coagulation? | Calcium |
| What vitamin is necessary for calcium absorption? | Vitamin D |
| What condition occurs with vitamin D deficiency? | Ricketts |
| Certain oxidative processes in the body require what mineral? | Calcium |
| What 4 conditions can lead to hypercalcemia? | 1)Hyperparathyroidism 2)Malignancy 3)Drug therapy (thiazides, lithium) 4)Milk-Alkali syndrome |
| The excretion of calcium is facilitated by the administration of what fluid? | Isotonic saline (with or without a loop diuretic) |
| What 3 types of medications help decrease bone resorption? | 1)Calcitonin 2)Bisphosphonates 3)Gallium nitrate |
| Corticosteroids and oral phosphates help decrease calcium absorption in what area of the body? | Intestines |
| Patients with what 6 types of conditions must be monitored for hypocalcemia? | 1)Hypoparathyroidism 2)Vitamin D deficiency 3)Phosphate excess 4)Acute pancreatitis 5)Pt's who receive large amounts of citrated blood 6)Pt's who have been lavaged with large volumes of albumin |
| Stored blood does not contain which mineral? | Calcium |
| Large amounts of blood transfusions require close monitoring of which element? | Calcium |
| How does hyperventilation affect calcium levels? | Causes respiratory alkalosis. Alkalization of the blood increases the affinity of plasma proteins (albumin) to bind with calcium, therefore decreasing free ionized calcium levels. |
| What are 3 types of drugs that can cause hypocalcemia? | Heparin, protamine, glucagon |
| What musculoskeletal symptoms may occur with hypocalcemia? (2) | Carpopedal spasms, tetany |
| What can happen to the airway in a hypocalcemic patient? | Laryngeal spasm |
| What cardiac side effects occur in a hypocalcemic state? (3) | 1)Dysrhythmias 2)Decreased contractility 3)Heart failure |
| What cardiovascular symptoms occurs with hypocalcemia? | Hypotension |
| In severe hypocalcemia with the acute onset of tetany or convulsions, an immediate transfusion of calcium gluconate must be given: at what percentage? what dosage? how fast? | 10% solution, 1-1.5ml/kg IV, 10min |
| An IV infusion of calcium should be slowed or temporarily dc'd if what two ECG changes occur? | Bradycardia or Q-T shortening |
| The removal of what two glands can cause acute hypocalcemia in the immediate post-op period? | Thyroid or parathyroid glands |
| Laryngospasm is the chief symptom presented after what procedure? | Removal of the thyroid or parathyroid glands |
| What are 3 possible interventions to treat a patient with severe hypocalcemia presenting with laryngospasm? | 1)Reintubation 2)Administration of IV calcium 3)PPV after giving 20mg succ |
| What is the lightest alkali metal? | Lithium |
| What are normal lithium levels? | 0.6-1.2 mEq/L |
| What is the major use for lithium? | Treatment for manic depression |
| Minor toxicity of lithium leads to what 4 symptoms? | 1)Trembling hands 2)Nausea 3)Increased UO 4)Some loss of coordination |
| Major toxicity of lithium leads to what 5 symptoms? | 1)Convulsions 2)Upper and lower spasticity 3)Blurry vision 4)Stupor or coma |
| Severe lithium toxicity may lead to ________. | death |
| What 3 halogens combine with anesthetic agents? | 1)Bromine 2)Chlorine 3)Fluorine |
| What is the functional group that contains the ether in volatile anesthetics? | The C O C group |
Created by:
philip.truong
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