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NU 624

Chemistry and Physics of Anesthesia - Exam 1 - Structure of Atom and Elements

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