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Anesthesia Chem/phys
gas laws, temps, heat,
| Question | Answer |
|---|---|
| Occurs when temperature is constant, pressure is inversely proportional to volume As pressure increase volume decrease As pressure decrease volume increase First gas law | Boyles Law |
| At a constant pressure the volume of a given mass varies directly with temperature. Second gas law Volume increase temp increase pressure is constant. This is a linear process Second gas law | Charles Law |
| At constant VOLUME the absolute pressure of a given mass varies directly with the absolute temperature. Third gas law | Gay Lussac's Law |
| Boyles Law, Charles Law, and Gay Lussac's Law any of these properties can be found mathematically. | Combined Law |
| The law states that the product of the volume of a gas and its pressure over the temperature is equal to a constant. Expressed mathematically as pV/T=k | Combined Law |
| For comparing the same substance under two different sets of conditions, the law can be written as | P1xV1/T1 = P2xV2/T2 |
| Equal volumes of gas, at the same temp and pressure, contain the same number of particles or molecules | Avogdro's Hypothesis |
| The idea gas constant has the same value for all gases | Avagadro's Law |
| The state of an amount of gas is determined by its pressure, volume, and temperature thus pv = nRt p= pressure, v= volume, n= number of moles, R= is the gas constant, t= temperature in kelvins | Idea gas law |
| What is the gas constant (R) of Pascals-Meter per mole-Kelvin | 8.314472 |
| What is the gas constant (R) of moles | .0821 |
| The idea gas law is most accurate for what type of gas | monotomic gases |
| Idea gas law is favored at _______ temperatures and _______ pressures | high and low |
| This law states that the total pressure exerted by gaseous mixture is equaled to the sum of the partial pressures of each individual component in a gas mixture | Dalton's Law also called Dalton Law of partial pressures |
| This law assumes that gases do not react with each other | Dalton's Law |
| Temperature above which a subtance can not be liquified no matter how much pressure is applied is known as? | Critical Temperature |
| Critical temp for Nitrous oxide is | 36.5 C |
| Adiabatic heating occurs when the _____ of a gas is _______ | Pressure and increased |
| Adiabatic cooling occurs when the _____ of a gas is ________ | pressure and decreased |
| The SI unit of work is | Joules |
| One Joule of work is done when a force of one ______ moves the point of applicaion one meter in the direction of force | Newton |
| Energy is always | Conserved |
| Work can be defined as | distance x force |
| If P = F/A therefore F = PA if V = DA therefore D = V/A Consequently work = | PA x V/A = PV |
| The energy for contraction is derived from the chemical energy conversion of | carbohydrates, fats, and proteins to ATP |
| Work = muscle shortening x | mean force exerted |
| Energy is not lost but converted from | one form to another |
| For calulations to work pressure must be in ____ and volume must be in __________ | pascals and cubic meters |
| Half of mechanical energy during inspiration is stored in the __________. The other half is used to overcome airway __________ | elastic tissues and resistnace |
| What is Osmosis | The passage of water from a less concentrated solution to a more concentrated solution when the two are seperated by a semipermeable membrane. |
| Heat is loss from the body by conduction, convection, evaporation, and radiation. Rank these routes from most to least heat loss | Radiation > convection > evaporation > conduction |
| Through which route does a burn partient lose the highest percentage of body heat? | Evaporation |
| For each one degree decrease in temperature, metabolism decrease by what percentage? | 7% for each degree centegrade |
| Where are the centers for heat loss and heat gain located? | heat loss center is located in the anterior hypothalmus and heat gain is located in the posterior hypothalmus |
| What is the more common temperature disorder during anesthesia, hypothermia or hyperthermia? | Hypothrmia |
| How does hypothermia alter systemic vascualr resistance and cardiac output? | Hypothermiais associated with increased SVR and myocardial depression (decreaed cardiac output). |
| What four groups of patients are at risk for intraoperative hypothermia? | 1. pediatrics, 2. geriatrics, 3. hypothyroid, 4. patients with hypothalmic lesions. |
| Hypothermia is associated with what hematologic changes? | 1. increase blood viscosity, 2. left shift shift in oxyhemoblobin curve, 3. impaired coagulation, 4. thrombocytopenia |
| Hypothermia has what effect on drug elimination? | Elimination of drugs are slowed because hepatic blood flow and metabolism are decreased, which slows excretion of drugs |
| Identify 6 physiologic disturbances caused by hypothermia. | 1.oxyhemoglobin curve shift to the left 2. increaed shivering 3. drug biotransformation are slowed 4. glomerular filtration rate is decreased 5. profound CNS depression 6. bradycardia and increased PVC's |
| Why is emergence delayed in the patient who is hypothermic | hypothermia reduces elimination of aneshtetics and prolongs awakening. Hypothermia decrease the overall rate of metabolism. |
| What is the earliest sign of Malignant Hypothermia | Increased end-tidal CO2 |
| How fast may temp rise during an epeisode of MH | 1-2 degrees Celsius every 5 mins |
| What is responsible for the increase sympathetic nerveous system stimulation during an episode of MH | Hypercarbia |
| Which drugs should be avoided in patients with a family history of MH | Succinylcholine and volatile agents ie desflurane, sevoflurane, isoflurane, halothane and enflurane |
| What nondepolarizing neuromuscular blocking agent may trigger MH | Tubocurarine (d-Tubocurarine chloride, dTC) |
| What body temperature should cooling be stopped with MH | 38 degrees C |
| If the blood:gas partition coeffecient is large, is the uptake slow or fast; is the onset slow or fast; and is the rise of the of the FA/FI slow or fast | An inhalational agent with a large blood:gas coeffecient is hghly lipid soluble. So uptake is FAST but speed of onset and the rise in FA/FI is slow. The higher the blood gas coeffecient, the greater the anesthetic uptake by the pulmonary circulation. |
| For a volatile agent that is poolry blood soluble (small blood:gas partition coeffecient)iss the uptake of agent by the blood slow or fastand is the rise in the FA/FI curve slow or fast | poorly soluble volatile agents the uptake is slow, the speed of onset is fast, the rise in the FA/FI curve is fast. |
| Brain uptake of anesthetics depend on what four factors? | 1. Blood solubilty, 2.Cardiac output (decrease in cardiac output increase anesthetic carried to the brain) 3. Alveolar ventilation 4. inspired concentration |
| How can you calculate how much oxygen is dissolved in the blood? What laws applies? | Multiply PO2 x 0.003 = amount of oxygen dissloved into blood. The units are ml O2/100ml of blood. This is Henry's law |
| When the PaO2 is 200 mm/Hg at normal body temperature, how many ml of oxygen will in 100 ml of blood plasma? | 0.003 x 200 = .6 ml O2/100 ml blood. |
| Process by which the molecules of a substance transfer through a layer or area such as the surface of a solution. | Diffusion |
| Diffusion is dependent on memebrane area and what? | thickkness |
| Diffusion is proportional to what? | Tension Gradient |
| With diffusion smaller molecules diffuse _______ and larger molecules diffuse ________ | Faster and Slower |
| If there is no tension gradient there is no what? | Diffusion |
| Rate of diffusion of a substance across a unit area is proportional to the concentration gradient | Fick's Law |
| Rate of diffusion is determined by what property | Solubility of gas |
| CO2 diffuses rapildly thus it has a ______ equilibration in a short peroid of time | fast |
| Blood transfer from capillaries to lungs in | .75 secs or 750 mili seconds |
| Problem with diffusion ultimately results in | hypoxemia |
| Diffusion is inveresly proportional to square root of molecular weight is known as? | Graham's Law |
| Diffusion is proportional to | membrane thickness |
| Diffusion is inversely proportional to the | molecular weight of the substance diffusing |
| Diffusion is directly proportional to the | membrane area |
| liquids diffuse faster or slower than gases | Slower |
| basic principle of osmosis is one mole of particles of solute in 22.4 liters produces how many kPa | 101.325 kPa or 1 atm |
| Osmolarity is moles per | liter |
| Osmolalty is moles per | kilogram |
| Oncotic pressure is osmotic pressure related to what? | proteins |
| What are the components of saline? | Sodium, potasium, calciuum, and lactate chloride |
| total osmolarity is | 278 mmol per liter |
| Body osmolarity is | 300 mmol per liter |
| Capillaries act as what | Semipermeable membranes |
| Interstial has no what? | Proteins |
| Difference in osmolar gradient is called | osmotic pressure |
| Provides flow out of arterioles to venules thus providing oxygen and wasing out CO2 | Oncotic pressure |
| Edema is caused by lack of | Oncotic pressure |
| Depression of vapor pressure of a solvent is proportional to the molar concentration of a solute | Raoult's Law |
| Used to measure osmolarity | Raoult's law |
| What are the four properties affected by osmolarity | 1. osmotic pressure, 2. freezing point depression, 3. vapor pressure reduction, 4. boiling point elevation |
| A mixture which vaporizes in the same proportion as its constituent volume proportions is known as | Application of Raoult's Law |
| Alcohol 96% and water 4% evaporate at the same rate. This is known as | Raoult's Law |
| Energy expended during stretch of elastic tissues = | 1/2 PV pressure times volume |
| Energy required for exhaling is | 1/2 PV |
| Energy required for inhaling is | twice that of exhaling |
| Inpsiration requires how many joules of energy | 300 mj |
| During spontaneous breathing how much energy is wasted on heat | 90% thus 10% effecient process |
| Expiration requires how many joules of energy | 150 mj |
| One watt equals | 1 joule per second |
| Power can be defined as | rate of work |
| power is measured how | watts |
| work of inspiration = 300 mj resp = 16 how many mW is this | 300 x 16 / 60 = 80 mW |
| Body's normal metabolic rate is | 80 watts |
| Pressure is proportional to flow; therefore power is proportional to flow squared | Laminar flow |
| Pressure is proportional to the square of the flow; therefore power is proportional to the third power of the flow | Turbulent Flow |
| As frequency increase the velocity in the airway _________ | Increases |
| In regards to hyperventilation, energy requirements increase by what power of the flow | Third power |
| During hyperventilation increase in oxygen can not keep up with ______________ requirements | Metabolic |
| As time constant decrease the frequency of ventilation | Increases |
| Work of myocardial contractions generateds how many mj? | 960 mj |
| For the right side of the heart P = 2.4 kPa flow is the same power is equal to how many watts? | 0.2 watts |
| Total power of the right side of the heart is equal to how many watts | 1.2 watts |
| Increase in BP and CO does what to the energy requirements of the heart? Which leads to what | Increase demand and heart failure |
| Name three govenmental agencies that are involved in the process of monitoring of temperature in the O.R. | JACHO, ASA, Accredidation agencies |
| Heat is what energy form | Kinetic |
| What does the thermal state of substance determines? | whether heat will flow to or from a substance |
| What is the Si units of heat | Kelvins |
| What are the four principle routes with typical heat losses in percent? | 1. Radiation 40% 2. Convection 30% 3. Evaporation 20% 4. Respiration 10% (8% evaporation 2% heating of air) |
| Radiation is depentdent on 2 things | Surrounding temperature and Surrounding radiant heat source |
| Radiation may account up to what percentage of heat losss? | 50% |
| How does metallic caps minimize heat loss? | By reflecting heat back to head |
| This type of heat loss can be minimize by trapping air betweeen a blanket, or other object an patient | Convection |
| Sweating may increase heat losss by a factor of ten | Surface Evaporation |
| Physiologic control of temperature is mediated by what part of the brain? | Hypothalmus |
| Body temperature below what degrees can be lethal | 35 Celsius |
| Proteins and enzymes work within a _______ temperature range. | Narrow |
| Thermoregulatory center may be set too high is known as | Pyrexia |
| Cerbral impairment may occur at what temperature because of a cascade effect? | 42 Celsius |
| What are known triggering agents of Malignant Hyperthermia? | Succinylcholine and volatile anesthetics |
| The amount of heat that is required to raise the temperature of 1 kilogram of a substance by 1 degree kelvin | Specific Heat |
| SI unit of specific heat capacity | J/(kg K) |
| How do you calculate Specific heat capacity? | Specific heat capacity is 3.5 kJ/(kg C)thus a 70kg patient = 3.5 x 70 = 245 kj/C this means that to change the temp of a 70 kg patient would either have to add or remove 245 kJ |
| what is the specific heat capacity | 3.5 kJ/Kg C |
| How long is it necessary to shiver to increase temperature by one degree C (assume a 70 kg pt) | 70 x 3.5 = 245kJ/C patient has 80 watts to begin with when they shiver the heat quadruples to 320. Subtract 80 from 320 = 240, 240 x 60 = 14400 or 14.4, 245/14.4 = 17.13 minutes |
| 4.18 J = how many calories | One calorie |
| 4.8 kJ = how many how many kilocalories | One kilocalorie = 1C |
| 2 kg of blood given to a patient patient's temp is 36 C what is the body's heat content? | 2kg x 3.6 kJ C kg x (36-5)thus 2x3.6x31)kJ = 223.2 kj |
| Air is equal to | 1.01 kJ C kg |
| How much energy does the body expend warming cool air at 7 liters per minute from room tempratures at 20 C to 36 C | 7L x 1.2(SH of air) x 14 (difference in temps)/60 thus 7 x 1.2 x 14 = 117.6/60 = 1.96 |
| Change of state without change in temperature is known as | Latent Heat |
| An example of latent heat is | when a substance change from a liquid to a gas |
| The heat required to convert 1kg of a substance from one phase to another at a given temperature is known as | Specific Latent Heat |
| the SI unit of specific latent heat is | Jkg-1 |
| In regards to specific heat; as temperature decreases the specific latent heat does what | increase |
| What is Ethyl Chloride used for | Anesthetize skin for minor procedures |
| When anesthetics vaporize it drops the pressure of the vapor, which does what to the concentraion of inhaled anesthetics | reduces the concentration |
| As nitrous oxide tanks empty the liquid turns into what? | a vapor |
| 4.1 bars equal how much pressure | 50 |
| If humidity in upper trachea is 34 mg/L and assuming the minute volume is 7L what is the total latent heat? | then 0.238 g/min = 7L/min x 34 mg/Lf total latent heat = specific heat of vaporizaton at 37 C x total water =2.42MJ/kg x 0.000238kg/min = 576 J/min = 9.6W |
| What is te total heat loss from respiration | Humified O2 = 9.6 watts warming O2 = 2 wattstotal energy = 11.6 watts |
| What law explains why gas bubbles distend when N2O is turned on or collapse when N2O is turned off? | Fick’s law of diffusion |
| What happens when to PACO2 and PAO2 when the N2O is shut off? | When N2O is shut off, gases in the alveoli are diluted by the in-rushing N2O,so PACO2 and PACO2 decrease |
| The dilutional effect of anesthesia occurs when which phase of anesthesia is initiated? | The dilutional effect occurs during emergence |
| If the patient has a closed pneumothorax and then N2O is turned on with the inspired concentration set at 75%, how long will it take for the volume of the pneumothorax to double? | twenty minutes |
| If the lipid solubility of an agent is high, then the MAC of the agent is | Low |
| Potency of an inhalational agent is directly related to its? | lipid solubility |
| MAC is inversely related to | Potency |
| If an agent is highly blood soluble, then the blood:gas coeffecient is | High |
| Blood solubility determines? | speed of uptake of agent y the brain |
| Brain uptake of an inhalational agent is related to cardiac output in what manner | inversely related brain uptake is accelerated if cardiac output is low |
| which inhalational agent causes the greatest change in heart rate | Enflurane |
| Which inhalational agent has the kleast effect on arterial blood pressure? | Sevoflurane |
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boharris6928
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