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# Anesthesia Chem/phys

### gas laws, temps, heat,

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
Created by: boharris6928

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