Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Anesthesia > 4. Nitrous I > Flashcards

4. Nitrous I Flashcards

1
Q

What are the conducting airways

A

larynx, trachea, bronchi, bronchioles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the respiratory airways

A

respiratory bronchioles
alveolar ducts
alveoli

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Blood supply to lungs

A
  • To the alveolar= bronchial circulation

- Participating in gas exchange= pulmonary arteries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Muscles that partake in inspiration and expiration

A

Inspiration- diaphragm and intercostals (accessory mm= SCM, scalenes and abdominal mm.)

Exhalation= passive elastic recoil

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Autonomic and Voluntary control centers of the brain for respiration

A
  • Autonomic- medullary reticular formation in pons

- Voluntary= cerebral cortex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Central and peropheral chemoreceptors that stimulate breathing

A 
Central= H+ conc. and Partial pressure CO2
Peripheral= Carotid and aortic bodies (Partial pressure O2)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Me chanoreceptors that modulate the rate and depth of respiraiton

A
  • J receptors
  • In lung periphery
  • Simulate ventilation in response to pulmonary vascular engorgement
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Rate of gas diffusion is directly proportional to

A

the partial pressure created by the gas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How does gas exchange between alveoli and capillaries occur

A

simple diffusion down a partial pressure gradient (rate of gas exchange primarily depends on the difference in partial pressures)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Factors that increase the alveolar partial pressure (tension)

A
  • Increased delivery (increase ventilation)

- Decreased removal (decreased solubility or CO)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Gasses with (high/low) solubility have a faster rate of equilibrization

A

low

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

The lower the solubility of a gas the (faster/slower) the onset and the (faster/slower) the recovery

A

faster… faster

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Solubility of a gas in blood is expressed how

A
  • Blood: gas or tissue: blood coefficient

- Oil:gas partition coefficient

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Define MAC

A

Minimal alveoalr concentration- concentration of anesthetic needed to produce immobility in 50% pateints

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the MAC of Nitrous

A

105

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Nitrous has a (high/low) blood: gas partition coefficient

A

low (lowest of all the gases

17
Q

General anesthesia is defined how

A

drug-induced state by absence of perception to all sensations

18
Q

MAC is a measure of the drugs (what property?)

A

potency

19
Q

Factors that lead to a decrease in MAC

A
  • Hypoxia
  • Increased hypercarbia (increased CO2)
  • Anemia (less O2 carrying ability)
  • Old age
  • Hypotension
  • Hypothermia
  • CNS depressants
  • LAs
  • Pregnancy
20
Q

Factors that increase the MAC s

A
  • Hyperthermia
  • Infants and adolescents
  • Microsomal inducing agent (chronic EtOH and Drug use)
21
Q

What is the most commonly used inhalation anesthetic in dentistry

A

nitrous oxide

22
Q

Four properties of N2O that can be beneficial or harmful

A
  • Expands the colume of gas filled spaces- not beneficial
  • Concentration effect- beneficial
  • Second gas effect- beneficial
  • Diffusion hypoxia- not beneficial
23
Q

Describe why N2O has the tendency to fill gas spaces

A

-N2O is more soluble in blood than N2 –> spaces fill more rapidly than the gas can diffuse out

24
Q

Areas where gas accumulation can lead to issues

A
  • Middle ear
  • Eye (post- retinal surgery)
  • Pneumothorax
  • GI in case of bowel obstruction
  • Air emboli enlargement
  • Emphysema blebs
25
Q

Describe diffusion hypoxia

A

Rapid outflow of N2O from the alveoli –> dilution of O2 (hypoxic conditions)

26
Q

Describe the concentration effect of n2O

A

the higher the conc. of anesthetic gas the greater the uptake and augmentation of inspired volume of that gase

27
Q

Describe the second gas effect

A

The use of one gas potentiates the sedative effects of a second gas

28
Q

N2O gas is mainly eliminated how? Minorly eliminated how?

A

Majorly= through lungs unchanged

-Minorly via gut flora ( pseudomonas dentrificans –< free radical formaiton)

29
Q

MOA of N2O causing analgesia

A

Direct interaction with opiod receptors and indirect increase in bodies endogenous opioids

30
Q

MOA of N2O in producing anxiolysis

A

-Bind GABA A receptors at the benzo site

31
Q

Chronic exposure to N2O can lead to

A

MS like symptoms (Irreversible inhibition of the cobalt atom on VitB12). Reduces the activity of VitB12 enzymes (methionine and thymidylate synthetase) vital in the synthesis of myelin and nucleic acids

32
Q

N2O exposure leads to (sympathetic/parasynpathetic) stimulation

A

sympathetic (offsets the myocardia depressive effects)

33
Q

Main side effect of N2O .

A

nausea (depression of the reflexes and GE sphincter muscles)

34
Q

Effect of N2O on airway resistance

A

increased airway resistance and decreased mucociliary activity (issue for asthmatics)

35
Q

What percent N2O is needed for Amnesia, Anxiolysis and analgesia

A 
Amnesia= 70% (not recommended) 
Anxiolysis= 20-30% 
Analgesia= 10-40%
36
Q

Absolute contraindications of nitrous

A
  • Pregnant
  • Bowel obstruction
  • Cranial injury with pneumocephalus
  • Neurosurgical procedure (craniotomy)
  • Open chest surgery
  • Pneumothorax
  • Bullous emphysema
  • Ocular surgery (recent)
  • Recent tympanic surgery
  • Air embolus
37
Q

Acute toxicity of N2O

A

bone marrow suppression

38
Q

Chronic toxicity of N2O

A
  • Inhibition of the cobalt atom of VitB12 (neurologic changes- ataxia and paresthesia)
  • Mutagenicity (changes in DNA)
  • Carcinogenicity (increased cervical cancer)
  • Teratogenic (spontaneous abortions)

Anesthesia (12 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions