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final exam principles of nurse anesthesia > Chemistry, Physics & OR Safety > Flashcards

Chemistry, Physics & OR Safety Flashcards

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1
Q

what are the Building block that makes up matter?

A

atom

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2
Q

what are the positively charged particles in an atom?

A

protons

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3
Q

where are protons located?

A

in the nucleus

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4
Q

what are the neutrally charged particles in the atom?

A

neutrons

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5
Q

where are neutrons located?

A

inside the nucleus

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6
Q

what are the negatively charged particles located in the atom?

A

electrons

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7
Q

where are electrons located?

A

orbit the nucleus in the electron cloud

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8
Q

describe the orbital shell around the nucleus?

A

each shell has a predefined number of electrons, and each shell must be complete before electrons can begin to fill the next shell

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9
Q

the electrons in the outermost shell are called?

A

valence electrons

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10
Q

an incomplete shell allows what to happen?

A

an atom to react with another atom

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11
Q

a full shell makes the atom?

A

nonreactive

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12
Q

an atom with have a neutral charge if?

A

electrons are equal to protons

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13
Q

an atom will have a positive charge if?

A

there are less electrons than protons

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14
Q

an atom will have a negative charge if?

A

there are more electrons than protons

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15
Q

an ions is an atom that?

A

carries a positive or negative charge

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16
Q

an atom with a positive charge is called?

A

a cation

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17
Q

an atom with a negative charge is called?

A

an anion

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18
Q

metals tend to ____, which non metals do not.

A

ionize

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19
Q

when two or more atoms are bonded together this is called a?

A

molecule

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20
Q

describe an ionic bond?

A

when a complete transfer of valence electrons occurs.

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21
Q

describe the two atoms following an ionic bond?

A

the transfer leaves one atom with a negative charge and the other with a positive charge.

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22
Q

what is the law that electricity in the OR follows

A

Ohm’s law: electromotive force (voltage) = current X Impedance

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23
Q

describe covalent bonding?

A

equal sharing of valence electrons

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24
Q

a single covalent bond is created when?

A

one pair of electrons is shared

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25
Q

a double covalent bond is created when?

A

two pairs of electrons are shared

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26
Q

a triple covalent bond is created when ?

A

three pairs of electrons are shared

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27
Q

describe polar covalent bonding?

A

unequal sharing of valence electrons, meaning the electrons remain closer to one atom over the other

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28
Q

polar covalent bonds creates a _____ molecule, meaning?

A

polar

meaning where one area of the molecule is relatively positive and the other is relatively negative

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29
Q

why does water dissolve hydrophilic molecules?

A

because the polar molecule is attracted to other polar molecules

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30
Q

however, water (polar molecule) does not dissolve hydrophobic substances like oil and fat?

A

because they are non-polarized

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31
Q

describe van der waals forces?

A

a very weak intermolecular force that holds molecules of the same type together

electrons are constantly orbiting a molecule which creates temporary partial positive and negative charges at different parts of the molecule at any given time.

Thus, electron rich areas of a molecule will be attracted to electron poor areas of another molecule

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32
Q

a base is a species that accepts a ______ ion from an acid

A

hydrogen

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33
Q

voltage=
current=
impedance=

A 
Voltage= driving pressure
current = flow
impedance = resistance
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34
Q

surgical electrocautery device delivers a high frequency current of ______ that is used to cut, coagulate, dissect or destroy tissue

A

500,000 to 1 million Htz

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35
Q

the current of cautery return must not pass across the

A

pacemaker

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36
Q

differentiate energy pathways for monopolar vs bipolar electrocautery

A

mono: uses a pin that enters that body

Bi: will not need a grounding pad

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37
Q

___ is placed on a patient to allow for the exit point of a return current

A

grounding pad (functional return electrode)

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38
Q

a fault in the return electrode places that patient at a risk for

A

burns

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39
Q

if the return electrode is malfunctioning, the electrical current will find another pathway to exit the body including

A

EKG electrodes
temperature probe
metal components of sx table

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40
Q

the smaller that are that the electricity exits the body, the

A

greater the intensity of the burn

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41
Q

a hydrogen ion is a _____

A

proton

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42
Q

acid-base pairs differ by one ?

A

hydrogen ion

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43
Q

the charge on the conjugate acid is always One _________ than the charge on its conjugate base.

A

greater

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44
Q

acid and bases react to give?

A

salts and water

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45
Q

the salt solution is actually a solution that contains the?

A

conjugate acid or base of some other acid or base

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46
Q

the pH of a salt solution depends on the acid/base strength of the?

A

acid or base from which it was derived.

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47
Q

salts of strong acids/bases, their conjugate bases have?

A

no base strength

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48
Q

what it the primary purpose of the Line isolation monitor

A

to alert the OR staff of the first fault (it does not protect personnel or patients from macro-micro shocks)

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49
Q

salts of weak acids are?

A

bases

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50
Q

the conjugate base of salts of weak acids?

A

have some appreciable base strength

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51
Q

salts of weak acids ____ the pH of a solution

A

increase

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52
Q

salts of weak bases are

A

acids

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53
Q

alkaloids are naturally occurring weak _____ organic compounds

A

basic

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54
Q

to prevent burns at the return pad site, the entire surface of the return electrode should

A

be in indirect contact with the patients skin (do not place over bony prominence or metal implants) for babies put it on their back

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55
Q

the electrode gel should be inspected for

A

dryness (if its too dry, the current wont have a direct path to the return electrode and will find another way to exit the body)

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56
Q

the electrocautery, in an oxygen rich environment can cause

A

a spark and cause a fire

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57
Q

for a bipolar electrocautery, the tip of the bipolar electrosurgical device (forceps) contain

A

the active and return electrode, therefore no return pad is needed

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58
Q

the current of cautery return must not pass across the

A

pacemaker

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59
Q

for a current to flow, there has to be a ____ difference across an ______

A

voltage difference (driving pressure) across an impedance

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60
Q

if a closed circuit exists, then exposure to a live electricity source provides a

A

electromotive force (voltage) that pushes the current through an impedance

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61
Q

an impedance is

A

can be either you or the patient

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62
Q

to receive a shock, a person must become a part of and complete an

A

electrical circuit

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63
Q

an electrical current that enters the body will exit the body along the

A

path of least resistance

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64
Q

what are the three consequences of electrical injury

A
  • -cardiac arrhythmias
  • -nerve injury (diaphragmatic paralysis)
  • -thermal injury (damage to internal organs may be more extensive that damage observed on skin)
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65
Q

Macroshock is a

A

larger amount of current that is applied to external surface to the body

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66
Q

the impedance of skin offers a higher resistance for macroshock, so it takes

A

larger current to induce Vfib

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67
Q

Microshock is a

A

smaller amount of current applied directly to the myocardium

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68
Q

what are examples of direct conductive pathways to the heart

A

central lines, PA catheters, pacing wires, which will increase the patients susceptibility to micro shocks

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69
Q

the electrical systems in the OR are designed to reduce the risk of electrical shock because (2)

A
  1. the OR power supply is not grounded

2. each piece of equipment is grounded

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70
Q

____ assesses the integrity of the ungrounded power system in the OR

A

Line Isolation monitor

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71
Q

what it the primary purpose of the Line isolation monitor

A

to alert

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72
Q

If the LIM alarm sounds, what should occur

A

the last piece of equiptment that was plugged in should be unplugged

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73
Q

At what level will the LIM alarm go off

A

2-5 mA of leak current is detected

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74
Q

what are the voltages in microshocks for max allowable current leak in the OR and ventricular fibrillation

A

max allowable leak in OR: 10 uA

Ventricular fibrillation: 10 uA

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75
Q

macroshocks voltage:

  1. threshold for touch perception of electrical shock
  2. maximum current for a harmless electrical shock
  3. let go current occurs before sustained contraction
  4. loss of conciousness
  5. ventricular fibrillation
A
  1. ) 1 mA
  2. ) 5 mA
  3. ) 10-20 mA
  4. ) 50 mA
  5. ) 100 mA
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76
Q

CRNAs are at greater risk for exposure to

A

ionizing radiation (anywhere fluoroscopy is used)

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77
Q

ionizing radiation can remove electrons from atoms causing

A

free radicals (which is damaging on the cellular level including tissue injury, chromosomal, malignancy)

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78
Q

most exposure is as a result of

A

scattered X-rays, not direct exposure

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79
Q

the Roentgen is used to

A

quantify exposure

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80
Q

dalton’s law of partial pressures states that the total gas pressure in a container is equal to ?

A

the sum of the partial pressures exerted by each gas

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81
Q

what is the yearly maximum radiation exposure

A

5 rem

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82
Q

what is the yearly maximum exposure for the fetus of a pregnancy worker

A

0.5 rem or 0.05 rem/month

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83
Q

for a non-pregnant person, what two body parts are most susceptible to injury

A

eye and thyroid

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84
Q

in the pregnancy person, what is most susceptible to injury

A

fetus

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85
Q

what are the different ways to protect yourself from radiatoin

A
  1. distance
  2. duration
  3. shielding

distance is an easy way to protect (minimum is 6 week away from radiation source)
5. radiation exposure obeys inverse square law

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86
Q

what is the inverse square law for radiation exposure

A

the amount of exposure is inversely propositional to the square of the distance of the source

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87
Q

many medications are organic amines, or _______.

A

alkaloids

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88
Q

alkaloids are not very water soluble, they are converted to their conjugate acid by reacting with a?

A

strong acid

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89
Q

Non ionized molecule is usually _____ soluble and can diffuse across the cell membrane. such as the blood brain barrier, renal tubular epithelium, gastrointestinal epithelium, placenta, hepatocytes

A

lipid

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90
Q

the non-ionized form of the drug that is pharmacologically _____.

A

active

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91
Q

the degree of drug ionization is a function of its ____ and ____ of the surrounding fluid.

A

dissociation constant (pK) and the pH

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92
Q

when the pK and pH are identical, ____% of the drug exists in both the ionized and nonionized form

A

50%

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93
Q

Acidic drugs tend to be highly ionized at an ________ pH

A

alkaline

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94
Q

what is the joule-thompson effect?

A

a gas stored at high pressure that is suddenly released escapes from its container into a vacuum. it quickly loses speed as well significant amount of kinetic energy , resulting in a fall in temperature. Conversely, rapid compression of a gas intensifies its kinetic energy, causing the temperature to rise.

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95
Q

acidic drugs examples

A

barbiturates

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96
Q

critical temperature is the highest temperature a gas can?

A

exist as a liquid

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97
Q

acidic drugs are usually supplied in a _____ solution to make them more soluble in water.

A

basic

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98
Q

basic drugs are supplied in _____ solution to make them more soluble in water

A

acidic

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99
Q

describe the boiling point?

A

the temperature at which a liquid’s vapor pressure equals atmospheric pressure (760 mmHg or 1 ATM)

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100
Q

increase in atmospheric pressure will ______ the boiling point

A

increase

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101
Q

what is an example of increased atmospheric pressure?

A

HBO chamber

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102
Q

decreased atmospheric pressure results in a _____ boiling

A

decreased

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103
Q

give an example of a decreased atmospheric pressure area?

A

high altitude

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104
Q

what is specific heat?

A

the amount of heat required to increase the temperature of 1 gram of a substance by 1 degree of celsius

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105
Q

explain what vapor pressure is?

A

in a closed container, molecules from a volatile liquid escape the liquid phase and enter the gas phase. the molecules in the gas phase exert a pressure on the walls of the container.

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106
Q

vapor pressure is primarily dependent on the liquid’s ______.

A

temperature

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107
Q

liquid temperature and vapor pressure are _______ proportional.

A

directly

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108
Q

increase in liquid temperature leads to a ______ in vapor pressure

A

increase

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109
Q

at body temperature, the vapor pressure of water is _____ mmHg

A

47

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110
Q

altitude ______ affect vapor pressure

A

does not

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111
Q

define vaporizaiton

A

the process by which a liquid is converted to a gas

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112
Q

vaporization requires _____ .

A

energy (heat)

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113
Q

what is latent heat of vaporization?

A

the number of calories required to convert 1 gram of liquid to vapor without a temperature change

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114
Q

what is sevoflurane vapor pressure?

A

157 torr

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115
Q

what is the isoflurane vapor pressure?

A

138 torr

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116
Q

what is the halothane vapor pressure?

A

243 torr

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117
Q

what is desflurane vapor pressure?

A

659 torr

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118
Q

at a high altitude, a liquid will boil at a ____ temperature as a function of the reduction in atmospheric pressure.

A

lower

119
Q

boiling requires an _____ container

A

open

120
Q

the fractional amount of pressure that a single gas exerts within a gas mixture is called?

A

partial pressure

121
Q

what does Laser stand for

A

light amplification by stimulated emission of radiation

122
Q

long wavelengths of lasers absorb ___ water and ____ penetrate deep into tissue

A

more water

do not penetrate deep into tissue

123
Q

short wavelengths of lasers absorb _____ water and ______ penetrate deep into tissues

A

less water

do penetrate deeper into tissue

124
Q

when using lasers, a source of _____ must be immediately available

A

water or saline

125
Q

what FiO2 should be used when lasers are implemented in the OR

A

< 30%

126
Q

most ETT are_______ and ____ laser resistant

A

flammable and not laser resistant (made of polyvinyl chloride, red rubber and silicone)

127
Q

for eye protection when using lasers, what should anesthesia providers do

A
  • tape eyes lids closed
  • avoid petrolium based lubricants
  • cover eye lids with saline soaked gauze
  • use protective glasses
128
Q

nitrous oxide supports

A

combustion, do not use it

129
Q

what are ignition sources of OR fires

A

electrosurgical cautery and laser

130
Q

what are oxidizers of OR fires

A

Nitrous oxide and oxygen

131
Q

what is the fuel in OR fires

A

ETT, drapes, surgical supplies

132
Q

list the 3 ingredients requires to produce a fire

A

ignition source
oxidiser
fuel

133
Q

list the steps to take when t\fire is present

A
  1. stop ventilation and remove ETT
  2. stop flow of all airway gases
  3. remove other flammable material from airway
  4. pour water/saline into airway
  5. if fire isnt extinguished on first attempt, then use CO2 fire extinguisher
134
Q

what are the steps to take after fire is controlled

A
  1. re-establish ventilation by mask (avoid supplemental O2 or nitrous oxide
  2. check ETT for damage (fragments may remain in pts airway)
  3. perform bronchoscopy to inspect for airway injury or retained fragments
135
Q

what is the body core temperature regulated between in the OR

A

36.7 and 37.1 C

136
Q

what does the afferent limb do to maintain body temp

A

thermoreceptors: skin deep tissue, spinal cord

137
Q

what are the control centers responsible for temperature control

A

hypothalamus (pre-optic region) and brainstem

138
Q

what is the efferent temperature response to how and cold

A

cold: vasoconstriction, piloerection, shiver (increases o2 consumption up to 400-500% and increases risk of MI), non-shivering (babies with brown fat)

Hot: vasodilation and diaphoresis

139
Q

what are the 4 ways to transfer heat

A

radiation (60%)
convection (15-30%)
conduction (<5%)
evaporation (20%)

140
Q

1 mole of any gas is made up of how many atoms?

A

6.023 x 10

141
Q

what degree is hypothermia defined as

A

<36C

142
Q

Phase I: with general, spinal or epidural anesthesia, there is a redistribution of heat from the

A

central compartment *thorax abd) to the peripheral compartment (extremities and skin)

143
Q

how do anesthetic agents impair thermoregulatory response

A

in the hypothalamus, prevent shivering, and cause vasodialation

144
Q

what are simple interventions that can be performed to conserve heat loss

A

placing warm blanket on patient before entering OR to minimize central peripheral temperature gradient

145
Q

the depth of anesthesia is determine by the partial pressure of the anesthetic agent in the ?

A

brain

146
Q

The tec 6 vaporizer is used for what anesthetic agent?

A

desflurane

147
Q

the tec 6 vaporizer does not compensate for ?

A

elevation

148
Q

a change in elevation , using the tec 6 vaporizer can result in what for the patient?

A

underdosing

149
Q

stability refers to the?

A

ability to resist breakdown or metabolism

150
Q

what is the toxic by product of sevo?

A

compound A

151
Q

what is the toxic by product of des and isoflurane?

A

carbon monoxide

152
Q

with vaporization, fresh gas flows over the anesthetic liquid, carrying away some of the ____ that exists in the gas phase

A

agent

153
Q

fresh gas flow over the anesthetic liquid cools the remaining liquid, which reduces what?

A

the vapor pressure of that liquid.

154
Q

the cooling of the liquid in the vaporizer results in a ____ in the vaporizer output

A

decrease

155
Q

modern vaporizers compensate for the temperature change produced by the carrier gas by using metals with a high thermal conductivity. Why?

A

they transfer heat easily like cooper and bronze

156
Q

modern vaporizers compensate for the temperature change produced by the carrier gas by using a _____ ______ valve to modulate the amount of FGF that is directed into the vaporizing chamber.

A

temperature compensation

157
Q

the modern vaporizer for desflurane compensates for temperature loss by the carrier gas by, applying _____ heat tot he anesthetic liquid.

A

direct

158
Q

what is the adiabatic process?

A

describes a process that occurs without gain or loss of energy (heat). For example, a very rapid expansion or compression of a gas where there is no transfer of energy.

159
Q

perioperative hypothermia is associated with increased risk of

A

morbidity and mortality

160
Q

what medications are used to treat postoperative shivering

A

meperidine, clonidine, and dexmedetonidine

161
Q

during perioperative hypothermia, oxygen consumption is decreased by

A

5-7% for every 1 degree C reduction in body temperature

162
Q

induced hypothermia is useful during what conditions

A
  • CVA
  • cerebral aneurysm clipping
  • TBI
  • Cardiopulmonary bypass
  • cardiac arrest
  • aortic cross clamping
  • carotid endarterectomy
163
Q

what are three measure that can be implemented to minimize intraoperative heat loss

A
  • heat/moisture exchanger
  • force air warming blanket
  • IV fluid warmers
164
Q

What are consequences of perioperative hypothermia for cardiovascular

A
  • -SNS stimulation
  • -shifts oxyhemoglobin dissociation curve to left
  • -vasoconstriction and decreased tissue PO2
  • -coagulopathy + plt dysfunction
  • -sickling of hemoglobin S
165
Q

what are the pharmacological effects of perioperative hypothermia

A

slowed drug metabolism and increased solubility of volatile agents

166
Q

describes how a jet flow attaches itself to a nearby surface and continues to flow along that surface when the surface curves away from the initial jet direction

A

Coanda EFFECT

167
Q

____ allows us to predict the type of flow that will occur in a given situation

A

Reynolds number

168
Q

laminar flow is dependent on ______ compared to turbulent flow which is dependent on ______

A

laminar: gas viscosity (poiseuille’s law)

Turbulent: gas density (graham’s law)

169
Q

In laminar flow, all of the molecules flow in ________ pattern and the Re < _____

A

parallel pattern

Re < 2,000

170
Q

molecules for laminar flow, travel at the fastest rate at ______

A

the center of the tube

171
Q

In turbulent flow, all of the molecules travel in _____ pattern and the Re >________

A

chaotic pattern

Re > 4,000

172
Q

the critical temperature of nitrous oxide is?

A

36.5 C

173
Q

why nitrous oxide exists as a liquid inside the cylinder?

A

because its critical temperature is 36.5 C and room temperature 20 C

174
Q

the critical temperature of oxygen is ?

A

-119

175
Q

what is the critical temperature of carbon dioxide

A

31 C

176
Q

what is the critical temperature of air?

A

-140C

177
Q

what is the critical temperature of nitrogen?

A

-147 C

178
Q

what is the definition of critical pressure?

A

the minimum pressure to convert a gas to a liquid at its temperature

179
Q

what is the absolute temperature scale is measured in?

A

kelvins

180
Q

0C is equal to ____ kelvins

A

273

181
Q

how to convert Celsius to kelvin?

A

C+273

182
Q

how to convert kelvin to celsius

A

K-273

183
Q

what is theoretically the lowest possible temperature?

A

0 kelvin

184
Q

____ degrees between the boiling and freezing points of water on the F scale

A

180

185
Q

only ____ degree on the C scale

A

100

186
Q

what is the scale for Celsius?

A

0-100

187
Q

to convert kelvin to fahrenheit, you must first convert to?

A

celcius

188
Q

how to get from kelvin to celsius?

A

C= K-273.15

189
Q

how to get from celsius to kelvin?

A

K= C+ 273.15

190
Q

how to convert fahrenheit to celcius?

A

C= (F-32) x 5/9

191
Q

how to convert Celsius to Fahrenheit

A

(Cx1.8) +32

192
Q

what is the equation for pressure?

A

pressure = force/area

193
Q

atmospheric pressure is the pressure associated with ____ in the atmosphere.

A

gas

194
Q

air pressure results from ____ pulling on the atmosphere.

A

gravity

195
Q

what type of gauge is used on gas cylinders?

A

bourdon gauge

196
Q

the bourdon gauge measures the pressure difference between?

A

pressure exerted by the gas in a cylinder and the atmospheric pressure.

197
Q

thus could a high altitude affect gauge pressure?

A

yes because gauge pressure inside a cylinder is affected by atmospheric pressure

198
Q

gauge pressure is the pressure of a system _______ atmospheric pressure.

A

above or below

199
Q

the total “absolute” pressure includes?

A

the atmospheric pressure plus the gauge pressure

200
Q

1 atm equals how many mm Hg?

A

760 mmHg

201
Q

760 mm Hg equal how many torr?

A

760 torr

202
Q

760 torr equal how many bar?

A

1 bar

203
Q

1 bar equal how many kPa?

A

100 kPa

204
Q

100 kPa equal how many cm H2O

A

1033 cm H2O

205
Q

1033 cm H2O equal how many lb/inch2

A

14.7 lb/inch2

206
Q

1 mm Hg is equal to how many cm H2O?

A

1.36 cm H2O

207
Q

1 cm H2O is equal to how many mmHg?

A

0.75 mm Hg

208
Q

what does STP stand for?

A

standard temperature and pressure

209
Q

what is the purpose of STP?

A

used to compare sets of data between gases

210
Q

STP of 0 C is how many atm?

A

1

211
Q

STP of 273.16 K of mmHg?

A

760 mmHg

212
Q

STP of 273.16 K and kPa?

A

101.325 kPA

213
Q

STP of 273.16K and torr?

A

760 torr

214
Q

what is the standard molar volume?

A

22.4L

215
Q

1 mole of any gas is made up of how many atoms?

A

6.023 x 10 to the 23rd power

216
Q

what can produce turbulent flow

A

change to narrow diameter
high gas flow
acute angle in tube
branching in tube

217
Q

In transitional flow, Re= _______ and flow occurs in what type of pattern

A

Re = 2,000 to 4,000

flow displays in turbulent pattern in the center of tube and laminar pattern near side walls of tube

218
Q

______ describes the relationship between the pressure and velocity of a moving fluid

A

Bernoulli’s Principle

219
Q

In Bernoulli’s principle, in the fluids velocity is high, then the pressure exerted on the walls of the tube will be

A

low

220
Q

In Bernoulli’s principle, in the fluids velocity is low, then the pressure exerted on the walls of the tube will be

A

high

221
Q

better understanding of bernoullis principle

A

as fluid moves from wider tube to narrow (constriction) the volume of that fluid that moves a given distance in a given time does not change. Therefore, the width of tube suddenly becomes smaller, then the fluid in the constricted region must move faster to achieve that result. And because the fluid velocity has increased at the area of constriction, there is a pressure drop at the area of constriction. AKA when a river is wide, the flow is slow but when the river is small the flow is fast

222
Q

if the pressure inside of the tube falls below atmospheric pressure, then air is entrained into the tube

A

venturi effect

is an application of the Bernoulli principle

223
Q

adjusting the diameter of the constriction allows for control of the pressure drop and the amount of air that is sucked into the tube and the key for venturi effect is

A

air entrainment!

EX (jet ventilator, venturi, and nebulizer

224
Q

a mole of gas is equal to the _____ ______ of that gas in ____.

A

molecular weight of that gas in grams

225
Q

diatomic gases have ____ molecules, so ____ the atomic weight

A

2 molecules

double

226
Q

oxygen atomic weight is?

A

16 grams

227
Q

oxygen is diatomic so the molecular weight of oxygen is?

A

32 grams

228
Q

one mole of oxygen is 32 gram and contains how many atoms?

A

two times 6.023 x 10 to the 23rd power atoms

229
Q

what is the equation for charles law?

A

volume/temperature

230
Q

with charles laws, volume and temperature has a _____ relationship

A

direct

231
Q

as volume increases, temperature _____

A

increases

232
Q

as volume decreases, temperature _______

A

decreases

233
Q

initial volume/ initial temperature is ____ to the second volume/ second temperature

A

equal

234
Q

a LMA cuff rupturing in the autoclave, is an example of what law?

A

charles laws

235
Q

the relationship between wall tension, internal pressure, and radius regarding spheres and cylinders

A

law of Laplace

236
Q

for the law of Laplace, pressure is a ____ force and tension is a _____force

A

pushing (pushes walls of the object apart)

pulling (holds the walls of the object together)

237
Q

surface tension of a sphere

A

Tension = (pressure X radium) / 2

example: alveolus, cardiac ventricle, saccular aneurysm

238
Q

surface tension of a cylinder

A

Tension = (pressure X radium)

Examples: blood vessels, aortic aneurysm

239
Q

Pressure is _________ to surface tension and _______to radius of alveolus

A

directly proportional

inversely proportional

240
Q

if two bubbles have the same surface tension, the small bubble will

A

have a higher pressure

241
Q

when do type II pneumocytes begin producing surfactant

A

22-26 weeks gestation with a peak production occurring at 35-36 weeks

242
Q

surfactant reduces ________ and prevents alveolar collapse

A

surface tension

243
Q

each alveolus contains _____ amount of surfactant

A

same

244
Q

daltons law of partial pressures define?

A

the total pressure is equal to the sum of the partial pressures exerted by each gas in the mixture
P(total)= P (gauge) + P (atmosphere)

245
Q

smaller alveoli have a __________ concentration of surfactant

A

higher

246
Q

as the radius changes the concentration of _____ changes

A

surfactant

247
Q

the left ventricle develops wall tension to over come after load which applies to what law

A

law of Laplace

248
Q

what is the formula for the law of laplace used in left the left ventricle

A

(LV pressure X radius) / (LV wall thickness X 2)

T = (P x r) / h

249
Q

wall tension/stress is reduced by

A

decreased intraventricular pressure, decreased radium, increased wall thickness

250
Q

what is the boyles law equation?

A

pressure x volume

251
Q

there is a ______ relationship between pressure and volume

A

inverse

252
Q

as pressure increases, the volume _____

A

decreases

253
Q

as pressure decreases the volume _____

A

increases

254
Q

a diaphragm contraction increases tidal volume is an example of what gas law?

A

Boyles law

255
Q

squeezing an Ambu bag is an example of what gas law?

A

Boyles law

256
Q

gay-lussac’s shows a _____ relationship of pressure and temperature

A

direct

257
Q

oxygen tank explodes in a heated environment because the pressure is increased is an example of what gas law?

A

gay-lussac law

258
Q

avogadros law defined?

A

equal volumes of differents gases under the same conditions have equal numbers of molecules

259
Q

with avogadros laws- as mols increases, so does ____ .

A

volume

260
Q

according to avogadro’s law, 1.2L of Carbon has the same number of molecules as ____ of Chlorine.

A

1.2L

261
Q

if we significantly increase the concentration of volatile anesthetic at the ________ interface, you can hasten the transfer into the bloodstream and ultimately the brain. this is called __________.

A

alveolocapillary

overpressuring

262
Q

ideal gas law defined?

A

PV= nrT which can be reduced, to
pressure is equal temperature/ volume since R and n are constant
n = number of moles
R= universal gas constant

263
Q

the only constant unit of measurement is temperature scale is _______ .

A

kelvin

264
Q

daltons law of partial pressures define?

A

the total pressure is equal to the sum of the partial pressures exerted by each gas in the mixture

265
Q

volume’s percent is a way to communicate a solution’s _______.

A

concentration

266
Q

volume percent is expressed as a volume fraction over?

A

a denominator of 100

267
Q

partial pressure = volume percent x ________

A

total pressure

268
Q

henry law - at constant temperature, the amount of gas that dissolves in solution is directly proportional to the?

A

partial pressure of the gas over the solution.

269
Q

the higher gas pressure, the more of it will ____ into a liquid (assuming a constant _____)

A

dissolve

temperature

270
Q

according to henry’s law, temperature affects ______

A

solubility

271
Q

increase temperature = _______ solubility

A

decreased

272
Q

decreased temperature = _____ solubility

A

increase solubility (the gases will be stuck causing pt. not to wake up)

273
Q

each gas has it own solubility ______.

A

coefficient

274
Q

the solubility coefficients represents how easily the gas can be?

A

put into solution (blood)

275
Q

what is oxygen’s solubility coefficient?

A

0.003 mL/dL/mmHg

276
Q

carbon dioxide’s solubility coefficient?

A

0.0067 mL/dL/mmHg

277
Q

carbon dioxide is ____ times more soluble than oxygen

A

20

278
Q

anesthetic emergence is prolonged in the hypothermic patient b/c the ____ of the gas is increased, so less of it leaves the body per unit of time.

A

solubility

279
Q

using henry’s law, you can calculate oxygen delivery. multiplying the PaO2 by oxygen solubility coefficient _____ allows us to calculate how much oxygen is dissolved in the blood.

A

0.003

280
Q

if we significantly increase the concentration of volatile anesthetic at the ________ interface, you can hasten the transfer into the bloodstream and ultimately the brain. this is called __________.

A

alveolocapillary

overpressuring

281
Q

what is grahams law?

A

it states the rate of gas diffusion is inversely proportional to the square root of its molecular weight

282
Q

the rate of gas diffusion is ______ proportional to the square root of its molecular weight

A

inversely

283
Q

ficks law of diffusion describes?

A

the transfer rate of gas through a tissue medium

284
Q

the rate of transfer of a gas through a tissue medium is directly proportional to what three things?

A

partial pressure difference (driving force)
diffusion coefficient (solubility)
membrane surface area

285
Q

the rate of transfer of gas through a tissue medium is inversely proportional to what two things?

A

membrane thickness
and
molecular weight

286
Q

what two gas laws are incorporated into the fick equation?

A

henry law and graham’s law

287
Q

name four examples ficks equation applies to clinical practice?

A

diffusion hypoxia

a patient with COPD has a reduced alveolar surface area, so has a slower rate of inhalation inductions

calculation of cardiac output

drug transfer across the placenta

288
Q

describe ohm’s law?

A

says that the current passing through a conductor is directly proportional to the voltage and inversely proportional to the resistance. This can be adapted to understand fluid flow.

289
Q

fluid is defined as the movement of?

A

electricity
fluid
or air per unit time

290
Q

voltage is what in the body?

A

driving pressure (blood pressure)

291
Q

current is what in the body?

A

flow (cardiac output)

292
Q

impedance is what in the body?

A

resistance (SVR)

293
Q

flow equation is what?

A

pressure gradient/ resistance

final exam principles of nurse anesthesia (12 decks)

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