Exam #1 Flashcards
Force
the amount of energy to move an object
Force = mass x acceleration
Pressure
force over area, increasing the area in which force is applied results in a lower pressure
P=f/a
Work
transfer of energy by a force acting on an object as it is displaced
W=Fs (force*displacement)
Energy
the capacity to do work or the exertion of force (potential +kinetic energy)
Power
amount of energy transferred or converted per unit time
P= force/velocity
Force SI units
newton
Pressure SI units
pascal (Pa)
Work SI units
joule
Energy SI units
joule
Power SI units
watt
Conduction
energy transfer between 2 objects in direct contact
Ex- touching a cold surface
Convection
air passing by aka wind chill
Body heat is lost to surrounding cold air. The surrounding air becomes warmer and rises; cool air falls and replaces the warm air (it’s a current/cycle).
Radiation
electromagnetic transfer of energy away from a warm body– biggest contributor
Evaporation
liquids on skin evaporate, utilizing energy to turn liquid to vapor
how to mitigate radiation in the OR
head is always perfused and major contributor to radiation heat loss, so it should be covered
how to mitigate convection in the OR
covering the patient with warm blankets forced air warming device
Close air vents to prevent a draft
how to mitigate conduction in the OR
preheat the OR table
Cover the table with blankets if possible
how to mitigate evaporation in the OR
HME, air humidifier on airway circuit
Be careful when scrubbing the surgical site with CHG, prep necessary sites only
Newton’s first law
objects have a tendency to maintain velocity unless acted on by unbalanced force
Law of inertia
Newton’s first law r/t anesthesia
blood loss-blood will have the tendency to maintain velocity, unless acted upon, such as clots or external pressure
Trauma- a gunshot will stay in motion unless acted upon, such as a skull.
Newton’s second law
F=m*a
Force= mass • acceleration
Newton’s second law r/t anesthesia
pressure bag for fluids
force=mass of fluid*velocity of fluid
Kelvin to celsius conversion
Celsius + 273.15= Kelvin
Newton’s third law
for every action, there is an equal and opposite reaction
Law of reciprocal action
Newton’s third law r/t anesthesia
heart failure cardiomegaly
low EF-> increased blood volume in LV to push out, but the blood also pushes on the cardiac muscle, stretching it out
CPR- the action of the RN pushing DOWN on the chest, reciprocal action- chest recoil
First law of thermodynamics
energy can’t be created or destroyed, only transferred (heat)
Law of conservation of energy
Second law of thermodynamics
no spontaneous transfer of heat from cold to hot
Energy moves towards greater entropy/randomness
temperature =
avg. KE
Average heat loss/gain of a system (think of ice melting in a cup of water)
KE equation
(m|v|^2)/2
PE equation
mgh (massgravity forceheight)
zeroth law of thermodynamics
systems in thermal equilibrium do not exchange energy in the form of heat
gravity force constant
9.81 m/s/s = 1 Newton
what is a pascal
1N/1m2
entropy
The equilibration of energy. Energy moves from high to low concentration to achieve equilibrium. The difference in the gradient influences the flow of energy.
fahrenheit to celsius
(f-32)/1.8
scalar values
magnitude only
distance
speed
vector values
magnitude and direction
displacement
velocity
how do surgical wounds contribute to heat loss?
convection
The open wound releases heat to warm up the surrounding cool air.
Biggest drop of heat loss in the perioperative phase
during the first 30-60mins of anesthesia
The adult body loses 1C.
what part of the brain is responsible for regulating temperature
hypothalamus
populations where shivering is detrimental
TTM
Shock
hypoxemic
Increases metabolic demand and o2 consumption
temp value indicating hypothermia
95F
35C
4 factors that affect rates of flow on IV fluids
pressure gradient
viscosity of fluid
length of tube
radius of tube
medications that cause vasodilation during anesthesia
Basically everything!!
volatile anesthetics
lidocaine
propofol
versed
fentanyl
hydralazine
dex (depends on dose)
how does neuraxial anesthesia cause decreased body temperature
brain doesn’t receive cold signal, thinks its warm
efferent nerves that control vasoconstriction and shivering are blocked
how does rapid NS infusion lead to hyperchloremic acidosis
^^chloride levels
bicarb doesn’t want to leave the cell d/t all the chloride
chloride can’t break down H+ to be excreted
acids build up
difference between accuracy and precision
accuracy- how close readings are to target
precision- how close readings are to each other
how can accuracy be improved
recalibration
maintain consistent experimental conditions
control external factors that can introduce variability
how can precision be improved
education on proper use of the device to use the device consistently
density
mass/volume
specific gravity
density of object/density of water
density of water in g/cm^3
1.06
density of water in lbs/ft^3
62.4
baricity
the ratio of the density of LA and CSF
How to determine the pH of a buffer
Henderson equation
pH = pKa + log10 ([A–]/[HA])
define anion gap
difference between measured serum cations and anions under normal conditions
anion gap formula
(Na+K)-(Cl+HCO3)
How to apply physics principles to traumatic brain injuries
coup and contrecoup lesions
brain will continue to move until acted up (the skill) damaging the opposite side of the brain from where the injury occurred.
How is the Periodic Table organized
It is organized by groups- vertical columns, and periods - horizontal rows. And it also has subgroups by elemental properties.
Covalent bonds
The physical sharing of electrons. can hold up to triple bonds. This tends to be bonding between atoms that share similar electronegativity.
Ion - Ion bond
The strongest electrostatic bond, occurs along the outer shell. Have the highest boiling and melting points.
Electrostatic bonds
The attraction of electrons between atoms due to electron distribution or electronegativity. This includes ion-ion, ion-dipole, and dipole-dipole interactions
Ion
Atoms that have gained or lost electrons from their natural composition. These atoms either have a positive or negative charge
Anion
Atom that has gained one or more electrons, is negatively charged.
Cation
An atom that has lost one or more electrons, is positively charged.
Isotopes
Same number of protons but different number of neutrons. This leads to a different mass number.
Ion dipole bond
A weak bond due to partial charges being involved. However, the molecule itself does not have a formal charge.
Isomers
Molecules that have the same chemical formula but different structures. Although the number and type of atoms and bonds are the same, the arrangement is different.
Hydrocarbon
Molecules composed entirely of carbon and hydrogen atoms. They often are formed and straight chained with or without branches.
Saturated hydrocarbon
Single bonded carbon chain with all available carbon bonds attached to hydrogen
Unsaturated hydrocarbon
One or more double or triple bonds between carbon atoms
-yne
Triple bonded carbon
-ene
Hydrocarbon with double bonded carbon
Cyclic hydrocarbon
Carbon chains in a ring structure. They May contain multiple carbon atoms with double or triple bonds.
-ane
Hydrocarbon containing only single bonded atoms
-yl
Saturated or unsaturated hydrocarbons that are missing hydrogens. Very reactive, usually bound to functional groups.
-ryl
Cyclic hydrocarbons that are missing a hydrogen on any carbon. Tend to bind with functional groups, are reactive
-Amine functional group
Ammonia derivative, loves to pair electrons on nitrogen
RNH2
Alcohol functional group
ROH
Hydroxyl is highly polar, it easily forms hydrogen bonds with other polar molecules. The OH polarity allows alcohol to dissolve and many other polar molecules like water.
Phenol functional group
ROH
A simple phenol is polar due to the OH group. More complex finals like propofol are not water soluble.
Oxidation
Process of losing electrons to another element.
Reduction
Process of gaining electrons from another element
What is oxidation and reduction based off?
The electronegativity of the elements. The more electronegative element will gain electrons or be reduced. The less electronegative element will lose electrons or be oxidized.
Ethers functional group
ROR’
The group is attached using oxygen. They are nurt and don’t react to oxidizing or reducing agents. They are highly flammable.
Halogen substitution on ethers altars anesthetic characteristics such as blood, solubility and potency.
Carbonyl functional group
Several functional groups have this arrangement. They are polar due to the electronegativity from oxygen.
The different groups in the Carbonyl functional group
Aldehydes RCHO
Ketones RCOR’
Carboxylic acid RCOOH
Esters RCOOR
Amides RCONH2, RCONHR, RCONR2
Alkali metals
Group 1
React violently with water
Alkaline Earth metals
Group 2
React with water
usually bonded with other elements
Metals
Group 3-12
Are solids at room temperature (except mercury/Hg is liquid)
Malleable
Good conductors of electricity
Halogens
Group 17/7
Brittle
Not malleable
Poor conductors
Are corrosive - very reactive
Noble gases
Group 8/18
Non reactive due to a full shell of electrons.
Colorless gases
Enthalpy
The total energy possessed by a system
KE+PE
Bond energy
The amount of energy needed to form or break a bond.
Energy is RELEASED when a bond is formed.
Energy is CONSUMED when a bond is broken.
** Covalent/short bids possess higher bond energies than the other bonds .
Structural isomer
one in which two or more organic compounds have the same molecular formulas but different structures.
Ex-Isoflurane and enflurane are both volatile anaesthetic agents
Stereo isomers
molecules have the same molecular formula and sequence of bonded atoms, but differ in the three-dimensional orientations of their atoms in space.
Ex-ropivacaine and levobupivacaine
Heat production
The body produces heat through metabolism and muscle movements (shivering)
Intraoperative Hypothermia
It’s a pattern-
The initial rapid drop in core temperature (1C in the first 30-60 min)
Slow linear reduction
Temperature stabilizer and remains unchanged
Bourdon gauges
Used in anesthesia to measure high pressures and are zeroed referenced to ATM.
This type of gauge uses a coiled tube that expands as pressure is applied.
Standardized atmospheric pressure
1 atm= 760 mmHg = 760 torr = 100kPa
Law of Laplace
Describes the relationship between pressure, radius, and wall tension in cylinders and spheres.
Law of Laplace equation for cylinders
Tension = pressure x radius
T=p*r
Law of Laplace equation for spheres
The wall tension goes up twice as fast due to two planes of curvature.
2T= P x r
T= p x (r/2)
Standard conditions for temperature and pressure (STP)
273.15 K= 0C
1 atm= 101.325 kPa
Normal body temperature
37 C = 98.6 F
This may vary +/- 0.5 t C
Humidity
A general term used to describe the amount of water vapor in a gas.
2 parts that make up organic molecules
carbon
hydrogen
why are functional groups important
they are the part of the compound that can undergo chemical reactions and transformations
3 types of steroids
testosterone
estrogen
progesterone
anesthetic agents are considered what kind of ethers?
halogenated
4 categories of biomolecules
nucleic acids
proteins
carbohydrates
lipids
alkanes
carbon-carbon single bonds
alkenes
one or more carbon-carbon double bonds
alkynes
one or more carbon-carbon triple bonds
cis isomerism
hydrogens on same side @double bond site
Creates a bend in molecule
Can’t pack closely together
Liquid at room temp
trans isomerism
hydrogens on opposite sides @double bond site
No bend in molecule
can be closely packed together
Solid @rm temp
How are carbohydrates classified?
monosaccharides
disaccharides
polysaccharides
most carbohydrates and triglycerides are metabolized through what type of reaction
hydrolysis
What is RNA
copy of DNA used to make proteins
What is DNA
blue print for all cell activities
What is a carbonyl group
carbon double bonded to oxygen
Bonds in organic compounds
covalent
bonds in inorganic compounds
ionic
organic compounds soluble or insoluble in water?
insoluble
do organic compound aqueous solutions conduct electricity
no
do organic compounds burn
yes
are organic compound reactions slow or fast
slow
inorganic compounds soluble or insoluble in water?
soluble
do inorganic compound aqueous solutions conduct electricity
yes they form ions
do inorganic compounds burn
no
are inorganic compound reactions slow or fast
fast
arenes
hydrocarbon that forms one or more benzine-line rings
carboxylic acids
combination of a carbonyl and a hydroxyl group
-COOH
chiral
different from mirror image
racemic drugs
mix of both enantiomers
enantiomer
same molecule, different layout
may he superimposable (achiral carbon) or non superimposable (chiral carbon)
anatomy of a triglyceride
glycerol backbone, 3 fatty acid chains
glycolysis
the process of breaking down glucose (yields 2 ATP)
gluconeogenesis
synthesis of new glucose from noncarb precurors
glycogenesis
the creation of glycogen from glucose
glycogenolysis
the breakdown of glycogen back to glucose
how are lipids metabolized prior to krebs cycle
beta oxidation
how are carbs metabolized prior to krebs cycle
glycolysis
urea cycle
mechanism to remove ammonia from body
ammonia
by produce of amino acid catabolism
where does urea cycle occur
liver
nucleotides are made up of what 3 parts?
phosphate group
nitrogenous base
pentose sugar
what type of molecule is ATP
nucleic acid
3 types of RNA
messenger RNA (mRNA)
ribosomal RNA (rRNA)
transfer RNA (tRNA)
messenger RNA
comes from DNA holds info
ribosomal RNA
where protein synthesis occurs
transfer RNA
codon
hydroxyl group
OH
sulfhydryl group
SH
amino group
NH2
methyl group
CH3
hydroxyl polar or nonpolar
polar
sulfhydryl polar or nonpolar
less polar
carbonyl group polar or nonpolar
polar
carboxyl group pH
acidic
amino group pH
basic
methyl group polar or nonpolar
nonpolar
phosphate group pH
acidic
losing electrons
oxidation
gaining electrons
reduction
what reaction creates polysaccharides
dehydration synthesis
what reaction breaks down starches to glucose
hydrolysis
3 components of amino acids
amino group
carboxyl group
side chair R groupp
Phase I metabolism
typically uses CYP450
uses enzymes called oxidases to unmask or introduce polar groups (OH or O) on the drug
Electronegativity
This is how polar molecules are created. Highly electronegative elements have a larger ratio of proton core so the core has a more positive charge. The shells have a more negative charge since they are filled with electrons. The strong positive core tends to pull and hog all the electrons from other less electronegative elements, such as hydrogen.
Hydrogen bond
This is the strongest type of bond. It is based on electronegativity. Since oxygen is more electronegative, it will pull and hog all of the electrons from hydrogen. This makes water polar.
Why is water polar?
When you look at the water molecule, the oxygen end is a more negative area and the hydrogen end is a more positive area.
Water is not an ion. It still has an overall neutral charge. To be an ion, water would have to completely lose or gain electrons. The oxygen and hydrogen are sharing electrons but oxygen is hogging most of the electrons.
