Exam 2: Uptake / Distribution of Inhalation Agents Flashcards

1
Q

Uptake =

A

ƛ * Q * (A-v)

Solubility * CO * difference in alveolar/venous partial pressures

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2
Q

For IAs, blood is an:

A

inactive reservoir

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3
Q

Higher blood-gas coefficient means:

A

Agent is more soluble

More agent in blood = less in alveoli/brain

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4
Q

Another name for blood-gas partition coefficient:

A

Oswaldt Solubility Coefficient

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5
Q

Brain-level activity of a highly vs. minimally soluble IA:

A

Highly soluble: low brain activity

Minimally soluble: high brain activity

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6
Q

Effect of solubility on induction and emergence:

A

Less soluble = faster induction/emergence

More soluble = slower induction/emergence

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7
Q

Five partial pressure gradients between vaporizer and end-target tissue:

A
Vaporizer and inflow
Inflow and circuit
Circuit and alveoli
Alveoli and blood
Blood and tissues
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8
Q

Impact of HCT on B/G coefficient:

A

↓ HCT = ↓ B/G coefficient
Dropping HCT from 21 –> 43 drops B/G coefficient by 20%
D/t less binding sites in the blood

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9
Q

FA vs. FI:

A
FA = alveolar concentration
FI = inspired concentration
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10
Q

FD = FI when:

A

High flow rate with no re-breathing

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11
Q

Make these changes to ventilation to ↑ uptake:

A

↓ TV, ↑ rate

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12
Q

PA of volatile anesthetic is determined by (4):

A

PI (inhaled partial pressure)
Alveolar ventilation
Breathing circuit
FRC

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13
Q

Normal VA:

A

4L/min

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14
Q

Solubility’s effect on the rate at which FA approaches FI:

A

Least soluble = fastest rate of matching FA to FI

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15
Q

Describe the FA/FI curve:

A
First rise: VRG uptake
First knee: VRG at equilibrium
Second rise: MG uptake
Second knee: MG at equilibrium
Third rise: FG/VPG uptake (very slow)
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16
Q

Solubility’s effect on the rate of rise of FA/FI curve:

A

Less soluble = faster rate of rise

17
Q

Overpressure is:

A

The use of high FD to increase the speed of FA=FI equilibration

18
Q

Effect of CO on induction speed:

A

↑ CO = ↓ induction speed

19
Q

Tissue uptake equation:

A

Uptake = tissue/blood coefficient * flow * (a-t)

20
Q

The coefficient that most influences FA/FI rise:

A

Blood-gas

21
Q

The coefficient that most influences the FA/FI tail:

A

Tissue-gas

22
Q

MAC is:

A

Minimum alveolar concentration; ED50 of inhaled anesthetics. The concentration that will produce absence of movement in 50% of the population.

23
Q

↑ ventilation will have more of an effect on FA/FI curve for this type of agent:

A

Highly soluble agent

24
Q

Effect of both ↑ ventilation and ↑ CO:

A

↑ ventilation has more effect (to speed induction) than ↑ CO does (to slow it)

25
Q

If only one lung is intubated, what is the effect on the rise in FA and rise in Pa?

A

FA rises faster than if the ETT was in the trachea

However, loss of uptake from unventilated lung leads to overall depressed ↑ in Pa

26
Q

Type of gas that will washout fastest:

A

Least soluble

27
Q

N2O is ____x as soluble as nitrogen:

A

34x

28
Q

Places that N2O can diffuse into during surgery:

A
ETT cuff
Bowel obstruction
Pneumothorax/pneumocephalus
Inner ear
Ophtho procedures using gas bubbles
Air embolus