IA Up/Dist

Question 1

Uptake =

Answer 1

Solubility (upside down y) x Q (CO) X (A-v)

A-v= diff in partial p of alveolar and venous blood

Question 2

If solubility, CO, or partial pressure difference is 0

Answer 2

Uptake will be 0

Question 3

Equilibrium refers to

Answer 3

State of equal partial pressures (not concentration)

Question 4

Blood/gas coefficients:
Des
N2O

Answer 4

0. 42

0. 47

Question 5

Blood/gas coefficients:
Sevo
ISO

Answer 5

0. 69

1. 4

Question 6

Blood/gas coefficients:
Enflurane
Halothane
Diethyl ether

Answer 6

1.8
2.4
12

Question 7

Order of low to high solubility

Answer 7

Do not say i eat heavy dopamine

Question 8

How hct alters blood gas coefficients

Answer 8

Lower hct= lower solubility coefficient. If anemic, alveolar buildup of gas is faster b/c fewer binding sites

Question 9

FA reaching FI determines what

Answer 9

When equal= faster uptake into brain and induction

Question 10

FA represents what

Answer 10

Partial p of anesthetic going into brain. No gradient between alveoli and brain bc large perfusion

Question 11

How we control FI

Answer 11

Vaporizer setting, inspired %

Question 12

Alveolar partial pressure used to estimate

Answer 12

Anesthetic depth, recovery, and MAC

Question 13

PA is determined by what

Answer 13

PI (inhaled partial p), alveolar ventilation, breathing circuit, and FRC

Question 14

Alveolar ventilation =

Answer 14

In one minute. Normal minute vent (VE) 6l - 2L (anatomical dead space)

Question 15

Change in alveolar concentration faster when anesthetist does what

Answer 15

Hyperventilates (faster rate lower volume)

Question 16

FA/FI curves 
First knee- 
Second knee- 
Continues \_\_\_ \_\_ after 
\_\_ \_\_ for agents

Answer 16

Initial rapid rise
Less rapid rise
More slowly
Same shape for all agents

Question 17

___ soluble agents have fastedt rate of alveolar gas/inspired conc over time

Answer 17

Least

Question 18

First knee __ __ group

Second knee __ group

Answer 18

Vessel rich

Muscle

Question 19

If uptake removes 1/2 anesthetic in lung, FA would be __ of FI

Answer 19

1/2

Question 20

If uptake removes 2/3 of anesthetic in lung, FA would be __ of FI

Answer 20

1/3

Question 21

Overpressure

Answer 21

Use of high delivered concentrations to compensate for slowness

Question 22

Impact of solubility on emergence

Answer 22

Lower the b/g solubility coefficient, shorter time emergence will take

Question 23

Emergence ___ induction with respect to solubility

Answer 23

Parallels. High solubility= takes longer to induce and emerge (more left in reservoir)

Question 24

How cardiac output affects induction

Answer 24

Dec CO- inc speed. Inc CO- dec induction speed. If CO 0= uptake = 0

Question 25

How CO effects FA/FI curve

Answer 25

Increase CO: ratio decreases, takes longer to rise | Decrease CO: inc ratio, straight up faster

Question 26

Effect of CO change greatest on FA/FI curve when what

Answer 26

Agent is more soluble (less effect on n20)

Question 27

Tissue uptake of anesthetic =

Answer 27

Same factors as lung. = tissue/blood coefficient x flow x (a-t)

Question 28

Coefficients for brain vs fat

Answer 28

Brain: 1-2 Fat: n20 (2.3) rest are higher 27-67

Question 29

Vessel rich group: components, equilibrium when

Answer 29

Brain, heart, liver, kidney. 5-15 min equilibrium w FI

Question 30

Muscle group: parts and what

Answer 30

Muscle, skin, highest % of body mass

Question 31

Vessel poor group

Answer 31

Bone, ligaments, tendons, 0% CO

Question 32

``` % Body mass VRG MG FG VPG ```

Answer 32

``` % body mass VRG- 9% MG- 50% FG- 19% VPG- 22% ```

Question 33

``` % of cardiac output VRG MG FG VPG ```

Answer 33

``` % CO VRG- 75% MG- 18% FG- 7% VPG- 0% ```

Question 34

What happens in FA/FI curve: Initial steep rise First knee

Answer 34

Initial: a-v diff= 0, no agent in alveoli, no uptake 1st: uptake by VRG balances input

Question 35

What happens in FA/FI curves 2nd rise 2nd knee

Answer 35

Rise: dec uptake by VRG, muscle group uptake Knee: 4-8 min, uptake by MRG slows

Question 36

PA (alveoli P) of volatile determined by what

Answer 36

PI, alveolar vent, breathing circuit, and FRC

Question 37

Impact of ventilation on induction and emergence

Answer 37

Increased: both more rapid Decreased: slower (both)

Question 38

Effect of increased ventilation on FA/FI curve

Answer 38

Increases it for a highly soluble agent. Wont inc for N20 (low solubility)

Question 39

How FRC/alveolar ventilation affects induction

Answer 39

Greater alveolar vent/FRC= faster induction. Dec FRC and inc alveolar vent= faster induction

Question 40

What happens when inc CO and ventilation

Answer 40

FA/FI increases slightly.

Question 41

V/Q abn have what effect on FA/FI

Answer 41

Rise in FA until ventil high, rise in arterial blood depressed (undervent lung not offset by inc vent lung). Dilutional effect= slower induction with LESS soluble agents

Question 42

Concentration effect is what

Answer 42

Large vol of gas abs: residual gas in lung is conc as vol decreases, ins vent increases which adds anesthetic and negative p created by uptake draws more gas into lung

Question 43

Washout Which agents washout 1st What happens as anes duration lengthens

Answer 43

Least soluble | Washout prolonged- more anesthetic in reservoirs

Question 44

Impact of solubility on emergence

Answer 44

Higher b/g solubility= longer emergence will take

Question 45

Slower inc in FA toward FA with ___ solubility | Washout more rapid with __ solubility

Answer 45

High | Low