Brainscape's Knowledge GenomeTM

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


See full index

RUSVM Anesthesiology > Inhalants Anesthesia > Flashcards

Inhalants Anesthesia Flashcards

1
Q

why use inhalant anesthesia

A

predictable effects (narcosis, muscle relaxation, not analgesic)

rapid adjustment of depth

minimal metabolism

economical

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

vapor

A

gaseous state of a substance that is a liquid at ambient temp and pressure

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

gas

A

exists in gaseous state a ambient temp and pressure

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

N2O

A

low blood gas PC

mild analgesic

acumulates in clased gas spaces

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

Xenon

A

expensive

mostly experimental at this time

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

Dalton’s Law of partial pressure

A

total pressure of a gas mixture is equal to the sum of the partial pressure of the individual gases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

vapor pressure

A

pressure exerted by vapor molecules when liquid and vapor phases are in equilibrium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

vapor pressure is dependent on…

A

temperature

increases with increasing temp; inversely related to boiling point

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

T/F desflurane is maintained in the gaseous form

A

True

blends with O2 to acheive vaporizer setting

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

saturated vapor pressure

A

maximum administration percentage

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

T/F vaporizers are needed to reduce the saturated vapor pressure to clinically useful doses

A

True

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

anesthetic vapors dissove in

A

liquids and solids

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

when is equalibrium reached

A

when the partial pressure of the anesthetic is the same in each phase

(partial pressure equal, but number of anesthetic molecules are not)

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

what is solubility expressed as

A

partition coefficient

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

what is the partition coefficient

A

concentration ratio of an anesthetic in the solvent and gas phase

describes the capacity of a given solvent to dissolve the anesthetic gas

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

what is the most clinically useful number

A

blood gas partition coefficient

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what is the blood-gas partition coefficient

A

amount of an anesthetic in the blood vs. alveolar gas at equal partial pressures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

the anesthetic in alveolar gas represents…

A

brain concentration

this is the location of effect

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

anesthetic dissolved in the blood is ppharmacologically…

A

Inactive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

low blood gas PC

A

less anesthetic dissolved in blood at equal patial pressure

(more in alveoli)

short induction and recovery - more clinically useful

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

high blood gas PC

A

more anesthetic dissolved in blood at equal partial pressure

(less in alveoli)

long induction and recover

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

the partial pressure in the brain is equal to

A

partial pressure in the aveoli

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

how can PA be increased

A

increase the anesthetic delivery to alveoli

decrease removal from alveoli

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

how can PI be increased

A

increase vaporizer setting

increase fresh gas flow

decrease breathing cicuit

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

decrease removal from alveoli by

A

decrease blood solubilty of anethetic

decrease CO - patients with low CO will have a faster rse of PA

decrease alveolar-venous anesthetic gradient

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

T/F the higher the PI the more rapidly PA approaches PI

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

as uptake into blood decreases PI can be

A

decreased

28
Q

anesthetic elimination requires

A

decrease in PA

29
Q

how can you quickly decrease PA

A

turn off vaporizer

disconnect patient and flush O2

turn up O2 flow

increase ventilation (IPPV)

30
Q

what is minimum alveolar concentration (MAC)

A

minimum alveolar concentration of and anesthetic that prevents movement in 50% of patients exposed to noxious stimulus

31
Q

What is MAC used for

A

compare potency between agents

inverse relationship (high MAC = low potency)

32
Q

T/F: Alveolar concentration is NOT the same as the vaporizer setting

A

True

33
Q

what increases MAC

A

hyperthermia

hypernatremia

drugs causing CNS stimulation

34
Q

what decreases MAC

A

hypothermia

hyponatremia

drugs causing CNS depression

MAP <50 mmHg

PaO2 <40 mmHg

PaCO2 >95 mmHg

pregnancy

age

35
Q

what are MAC multiples

A

used to describe dose of gas in relation to pharmacologic and physiologic effect

1.2-1.4 times MAC ensures immobility in 95% of patients

36
Q

T/F MAC is additive

A

True

(0.5 MACa) + (0.5 MACb) = 1 MACc

37
Q

when is MAC important

A

changing gases in middle of a case

usig N2O

using partial intravenous anesthesia (PIVA)

38
Q

cardiovascular effects of volatile anesthetics

A

CO, BP, SVR, contractility - decrease

HR - no change to increase

39
Q

when is there an increase in intracranial pressure

A

>1 MAC

40
Q

which doesnt suppress seizure activity

A

enflurane

41
Q

renal effects of volatile anesthetics

A

decrease GFR and renal blood flow due to decreased CO

renal failure

42
Q

what is compound A

A

produced from sevoflurance breakdown in CO2 absorbent

higher concentrations formed during: prolonged anesthesia, low fresh gas flow, desiccated absorbent

43
Q

hepatic effects

A

reduce live blood flow and O2 delivery (decreased CO)

44
Q

2 types of hepatotoxicity caused by halothane

A

increased liver enzymes

“halothane hepatitis” - immune mediated, often fatal

45
Q

which inhalant anesthetic is more likely to cause malignant hyperthermia

A

halothane

46
Q

Tx of malignant hyperthermia

A

discontinue volatile anesthetic, flush with O2, switch to new circuit if possible

provide 100% O2

administer dantrolene (muscle relaxant)

fluids, active cooling

47
Q

max administration of N2O

A

75%

need at least 25% O2

48
Q

CV effects of N2O

A

minimal CV and resp drepression

49
Q

T/F N2O transfers to closed gas spaces

A

True

GI tract, sinuses, middle ear, pneumothorax, GDV, cuff of ET tube

avoid in disease states causing increased closed gas space

50
Q

what is diffusion hypoxia

A

N2O administration is stopped, it diffuses quickly out of the blood into alveoli

displaces O2 from alveoli

if breathing room air → hypoxia

51
Q

MAP with hypotension

A

<60 mmHg (small) and <70 mmHg (large)

52
Q

what is the most appropriate and effective treatment for hypotension during inhalant anesthesia

A

turn down the vaporizer

53
Q

if patient is light and hypotensive

A

add MAC-sparing drug then turn down vaporizer

opioids, benzo, lidocaine, ketamine

54
Q

definitition of hypoventilation

A

PaCO2 >40 mmHg or EtCO2 >45 mmHg

55
Q

what can happen is pop off is closed

A

pneumothorax

decreased CO

56
Q

what signs are seen with stuck inspiratory-expiratory valves

A

rebreathing waveform on capnograph

57
Q

what will you see with exhausted soda lime

A

rebreathing- waveform on capnograph

58
Q

most common cause of laryngeal damage

A

from laryngoscope or stylet

59
Q

tracheal tears are common in

A

cats

60
Q

signs of tracheal tears

A

SQ emphysema

pneumomediastinum and pneumpretroperitoneum

61
Q

T/F inhalant anestheritics have a very low therapeutic index

A

True

62
Q

what indicates inadequate cerebral blood flow for consciousness

A

low blood pressure

MAP <50 mmHg

63
Q

PA

A

partial pressure in the alveoli

64
Q

PA =

A

gas delivery to alveoli - removal by the lungs

65
Q
A

RUSVM Anesthesiology (39 decks)

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