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Nitrous I Flashcards

1
Q

The volume of breath that does not participate in gas exchange.

A

Dead space

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2
Q

How is anesthesia transported?

A

In the blood

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3
Q

Conducting airways have what kind of air flow?

A

Laminar

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4
Q

Structures that make up the conducting airways.

A

Larynx
Trachea
Main stem bronchi
Bronchioles

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5
Q

Structures that make up the respiratory zone.

A

Respiratory bronchioles
Alveolar ducts
Alveoli

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6
Q

Type of air flow in respiratory zone.

A

Turbulent.

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7
Q

This part of the airway has increased cross-sectional area, therefore, decreased resistance.

A

Respiratory zone.

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8
Q

This lung circulation brings nutrients to the lungs/Surface area for gas exchange.

A

Bronchial circulation

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9
Q

Arteries that bring deoxygenated blood to the lungs, where they get oxygenated at the alveoli.

A

Pulmonary arteries

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10
Q

Primary muscles for inspiration.

A

Diaphragm

Intercostal muscles

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11
Q

Accessory muscles for inspiration.

A

SCM
Scalenes
Abdominal muscles

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12
Q

Expiration uses:

A

Passive elastic recoil

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13
Q

T/F:

The phrenic nerve is more sensitive to sedative agents.

A

True

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14
Q

Breathing in which the abdominal muscles move instead of the diaphragm.

A

Reverse breathing

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15
Q

Efferent neurons that are respiratory effectors

A

Phrenic nerve
Cranial nerves
Cervical nerves

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16
Q

Autonomic respiratory control centers.

A

Medullary reticular formation with input from the pons

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17
Q

Voluntary respiratory control area that may override the autonomic.

A

Cerebral cortex

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18
Q

The main drive for breathing.

A

CO2 levels

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19
Q

CENTRAL respiratory chemoreceptors

A

Medulla

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20
Q

Medullary chemoreceptors sense what?

A

H+ and Arterial CO2

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21
Q

Location of peripheral chemoreceptors.

A

Carotid and Aorta

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22
Q

Peripheral chemoreceptors are more sensitive to this.

A

Arterial O2

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23
Q

These chemoreceptors respond less to changes in H+ and Arterial CO2

A

Peripheral (Aortic and Carotid)

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24
Q

Control rate and depth of respiration in response to stretch.

A

Mechanoreceptors.

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25
Located in the juxtacapillary regions in the lung periphery to stimulate ventilation in response to pulmonary vascular engorgement. A type of mechanoreceptor.
J receptors
26
Volume inhaled or exhaled per minute.
Minute volume
27
Minute volume is the equivalent of what cardiac event?
Cardiac output
28
Tidal volume x Respiratory Rate
Minute ventilation
29
The amount of air entering alveolar units capable of gas/blood exchange per minute.
Alveolar ventilation
30
T/F: Rate of diffusion of a particular gas is directly proportional to the partial pressure of the gas. The higher the partial pressure of the gas, the greater the rate of diffusion.
True
31
Gas exchange between alveoli and capillaries occurs by what kind of diffusion?
Simple diffusion down partial pressure gradients.
32
T/F: The rate at which gas exchange takes place depends mostly on the difference in partial pressure between one compartment and another.
True
33
Concentration of a gas equation.
(Solubility)(Partial Pressure)
34
Factors that increase the partial pressure of inhaled anesthetic:
1) Increased partial pressure 2) Increased minute ventilation 3) Decreased removal
35
How to decrease removal of an inhaled anesthetic:
1) Decrease CO 2) Decrease alveolar/venous anesthetic gradient. 3) Decreased solubility
36
When the anesthetic gas goes from brain to blood to alveoli, back out to the atmosphere.
Recovery
37
Gases absorb and distribute as a result of what?
Pressure gradients.
38
The lower the solubility, the faster the ______ and the faster the ______.
onset recovery
39
Anesthetic with the fastest onset of all inhalational agents.
Nitrous Oxide
40
The greater this coefficient is, the more fatty tissues absorb this agent, making it longer to eliminate from the body.
Oil:gas partition coefficient
41
MAC stand for
Minimum Alveolar Concentration
42
Minimum Alveolar Concentration for nitrous in order to get a surgical level of anesthesia.
105%
43
Nitrous has high or low oil:gas and blood:gas partition coefficients?
Low
44
Concentration at which 50% of the people get a surgical level of anesthesia.
MAC Minimum Alveolar Concentration
45
Type of anesthesia where you are cut into, but you don't feel it.
Surgical anesthesia
46
T/F: Anything that compromises your ability to carry oxygen will help you go to sleep faster when given sedative agents.
True
47
Factors that decrease minimum alveolar concentration.
- Hypoxia - Anemia - Hypotension - Hypothermia - Local anesthetics - Pregnancy (can't move diaphragm as much).
48
Infants and adolescents have increased or decreased MAC?
Increased
49
How does chronic alcohol and barbiturate use affect MAC?
Increases
50
Dangerous physical property of nitrous.
Supports COMBUSTION So do not use an electrosurge when giving nitrous, bc it can smoke someone's lungs, which is a lifetime disability.
51
When a gas lowers the minimum alveolar concentration of other gases.
Second gas effect
52
When a gas displaces all the oxygen in your lungs.
Diffusion hypoxia
53
How to prevent diffusion hypoxia when using nitrous.
Turn off the NO and give 100% oxygen for 5-10 minutes.
54
4 properties of Nitrous
1) Expands volume of gas filled spaces (like the lungs). 2) Concentration effect 3) Second Gas Effect 4) Diffusion hypoxia
55
Rapid outflow of nitrous oxide (N2) from the blood dilutes the O2 in the alveolus, lowering the arterial pressure of oxygen, causing a hypoxia.
Diffusion hypoxia
56
The higher the concentration of anesthetic given, the greater the inspired volume of that gas.
Concentration effect
57
A large intake of the first gas causes a large intake of the second gas.
Second gas effect
58
Metabolism of Nitrous
Most is eliminated unchanged via the lungs
59
Nitrous binds to which receptors to cause analgesia?
Opioid
60
Nitrous indirectly stimulates the release of these.
Endogenous opioids
61
Nitrous binds to which receptors to cause anxiolysis?
GABAa
62
1) Nitrous binds to opioid receptors to cause _____. | 2) Nitrous binds to GABA receptors to cause _____.
1) Analgesia | 2) Anxiolysis
63
Chronic exposure of nitrous causes this.
Paresthesia (Impaired metabolism of vitamin B12)
64
Associated with Vitamin B12 deficiency.
Paresthesia
65
CNS effects of nitrous.
- Increased cerebra; blood flow. - Decrease in cerebral metabolic rate. - Nausea - maybe affect medullary vomiting center.
66
Does nitrous effect coronary flow?
NO (just cerebral)
67
T/F: Nitrous increases CO, HR, and stroke volume.
True
68
Nitrous effect on renal flow.
Decreased renal flow.
69
Respiratory effects of nitrous.
1) Decrease in tidal volume 2) Increase in respiratory rate 3) Increase in airway resistance
70
T/F: Nitrous causes: 1) Blunted response to increased arterial CO2. 2) Blunted response to decreased arterial O2. 3) Decreased pharyngeal reflexes
True
71
Gastrointestinal effects of nitrous.
Possible depression of reflexes and relaxation of the GE sphincter. Increased risk of vomiting and aspiration.
72
Nitrous effects on Renin-Angiotensin-Aldosterone system
Activates RAAS Increased ADH release
73
Nitrous effects on blood sugar and cortisol.
Increases
74
Can get long-term symptoms of this with nitrous.
Multiple Sclerosis
75
Nitrous reduces the activity of enzymes that rely on this vitamin.
B12
76
Nitrous irreversibly oxidizes this.
The Cobalt atom in Vit B12
77
These changes in bone marrow are seen after 24 hours of nitrous exposure.
megaloblastic
78
% of nitrous needed to cause amnesia.
70%
79
Nitrous causes venodilation, so it can be given before starting an ___.
IV Makes it easier to get the catheter in the vein.
80
Absolute contraindications to Nitrous
- Pregnancy - Bowel obstruction - Recent cranial injury - Recent neurosurgical procedure - Recent pneumothorax - Bullous emphysema - Recent ocular surgery - Recent tympanic surgery - Air embolus
81
Nitrous causes bone marrow suppression, which includes:
Myeloid and Erythroid suppression
82
Acute toxicity by nitrous includes:
Germ cells (ovaries). Myeloid and Erythroid suppression.
83
What is Vit B12 needed for?
DNA and bone marrow synthesis.
84
Nitrous irreversibly oxidizes this.
Vit B12, needed for bone marrow and DNA synthesis
85
Definition: | The ability to damage or change DNA.
Mutagenicity
86
Nitrous may cause a 1.3-2 x increase in this kind of cancer.
Cervical
87
Chronic nitrous exposure increases the risk of this women.
Spontaneous abortions

Anesthesia (11 decks)

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