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Anesthesia > Nitrous I > Flashcards

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
Q

Located in the juxtacapillary regions in the lung periphery to stimulate ventilation in response to pulmonary vascular engorgement.

A type of mechanoreceptor.

A

J receptors

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26
Q

Volume inhaled or exhaled per minute.

A

Minute volume

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27
Q

Minute volume is the equivalent of what cardiac event?

A

Cardiac output

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28
Q

Tidal volume x Respiratory Rate

A

Minute ventilation

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29
Q

The amount of air entering alveolar units capable of gas/blood exchange per minute.

A

Alveolar ventilation

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30
Q

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.

A

True

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31
Q

Gas exchange between alveoli and capillaries occurs by what kind of diffusion?

A

Simple diffusion down partial pressure gradients.

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32
Q

T/F:

The rate at which gas exchange takes place depends mostly on the difference in partial pressure between one compartment and another.

A

True

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33
Q

Concentration of a gas equation.

A

(Solubility)(Partial Pressure)

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34
Q

Factors that increase the partial pressure of inhaled anesthetic:

A

1) Increased partial pressure
2) Increased minute ventilation

3) Decreased removal

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35
Q

How to decrease removal of an inhaled anesthetic:

A

1) Decrease CO
2) Decrease alveolar/venous anesthetic gradient.
3) Decreased solubility

36
Q

When the anesthetic gas goes from brain to blood to alveoli, back out to the atmosphere.

A

Recovery

37
Q

Gases absorb and distribute as a result of what?

A

Pressure gradients.

38
Q

The lower the solubility, the faster the ______ and the faster the ______.

A

onset

recovery

39
Q

Anesthetic with the fastest onset of all inhalational agents.

A

Nitrous Oxide

40
Q

The greater this coefficient is, the more fatty tissues absorb this agent, making it longer to eliminate from the body.

A

Oil:gas partition coefficient

41
Q

MAC stand for

A

Minimum Alveolar Concentration

42
Q

Minimum Alveolar Concentration for nitrous in order to get a surgical level of anesthesia.

A

105%

43
Q

Nitrous has high or low oil:gas and blood:gas partition coefficients?

A

Low

44
Q

Concentration at which 50% of the people get a surgical level of anesthesia.

A

MAC

Minimum Alveolar Concentration

45
Q

Type of anesthesia where you are cut into, but you don’t feel it.

A

Surgical anesthesia

46
Q

T/F:

Anything that compromises your ability to carry oxygen will help you go to sleep faster when given sedative agents.

A

True

47
Q

Factors that decrease minimum alveolar concentration.

A
  • Hypoxia
  • Anemia
  • Hypotension
  • Hypothermia
  • Local anesthetics
  • Pregnancy (can’t move diaphragm as much).
48
Q

Infants and adolescents have increased or decreased MAC?

A

Increased

49
Q

How does chronic alcohol and barbiturate use affect MAC?

A

Increases

50
Q

Dangerous physical property of nitrous.

A

Supports COMBUSTION

So do not use an electrosurge when giving nitrous, bc it can smoke someone’s lungs, which is a lifetime disability.

51
Q

When a gas lowers the minimum alveolar concentration of other gases.

A

Second gas effect

52
Q

When a gas displaces all the oxygen in your lungs.

A

Diffusion hypoxia

53
Q

How to prevent diffusion hypoxia when using nitrous.

A

Turn off the NO and give 100% oxygen for 5-10 minutes.

54
Q

4 properties of Nitrous

A

1) Expands volume of gas filled spaces (like the lungs).
2) Concentration effect
3) Second Gas Effect
4) Diffusion hypoxia

55
Q

Rapid outflow of nitrous oxide (N2) from the blood dilutes the O2 in the alveolus, lowering the arterial pressure of oxygen, causing a hypoxia.

A

Diffusion hypoxia

56
Q

The higher the concentration of anesthetic given, the greater the inspired volume of that gas.

A

Concentration effect

57
Q

A large intake of the first gas causes a large intake of the second gas.

A

Second gas effect

58
Q

Metabolism of Nitrous

A

Most is eliminated unchanged via the lungs

59
Q

Nitrous binds to which receptors to cause analgesia?

A

Opioid

60
Q

Nitrous indirectly stimulates the release of these.

A

Endogenous opioids

61
Q

Nitrous binds to which receptors to cause anxiolysis?

A

GABAa

62
Q

1) Nitrous binds to opioid receptors to cause _____.

2) Nitrous binds to GABA receptors to cause _____.

A

1) Analgesia

2) Anxiolysis

63
Q

Chronic exposure of nitrous causes this.

A

Paresthesia (Impaired metabolism of vitamin B12)

64
Q

Associated with Vitamin B12 deficiency.

A

Paresthesia

65
Q

CNS effects of nitrous.

A
  • Increased cerebra; blood flow.
  • Decrease in cerebral metabolic rate.
  • Nausea - maybe affect medullary vomiting center.
66
Q

Does nitrous effect coronary flow?

A

NO (just cerebral)

67
Q

T/F:

Nitrous increases CO, HR, and stroke volume.

A

True

68
Q

Nitrous effect on renal flow.

A

Decreased renal flow.

69
Q

Respiratory effects of nitrous.

A

1) Decrease in tidal volume
2) Increase in respiratory rate
3) Increase in airway resistance

70
Q

T/F:

Nitrous causes:

1) Blunted response to increased arterial CO2.
2) Blunted response to decreased arterial O2.
3) Decreased pharyngeal reflexes

A

True

71
Q

Gastrointestinal effects of nitrous.

A

Possible depression of reflexes and relaxation of the GE sphincter.

Increased risk of vomiting and aspiration.

72
Q

Nitrous effects on Renin-Angiotensin-Aldosterone system

A

Activates RAAS

Increased ADH release

73
Q

Nitrous effects on blood sugar and cortisol.

A

Increases

74
Q

Can get long-term symptoms of this with nitrous.

A

Multiple Sclerosis

75
Q

Nitrous reduces the activity of enzymes that rely on this vitamin.

A

B12

76
Q

Nitrous irreversibly oxidizes this.

A

The Cobalt atom in Vit B12

77
Q

These changes in bone marrow are seen after 24 hours of nitrous exposure.

A

megaloblastic

78
Q

% of nitrous needed to cause amnesia.

A

70%

79
Q

Nitrous causes venodilation, so it can be given before starting an ___.

A

IV

Makes it easier to get the catheter in the vein.

80
Q

Absolute contraindications to Nitrous

A
  • Pregnancy
  • Bowel obstruction
  • Recent cranial injury
  • Recent neurosurgical procedure
  • Recent pneumothorax
  • Bullous emphysema
  • Recent ocular surgery
  • Recent tympanic surgery
  • Air embolus
81
Q

Nitrous causes bone marrow suppression, which includes:

A

Myeloid and Erythroid suppression

82
Q

Acute toxicity by nitrous includes:

A

Germ cells (ovaries).

Myeloid and Erythroid suppression.

83
Q

What is Vit B12 needed for?

A

DNA and bone marrow synthesis.

84
Q

Nitrous irreversibly oxidizes this.

A

Vit B12, needed for bone marrow and DNA synthesis

85
Q

Definition:

The ability to damage or change DNA.

A

Mutagenicity

86
Q

Nitrous may cause a 1.3-2 x increase in this kind of cancer.

A

Cervical

87
Q

Chronic nitrous exposure increases the risk of this women.

A

Spontaneous abortions

Anesthesia (11 decks)

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