Chemistry and Physics of Anesthesia Exam Flashcards

Terms Definitions
Is nitrous oxide combustible?
Yes
What system is Kelvin?
SI
What is hypoxic hypoxia?
Generalized hypoxia
Do anesthetics have receptor sites?
No
What percentage of membrane permeability is responsible for negative cell charge?
80%
Anesthetics with high solubilities are more powerful. True or false?
True
How many amino-acid peptides do endorphins have?
31
At higher temperatures, less gas dissolves. True or false?
True
What is Morphine metabolized to?
Morphine 6-glucuronide
What symptoms is Delta responsible for?
Periphery
What alveolar cells produce surfactant?
Type II
What is the density of mercury?
13.6g/cm3
What does one Torr equal?
1mmHg mercury
What are the short-acting barbiturates, what is their time of action, and what are they classified as?
Hexobarbital, pentobarbital, secobarbital, 2 hours, hypnotics
What is the danger of methadone?
Cumulative toxicity
What is surfactant?
Phospholipids that reduce surface tension of the alveoli
What is the surface area of alveoli?
60-100m2
What three factors control BP?
Resistance, HR, volume
What is the molecular weight of chloral hydrate?
165.5
How many subtypes of opioid receptors are there?
4
How much blood is in the arteries?
13%
What is the solubility of nitrous oxide at temp 37 and partial pressure of 100pKa?
0.39
What are the Agonists/Antagonists?
Pentazocine (Talwin), Butorphanol (Stadol), and Nalbuphine (Nubain)
Is first pass metabolism present when taken orally?
Yes
How much more potent are opiopeptines than morphine?
200
How fast is an action potential?
100-120 m/s
What is the extracellular concentration of Na+, K+, and A-?
150mM/L, 5mM/L, 0mM/L
What segment of Morphine comprises codeine?
3-methylether of morphine
Total resistance is less than the sum of all resistances in series or parallel?
Parallel
What are the antagonists?
Naloxone (Narcan) and Naltrexone (Deprade, ReVia)
What symptoms is Sigma responsible for?
Hallucinations, respiratory stimulation, and vasomotor stimulation
What type of receptors are opioid receptors?
G-protein family
What is the main effect of opioid receptors on the cell membrane?
Inhibition
What is heroin converted to in the body?
Morphine
What anesthetic is used in day surgery and cannot be used in infants/children w/mask because of upper airway irritation?
Desflurane
What is the viscosity range of whole blood?
3-5
When is Naltrexone contraindicated?
Anytime the liver is impaired.
What does the efficacy of barbiturates depend on?
Lipid solubility
How much blood is in the pulmonary circulation?
9%
The sum of all resistances = total resistance in series or parallel?
Series
What is LaPlace's Law?
P(collapsing pressure) = 2T(surface tension)/R(alveolar radius)
What is the Ideal Gas Law?
PV = nRT
What is Kelvin?
It is the absolute thermodynamic temperature scale
How is pressure expressed in SI unit?
In Pascals
What are the three SI units?
Meter, kilogram, second
What is threshold?
The minimal amount of stimulation required to initiate an action potential
What does 30mg of codeine equal to in relation to aspirin?
600mg
What is the analgesic potency of meperidine?
1/8th of morphine
What are the intermediate barbiturates, what is their time of action, and what is their classification?
Amobarbital, butabarbital, 3-5 hours, hypnotics
What does sympathetic stimulation have upon the heart?
Norepinephrine increases permeability of fibers to sodium and calcium. Increases heart rate. Increases contractility
What does a sudden break in chloral hydrate tolerance lead to?
Acute intoxication
What two systems control heart rate?
Parasympathetic and Sympathetic nervous systems
What two factors determine stroke volume?
SNS and venous return
What two groups of alcaloids does opium resin contain?
Phenanthrenes and Isoquinolines
How many amino-acid peptides do enkephalines have?
5. They are pentapeptides
What are the anesthetic properties of ketamine?
Hallucinations, trance-like state
What three factors affect alveolar stability?
Alveolar interdependence, pulmonary surfactant, residual volume
What are the Codeine-like agonists?
Codeine, Tramadol, Hydrocodone, and Oxycodone
What symptoms is Mu responsible for?
Analgesia, supraspinal analgesia, respiratory depression, euphoria, and physical dependence
What are ependymal cells?
Supporting cells that participate in the filtration and cleansing of CSF
What is the formula for pressure?
Pressure = Force/Surface Area
What is the membrane permeability of the Na+, K+, A-?
1, 60, 0
What products comprise local blood flow control?
Carbon dioxide, lactic acid, adenosine, histamine, K+ ions, H+ ions, and nitric oxide
Enflurane is characterized by what side effects?
Stimulates salivation, dissolves in rubber, and suppresses laryngeal reflexes
What are the physiological effects of anesthesia on the CNS?
Decreased awareness, decreased cerebral metabolism, increased cerebral blood flow, increased CSF pressure, EEG changes, seizures, shivering
How is Halothane biotransformed?
5% is biotransformed by P-450 by removal of bromide and chloride
How does Flumazenil work?
It is a competitive antagonist for benzodiazepine site on GABAa complex
What is the ultra-short barbiturate, what is its time of action, and what is it typically used for?
Thiopental, 0-30s, adjuvant to anesthesia
What is the range of negative pressure in the pleural cavity?
-4 to -9
What is Henry's Law?
At a constant temperature, the amount of a given gas dissolved in a liquid is directly proportional to the partial pressure of that gas in equilibrium with that liquid
At a temp of 37, what is the nitrous oxide gas-blood partition coefficient?
2.1
At 21% O2 and 1 ATM, what is the amount of O2 in the blood?
0.3m/O2
What are the four types of receptors?
Mu, Kappa, Sigma, Delta
What are Schwann cells?
A supporting cell that wraps around the neuron to form a myelin sheath.
How does spider venom work?
It stimulates the release of acetylcholine to induce overcontraction symptoms like cramping, tetany, and pain
What is Celsius?
It is the 1/100th of the difference between the temperature of freezing water and boiling water at a pressure of one atmosphere
What is the relationship between Kelvin and Celsius?
Kelvin(K) = Celsius + 273.15
What is the percentage of H2O in the atmosphere? In alveoli?
0.46%, 6.2%
What is the percentage of O2 in the atmosphere? In alveoli?
20.9%, 13.7%
What is the formula for the universal gas constant?
P1V1/T1 = P2V2/T2
What is repolarization?
The removal of a positive charge like potassium
What two factors comprise nervous system blood flow control?
Innervation of all blood vessels except capillaries and precapillaries. Vasoconstrictor and vasodilatory fibers
What is circulatory hypoxia?
When organs and tissues do not receive enough oxygen
What are the anesthetic properties of benzodiazepines?
Rapid induction, rapid recovery, minimal respiratory depression
What is histotoxic hypoxia?
When cells are receiving enough O2 but they cannot utilize it well because they have impaired oxidative phosphorylated enzymes
What is the equivalent dosage of heroin to morphine?
3mg heroin = 10mg morphine
What is Ohm's Law?
Q(flow in the system) = P(pressure in the system)/R(resistance in the system)
What are the four types of endogenous opioids?
Enkephalines, dynorphins, endorphins, and endomorphins
Where are opioid receptors found?
The limbic system, the medial and lateral thalamus, the hypothalamus, the medulla oblongata, and the spinal cord
What are some significant side effects of meperidine?
Smooth muscle spasm (bronchospasm), atropine-like activity (dry mouth, blurring of vision), hyperthermia, and convulsions with MAO
What are the pharmacodynamics of benzodiazepines?
They potentiate the binding of inhibitory GABA to GABA receptors, benzodiazepine receptors are in the thalamus, the limbic system, and cortex; and they bind to GABAa to increase the frequency of calcium channel opening
What are the two classifications of neurons?
Afferent (sensory) and Efferent (motor)
What the 5 types of supporting cells for neurons?
Schwann, oligodendrites, microglia, astrocytes, and ependymal
What is the cerebellum responsible for?
Balance, muscle tone, coordination of voluntary movement.
What is minute respiratory volume?
The volume of air that can be inhaled/exhaled in one minute
How do barbiturates act on GABA receptors?
GABA binds to GABAa receptor. Barbiturates binding to receptor potentiates this binding. Chloride rushes into the cell making the membrane stable and making depolarization difficult.
What is the difference between the pharmacodynamics between barbiturates and benzodiazepines?
Cloride channels open more frequently in benzodiazepines and channel opening is prolonged in barbiturates
What is a solubility coefficient?
A measure of how easily gas dissolves in liquid
What are the principles of the Overton-Meyer correlation?
Anesthetic potency is proportional to lipid solubility; there is a linear relationship b/t oil/gas partition coefficient and potency; olive oil is used to measure lipid solubility
What is the partition coefficient?
The ratio of a substancein one phase compared with the other. The two phases are of equal volume and are in equilibrium
What is the brain stem responsible for?
Peripheral cranial nerves, basic life support functions, regulation of muscle reflexes with equilibrium, posture, sleep center.
What are the two types of action potential propogation?
Local currents and saltatory conduction
What is a neuromuscular synapse?
A space between a neuron and a muscle
One mole of any gas at ATP occupies how many Liters? What is the formula?
22.4L. V1/n1 = V2/n2
What is refractory period?
A period in which it is impossible to create the next action.
What is a Newton?
A force that gives a mass of one kilogram and an acceleration of 1m/s2
How is one Pascal expressed in one Newton?
One Pascal = One Newton/m2
What are the major functions of the basal nuclei?
Inhibition of muscle tone, coordination of slow movements, and suppression of useless patterns of movement
What is inspiratory capacity?
This is the volume of air that can be inhaled after normal exhalation
What is the process of opioid receptor inhibition?
Phospholipase C is activated which inhibits adenylate cyclase which inhibits cAMP. This opens K channels causing repolarization and closes Ca channels causing the inhibition of neurotransmitter release.
What factors control the return of venous blood to the heart?
Low pressure in right atrium, low pressure in thoracic cage, valves provide unidirectional flow, and muscle pumps
What is the Oswald Solubility Coefficient?
The volume of gas which dissolves in one unit volume of liquid at a known temperature
What is total lung capacity?
The volume of air in the lungs after maximal inhalation
What are the skin effects of Morphine?
Allergic skin rashes and dilation of cutaneous vessels
What is the third gas law?
It states that at constant volume a doubling of temperature will result in doubling of pressure
What is the first gas law?
Boyle's law states that at a constant temperature the volume of a mass of a gas is inversely proportional to the absolute pressure
What does Halothane do to metals and rubber?
It corrodes metal and reacts with rubber
Why do bubbles of air form in infusion lines passing through warming coils?
At higher temperatures, less gas dissolves
What is inspiratory reserve volume and what does it equal?
IRV is the additional volume of air that can be breathed in after normal respiration. It equals 3000ml.
What are the six rules pertaining to gases?
Gas molecule size is extremely small compared to the distance between gas molecules. They behave in accord with classical laws of motion. Their movement is random. There are no attractive forces between gas molecules and molecules of container. Overall energy is conserved in collisions. Kinetic energy is proportional to absolute temperature
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