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Gases Flashcards

1
Q

How much of air is Oxygen?

A

21%
depends on altitude

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1
Q

Sea level air & pressures

A

760 mm Hg/torr
&
21% O2 = 160 mmHg (partial pressure of O2)

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2
Q

Increasing altitude decreases pO2, thus…

A

decreased driving force of O2 entry into tissues (diffusion)

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3
Q

what pressure/altitude do we become concerned with SpO2

A

~500 mmHg atmospheric pressure
10-12k feet
not enough O2 in air

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4
Q

hyperbaric therapy

A

up to 1300 mmHg
increases pO2

increases:
O2 diffusion into tissue & O2 blood solubility
crosses into tissue better

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5
Q

Normal O2 sat

A

98%
Above 98% requires much higher [ ] not very beneficial

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6
Q

At what PO2 do we see a decrease in sat?
when do we see a major effect in O2 tissue delivery?

A

below 100 mmHg (starts to decrease)

below 70 mmHg (now concerned)

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7
Q

How does pH affect the oxyhgb curve?

A

Left shift = high pH
Right shift = low pH

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8
Q

A (high/low) pH makes the oxyhgb curve easier to saturate

A

Left shift = easier to saturate
(high pH)

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9
Q

DPG

A

2,3- diphosphoglyceric acid
Produced in RBC to control O sat

more DPG = R shift

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10
Q

Oxygen Deficiency
Causes

A

low inspired fraction (FIO2) (low room [ ])

increased diffusional barrier (lung scarring)

hypoventilation

ventilation – perfusion mismatch

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11
Q

_____ [ ] stimulates respiratory drive & ventilation rate.

A

increased PCO2

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12
Q

Which stimulates ventilation more?
higher PCO2
low PO2

A

higher PCO2

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13
Q

T/F
The body will not increase ventilation d/t low PO2 alone. PCO2 must be elevated.

A

False
a low PO2 w/ high PCO2 can still increase resp. drive

(high PCO2 is just a more effective stimulator)

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14
Q

Hypoxic effects

A

Increased ventilation

sympathetic stimulation (tachycardia, decreased PVR <= local effect)

pulmonary vasoconstriction (optimize V/Q)

impaired CNS function

anerobic metabolism (decreased ionic gradients – ↑ lactic acid, H+, Ca++, Na+ => cell death)

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15
Q

Tissue hypoxia
local control mechanism

A

produce nitric oxide
into muscle
increase BF and perfusion
local vasodil8n

all to get more O2 into tissue

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16
Q

An increase of ___, especially, will trigger auto lysis.

A

Ca++

(H+ and Na+ also can)

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17
Q

Due to dissociation curve, increasing inspired O2 [ ] …..

A

does not greatly increase blood O2

Giving 100% not always beneficial bc O2sat is 98% until 90 PO2

will help if hypoxic d/t:
low hgb, BF or RR
damaged diffusion barrier in lungs

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18
Q

hyperbaric therapy uses

A

deep tissue/bone infxn

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19
Q

O2 toxicity

A

over-exposure => peroxide formation

H2O2 formed from oxygen and water
Very reactive & can damage tissue

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20
Q

Why does increased PCO2 lead to resp acidosis

A

using LeChat’s principle:
(CO2 + H2O ↔ H2CO3 ↔ H+ + HCO3-)

increasing CO2 = increased carbonic acid = increased H+ = low pH

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21
Q

Why is hypocarbia used in neurosurgery?

A

resp alkalosis can constrict cerebral vessels and decrease brain size

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22
Q

T/F
CO2 is commonly used to increase RR

A

False
it would work but also changes blood pH

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23
Q

CO2 in Cardiac Sx

A

decrease air (insoluble N2) around heart

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24
main drive mechanism for vasodilation of many arterioles
Nitric Oxide (NO)
25
Nitric Oxide (NO) & the oxyhgb curve
may shift left increasing the oxygen affinity of hemoglobin
26
Nitric Oxide (NO) is a ___ moelecule
signaling
27
main use in pulmonary function testing, laser airway surgery and diving
Helium
28
Helium in airway Sx
reduce O2
29
T/F Helium is reactive
False inert gas
30
Why use Helium in diving tanks?
Diving = increased pressure around us O2 pressure in tank will double too much pO2 = H peroxide mix w/ He to decrease high O2 pressure
31
Why can we apply gas laws to our volatile agents?
VAs: liquid --> gas phase only small deviation from "ideal gas"
32
Transport Processes
Osmosis (mvmt across semi-perm membrane) Fick’s law of diffusion Grahams’s law of diffusion
33
Osmosis requires....
-semi-permeable membrane -difference in [ ] of solutes on each side
34
T/F Albumin can move via osmosis
False too large (MW ~69K)
35
Albumin is higher in the ___
ECF
36
Sq. Root of the Molecular Weight is a measure of the ___
(Fick's Diffusion) molecular diameter large # = larger diameter = slower diffusion
36
Fick’s law of diffusion What increases diffusion rate?
Higher: partial pressure gradient membrane area solubility of a gas in the membrane lower: membrane thickness sq. root of the MW
37
Grahams’s law of diffusion
Faster diffusion: lower sq rt of gas' **density** Slower diffusion: **higher Gas density** => higher M. Mass
38
Grahams’s law of diffusion rate of diffusion is inversely proportional to ....
the square root of the molar mass
39
(assuming ideal gases) the ... in a gas is the same for all gases at the same temperature and pressure
number of molecules
40
Which law focuses more on molar mass? Fick's diffusion Grahams's diffusion
Grahams's diffusion (Fick's includes MW)
41
Henry’s Law
↑ partial pressure = ↑ dissolve in a liquid
42
T/F Hgb is the only transport mechanism for O2 transport
False can also diffuse O2 into tissue using pressure Hgb = primary method
43
amount of O2 that dissolves in blood
0.003 ml/100 ml blood/mmHG partial pressure ex: PaO2 300 mmHG 300 mmHG x 0.003 = 0.9 ml O2/100 ml blood
44
PP of NO @ sea level
600 mmHg O2 = 160 mm Hg/21%
45
If the PaO2 is 300 mmHg, how much O2 is dissolved in 100 ml of blood?
0.9 ml O2 per 100 ml blood multiply PaO2 by 0.003 and put that over 100m ml of blood
46
Gases flow as a __
fluid/liquid Bromine is a good example colored & high density
47
Laws are based on ___ flow
laminar
48
Laminar flow
Molecules move relative to one another (rush hour; traffic moving along together) Against walls = slowest (interact w/ wall,) resistance Center moves fastest Resistance from walls can affect center molecules as well Laminar = Peak rate of movement
49
Turbulent flow
Started as laminar but something disrupted Molecules bounce off walls and affect other molecules
50
____ flow is predictable via math
laminar turbulent is unpredictable
51
What flow do we see in the lungs and tubing?
A mix of both laminar & turbulent can become turbulent in kinks/curves sort themselves back into laminar
52
Has the greatest effect on airway resistance
radius of tube
53
What increases and decreases airway resistance?
higher resistance: ↑tubing length & viscosity ↓ tubing diameter lower resistance: ↑tubing diameter
54
how does diameter affect laminar flow
larger diameter = more laminar flow
55
T/F Small changes in radius = big changes in resistance
True
56
How does narrowing of tubing affect flow and speed?
increased speed in narrowed space Once opens back up, some temporary turbulent flow
57
When do we see turbulent flow in anesthesia?
High flow rate Rough/corrugated tube Kinks bends sudden changes in diameter flow thru an orifice
58
Why do we use corrugated tubing?
1) turbulent flow is limited d/t size of diameter 2) smooth tubing = increased risk of kinks Corrugated will bend before it kinks
59
resistance increases proportionately with flow
turbulent flow
60
Fluid Flow
Poiseuille’s Law Bernoulli’s Principle Venturi Principle
61
Reynolds Number
help predict laminar/turbulent flow low (<1000) = laminar high (>1500) = turbulent in between = we don't know more abt relative #s vs. exact values (Will not have to calculate; know what values mean)
62
Fluid density vs. viscosity
density is based on weight viscosity based on interactions
63
Poiseuille’s Law F = (πr4ΔP)/(8ηL) relationships
F = rate of fluid flow greater flow: ↑ radius ↑ pressure gradient (ΔP) lower flow: ↑ viscosity (η) ↑ length (L)
64
Bernoulli’s Principle Is based on ___ rather than flow
total conservation of energy
65
Bernoulli’s Principle determines ...
energy of fluid flow (E) E = PV + mgh + ½ mv2
66
potential energy of pressure (PV)
(Bernoulli's Principle) E = PV + mgh + ½ mv2 raising the uncapped end of a tube of liquid increases its potential energy (gravitational pull)
67
A narrowed portion of a tube will show...
greater velocity lower pressure
68
Venturi/venti masks follow which principle
Bernoulli's lower pressure can draw another fluid into the narrowing
69
Bernoulli's Principle increasing the fluid velocity (through a narrowing) will cause a pressure decrease in the narrowing if...
E is constant
70
mgh
**potential** energy of gravity
71
½ mv2
**kinetic** energy of movement
72
In a narrowing, assuming _____ , resistance (R) and pressure will decrease in the narrowing
constant flow
73
Flow exiting the narrowing becomes ___
turbulent
74
Turbulent flow is more related to (density/viscosity)
density In turbulent flow, the **density** (ρ) is **inversely** proportional to the flow
75
dialing flow rate mechanism
fluid/gas flows thru system alters diameter of orifice allows different amount of venturi effect to pull gas into fluid's flow
76
Venturi Principle Allows another tube attached ____ in this region to have fluid pulled into main flow path
at a right angle
77
Absolute humidity
mass of water vapor in a given volume of air Set # no matter the location
78
Relative humidity (%)
(Actual vapor pressure / Saturated vapor pressure) x 100
79
Why isn't humidity constant?
saturated VP changes based on T at diff temps, diff amounts of water are soluble (Relative humidity (%) = (Actual vapor pressure / Saturated vapor pressure) x 100)
80
water vapor is more soluble in the air when it's...
very warm
81
Dew point
Actual vapor pressure = Saturated vapor pressure water begins to condense
82
Water condenses on a cold drink on a hot day b/c
Sat VP drops actual VP/Sat VP becomes 1:1 condensation!
83
Ohm’s Law
E = IR E = energy (in Volts) I = current (in Amperes) R = resistance (in Ohms) Can be used to quickly tell if too much current is being drawn from source.
84
T/F Electric and water move similarly
⚡️ 💧 energy = pressure Current = flow Resistance = Resistance
85
Too much electrical components on anes machine (current/flow requirement)
Flow requirements increase exceed max current/flow = Pop breaker difficult to resume flow at that point
86
Which of these values doesn't change?
E this tells us that current (Amps) & resistance (ohms) share a relationship
87
If we exceed max current a wire can handle
try to pull too many e- resistance ↑↑↑↑ as flow ↑ increase in resistance = heat = melt wire= fire
88
Boyle's Law
pressure and volume of a gas have an inverse relationship
89
Gay-Lussac’s Law
pressure of a given mass of gas varies directly with the absolute temperature of the gas, when the volume is kept constant.
90
Charle's Law
volume of a given mass of gas varies directly with the absolute temperature
91
Combined Gas Law
that pressure and volume are inversely related to each other, and that they are both directly related to temperature
92
Ideal Gas Law
under the same temperature, pressure and volume all gases contain the same number of molecules
93
Dalton’s Law of Partial Pressures
the total pressure by a mixture of gases is equal to the sum of the partial pressures of each of the constituent gases

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