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Daddy Pharm > Gases > Flashcards

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
Q

main drive mechanism for vasodilation of many arterioles

A

Nitric Oxide (NO)

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25
Q

Nitric Oxide (NO) & the oxyhgb curve

A

may shift left
increasing the oxygen affinity of hemoglobin

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26
Q

Nitric Oxide (NO) is a ___ moelecule

A

signaling

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27
Q

main use in pulmonary function testing, laser airway surgery and diving

A

Helium

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28
Q

Helium in airway Sx

A

reduce O2

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29
Q

T/F
Helium is reactive

A

False
inert gas

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30
Q

Why use Helium in diving tanks?

A

Diving = increased pressure around us
O2 pressure in tank will double
too much pO2 = H peroxide
mix w/ He to decrease high O2 pressure

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31
Q

Why can we apply gas laws to our volatile agents?

A

VAs: liquid –> gas phase

only small deviation from “ideal gas”

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32
Q

Transport Processes

A

Osmosis (mvmt across semi-perm membrane)

Fick’s law of diffusion

Grahams’s law of diffusion

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33
Q

Osmosis requires….

A

-semi-permeable membrane
-difference in [ ] of solutes on each side

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34
Q

T/F
Albumin can move via osmosis

A

False
too large (MW ~69K)

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35
Q

Albumin is higher in the ___

A

ECF

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36
Q

Sq. Root of the Molecular Weight
is a measure of the ___

A

(Fick’s Diffusion)
molecular diameter
large # = larger diameter = slower diffusion

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36
Q

Fick’s law of diffusion
What increases diffusion rate?

A

Higher:
partial pressure gradient
membrane area
solubility of a gas in the membrane

lower:
membrane thickness
sq. root of the MW

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37
Q

Grahams’s law of diffusion

A

Faster diffusion:
lower sq rt of gas’ density

Slower diffusion:
higher Gas density => higher M. Mass

38
Q

Grahams’s law of diffusion
rate of diffusion is inversely proportional to ….

A

the square root of the molar mass

39
Q

(assuming ideal gases)
the … in a gas is the same for all gases at the same temperature and pressure

A

number of molecules

40
Q

Which law focuses more on molar mass?
Fick’s diffusion
Grahams’s diffusion

A

Grahams’s diffusion

(Fick’s includes MW)

41
Q

Henry’s Law

A

↑ partial pressure = ↑ dissolve in a liquid

42
Q

T/F
Hgb is the only transport mechanism for O2 transport

A

False
can also diffuse O2 into tissue using pressure

Hgb = primary method

43
Q

amount of O2 that dissolves in blood

A

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
Q

PP of NO @ sea level

A

600 mmHg

O2 = 160 mm Hg/21%

45
Q

If the PaO2 is 300 mmHg, how much O2 is dissolved in 100 ml of blood?

A

0.9 ml O2 per 100 ml blood

multiply PaO2 by 0.003 and put that over 100m ml of blood

46
Q

Gases flow as a __

A

fluid/liquid

Bromine is a good example
colored & high density

47
Q

Laws are based on ___ flow

A

laminar

48
Q

Laminar flow

A

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
Q

Turbulent flow

A

Started as laminar but something disrupted

Molecules bounce off walls and affect other molecules

50
Q

____ flow is predictable via math

A

laminar

turbulent is unpredictable

51
Q

What flow do we see in the lungs and tubing?

A

A mix of both laminar & turbulent

can become turbulent in kinks/curves
sort themselves back into laminar

52
Q

Has the greatest effect on airway resistance

A

radius of tube

53
Q

What increases and decreases airway resistance?

A

higher resistance:
↑tubing length & viscosity
↓ tubing diameter

lower resistance:
↑tubing diameter

54
Q

how does diameter affect laminar flow

A

larger diameter = more laminar flow

55
Q

T/F
Small changes in radius = big changes in resistance

A

True

56
Q

How does narrowing of tubing affect flow and speed?

A

increased speed in narrowed space

Once opens back up, some temporary turbulent flow

57
Q

When do we see turbulent flow in anesthesia?

A

High flow rate
Rough/corrugated tube
Kinks
bends
sudden changes in diameter
flow thru an orifice

58
Q

Why do we use corrugated tubing?

A

1) turbulent flow is limited d/t size of diameter

2) smooth tubing = increased risk of kinks
Corrugated will bend before it kinks

59
Q

resistance increases proportionately with flow

A

turbulent flow

60
Q

Fluid Flow

A

Poiseuille’s Law
Bernoulli’s Principle
Venturi Principle

61
Q

Reynolds Number

A

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
Q

Fluid density vs. viscosity

A

density is based on weight

viscosity based on interactions

63
Q

Poiseuille’s Law
F = (πr4ΔP)/(8ηL)
relationships

A

F = rate of fluid flow

greater flow:
↑ radius
↑ pressure gradient (ΔP)

lower flow:
↑ viscosity (η)
↑ length (L)

64
Q

Bernoulli’s Principle
Is based on ___ rather than flow

A

total conservation of energy

65
Q

Bernoulli’s Principle determines …

A

energy of fluid flow (E)

E = PV + mgh + ½ mv2

66
Q

potential energy of pressure (PV)

A

(Bernoulli’s Principle)
E = PV + mgh + ½ mv2

raising the uncapped end of a tube of liquid increases its potential energy (gravitational pull)

67
Q

A narrowed portion of a tube will show…

A

greater velocity
lower pressure

68
Q

Venturi/venti masks follow which principle

A

Bernoulli’s
lower pressure can draw another fluid into the narrowing

69
Q

Bernoulli’s Principle
increasing the fluid velocity (through a narrowing) will cause a pressure decrease in the narrowing if…

A

E is constant

70
Q

mgh

A

potential energy of gravity

71
Q

½ mv2

A

kinetic energy of movement

72
Q

In a narrowing, assuming _____ , resistance (R) and pressure will decrease in the narrowing

A

constant flow

73
Q

Flow exiting the narrowing becomes ___

A

turbulent

74
Q

Turbulent flow is more related to (density/viscosity)

A

density

In turbulent flow, the density (ρ) is inversely proportional to the flow

75
Q

dialing flow rate mechanism

A

fluid/gas flows thru system
alters diameter of orifice
allows different amount of venturi effect to pull gas into fluid’s flow

76
Q

Venturi Principle
Allows another tube attached ____ in this region to have fluid pulled into main flow path

A

at a right angle

77
Q

Absolute humidity

A

mass of water vapor in a given volume of air

Set # no matter the location

78
Q

Relative humidity (%)

A

(Actual vapor pressure / Saturated vapor pressure) x 100

79
Q

Why isn’t humidity constant?

A

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
Q

water vapor is more soluble in the air when it’s…

A

very warm

81
Q

Dew point

A

Actual vapor pressure = Saturated vapor pressure

water begins to condense

82
Q

Water condenses on a cold drink on a hot day b/c

A

Sat VP drops
actual VP/Sat VP becomes 1:1
condensation!

83
Q

Ohm’s Law

A

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
Q

T/F
Electric and water move similarly

A

⚡️ 💧
energy = pressure
Current = flow
Resistance = Resistance

85
Q

Too much electrical components on anes machine (current/flow requirement)

A

Flow requirements increase
exceed max current/flow = Pop breaker
difficult to resume flow at that point

86
Q

Which of these values doesn’t change?

A

E
this tells us that current (Amps) & resistance (ohms) share a relationship

87
Q

If we exceed max current a wire can handle

A

try to pull too many e-
resistance ↑↑↑↑ as flow ↑

increase in resistance = heat = melt wire= fire

88
Q

Boyle’s Law

A

pressure and volume of a gas have an inverse relationship

89
Q

Gay-Lussac’s Law

A

pressure of a given mass of gas varies directly with the absolute temperature of the gas, when the volume is kept constant.

90
Q

Charle’s Law

A

volume of a given mass of gas varies directly with the absolute temperature

91
Q

Combined Gas Law

A

that pressure and volume are inversely related to each other, and that they are both directly related to temperature

92
Q

Ideal Gas Law

A

under the same temperature, pressure and volume all gases contain the same number of molecules

93
Q

Dalton’s Law of Partial Pressures

A

the total pressure by a mixture of gases is equal to the sum of the partial pressures of each of the constituent gases

Daddy Pharm (13 decks)

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