Test 4 Chem Phys

Front 1

Concentration


Amount

Back 1

amount/volume


conc X vol

Front 2

Take 1gm of drug and put it into 500ml H2O, what is the final concentration in %, and mg/ml?

Back 2

1gm=1000mg 1000mg/500ml=2mg/ml
= 0.2%

Front 3

Concentrations (NOT PERCENTS)

Back 3

% of 1000= mg/ml

or gm/100ml

Example: 2% Lidocaine

% of 1000 = mg/ml
2% of 1000= 20mg/ml

EX 2

0.2% = 2mg/ml
0.75% bupivicaine = 7.5mg/ml

Lidocaine 1% = 10mg/ml
Bupivicaine 0.75 = 7.5mg/ml

Front 4

How many mg are in 5ml of 4% cocaine solution?

Back 4

Amount = conc x vol
40 X 5ml= 200mg

Front 5

Concentrations

Back 5

Epi
1:100,000 or 10mcg/ml
1:200,000 or 5mcg/ml (common conc)
1:500,000 or 2mcg/ml

Front 6

Epi labeled in gm/ml

want to know mcg/ml

Back 6

1:200,000 or 1gm in 200,000ml

if 1gm = 1000mg or 1,000,000 mcg
1,000,000/200,000ml = 5mcg/ml

Same holds true for epi 1:100,000

1gm in 100,000ml

1gm = 1000mg or 1,000,000mcg

1,000,000/100,000=10mcg/ml

Front 7

Calculating the % of conc to mg/ml

A 25 ml vial of 1% lidocaine with 1:500,000 epi contains how many mg of each drug?

Back 7

As before, lidocaine is 1% or 10mg/ml

total amount= conc x vol
10mg/ml x 25ml= 250mg of lido

epi 1:500,000 = 1,000,000/500,000=2mcg/ml
2mcg = .002mg
.002mg/ml x 25ml= 0.05 mg of epi

Front 8

E cylinder pressures

If flow of O2 from the E tank is 5 l/min, how long until empty?

Back 8

@ 20C full E tank has 2200 PSI and 660L.

660L/5L/min = 132 min or 2hrs and 12min

Front 9

A half full cylinder that flows at 10 l/min?

Back 9

@ 20C, half full e tank would have 1100psi and 330L, so

1100/330 = 33min

Front 10

LBS to kg

Back 10

divde by two and subtract first number from total, or first two if 100 or greater

ex
173lbs = 86.5 - 8 = 78.6kg
400lbs = 200lbs - 20 = 180kgs
(180kgs x 2.2 = 396lbs, so close)

Front 11

Which unit is associated with this commonly used ratio 1:1000.

Back 11

gm/ml

Front 12

An epinephrine solution of 1:100,000 equals _______mcg/ml

Back 12

10
1: 100,000 = 1 gm/ 100,000 ml
1 gm = 1,000,000 mcg
1,000,000 mcg/ 100,000 ml = 10 mcg/ml

Front 13

An epinephrine solution of 1:1000 equals ______ mcg/ml

Back 13

1000

1: 1000 = 1gm/ 1000 ml
1 gm = 1,000,000 mcg
1,000,000 mcg/ 1000 ml = 1,000 mcg/ml

Front 14

A 2% solution of lidocaine contains _______ mg/ml

Back 14

20
% of 1,000 = mg/ml
2 % of 1,000 = 20 mg/ ml

Front 15

You gave 20 mls of 0.5% bupivacaine. How many mg did you give?

Back 15

100mg
% of 1,000 = mg/ml
0.5 % of 1,000 = 5 mg/ml
5 mg/ml X 20 ml = 100 mg

Front 16

You are giving a spinal block for C-section. The book suggests mixing fentanyl and bupivacaine together for this block. The book recommends the following dosage: Bupivacaine 12 mg along with 25 mcg of fentanyl. The spinal tray comes with 0.75% bupivacaine and fentanyl comes in 2 ml vials of 50 mcg/ml. Calculate the following:

Back 16

a. How many ml of bupivacaine will you give?

7.5% bupivicaine = 7.5mg/ml
12mg/7.5mg/ml = 1.6ml

b.How many ml of fentanyl will you give?

50mcg/ml / 25mcg = 0.5ml

c.What is the concentration of bupivacaine in the final mixture?

Total volume is now 2.1ml, so

12mg/2.1ml= 5.7mg/ml

d.What is the final concentration of fentanyl in the mixture?

25mcg/2.1ml = 11.9mcg/ml

e.How many total ml will you be giving?

2.1ml

Front 17

You are pre-oxygenating your patient prior to induction of a general anesthesia. You are giving the patient 8 liters of O2 through the mask on the anesthesia circuit. Answer the following:
a.You are providing _____% oxygen.

b.The vapor pressure of oxygen in this example is _________.

Back 17

100%

760mmHg

Front 18

You are providing regional anesthesia for a hip replacement surgery. You need to give 12mg of 1% tetracaine with epinephrine 1:200,000

a.How many total ml's of tetracaine will you give?

b.How many total ml's of epinephrine will you give?

Back 18

1% tetra = 10mg/ml

12mg / 10mg/ml = 1.2ml of tetra

Epi 1:200,000, 1gm in 200,000
1gm = 1,000,000mcg
conc = amount/vol
conc = 1,000,000 / 200,000 = 5mcg/ml

1.2ml x 5mcg/ml = 6mcg or 0.006ml

Front 19

You are providing general anesthesia. You machine settings are as follows:
Oxygen 1.5 LPM , N2O 1.5 LPM, isoflurane 1.2%. Calculate the following:
a.Partial pressure of oxygen.

b.Partial pressure of isoflurane.

c.Partial pressure of N2O.

Back 19

Iso = 1.2%
100% - 1.2% is 98.8%

since both O2 and N2O are at the same rate, thee is a 50/50 mix or 98.8% / 2 = 49.4% each

1.2% x 760mmHg = 9.12mmHg

49.4% x 760mmHg = 375.44mmHg for O2 and N2O

Front 20

Atmospheric pressure

Back 20

760mmHg at sea level

changes with altitude

Front 21

1 atm

Back 21

760mmHg

Front 22

Nitrogen

Oxygen

Back 22

79% of 1 atm

21% of 1 atm

Front 23

Vapor pressure @20C

Back 23

Sevo 170mmHg
Enflurane 175mmHg
Iso 239 mmHg
Halo 243 mmhg
Des 669 mmHg

Front 24

Equations

Back 24

K = C + 273.16

C = K - 273

C to F = C(9/5 or 1.8) + 32

F to C = (F - 32)/1.8

Front 25

Critical numbers

Back 25

35-39 centigrade

37.5 centigrade normal

Front 26

Boiling points

Back 26

373.15K
100C
212F

Front 27

Freezing points

Back 27

273.15K
0C
32F

Front 28

165lbs to kg

Back 28

165/2 = 82.5

82.5 - 8 = 74.5kg

Front 29

Capnography

Back 29

Predicts PCO2

Identifies changes r/t patients physiological status

helps to identify equip probs

ET tube placement

Malignant hyperthermia

Front 30

How does it work?

Back 30

control gas sample of CO2 is compared to sample form breathing circuit

IR lights @ 2 wavelengths (2600 and 4300 nm)

Calculation displayed as a number/waveform

Front 31

What is the gold standard for ETT verification?

Back 31

Capnography

Front 32

Where does the calculated number usually run?

Back 32

5-10 less than arterial PaCo2, so...

normal is 35-45mmHg, then try to stay around 32-33 (range could be anywhere from 25-40)

Front 33

A variance in wave form is good for what?

Back 33

Diagnosing many resp probsranging from mechanical to physiological

Front 34

Should the CRNA always pay close attention to the wave form?

Back 34

Yes

Front 35

How long should the sample line be? Are debris/condensation/kinks okay?

Back 35

Sample line should be as short as possible, and clean of debris/condensation, with no kinks. The filter must be clean as well

Front 36

Capnograms

Back 36

see http://www.capnography.com/new/index.php?option=com_content&view=article&id=95&Itemid=61

Front 37

Pulse oximetry

Back 37

detects early signs of hypoxemia

Accurately predicts PaO2 (Press of O2 in blood)

Accurately detects Sao2 (Sat Hgb)

Front 38

Pulse Ox is based on whose law?

Back 38

Beers

Front 39

Beers law

Back 39

I transmitted = (I incident)(e-DCa),
where D is distance into the solution, C is the concentration of the sub in liquid, a is a constant

Front 40

How does it work?

Back 40

Beers law, basically the intensity of the light is altered as it travels through the liquid. the intensity of the light falls exponentially

Front 41

How many wavelengths are there?
How do the travel?

Back 41

2 wavelengths, 660nm (red), and 940 or 990 IR are passed through the arterial bed in a pulsatile fashion

Front 42

How are the waves analyzed?

Back 42

based on the light reaching the detector

Front 43

Is a good arterial bed necessary?

Back 43

It is very important, so yes

Front 44

Does pulse ox respond to non pulsatile signals?

Back 44

No

Front 45

Why use IR and red light?

Back 45

Red light is absorbed by deoxyhemoglobin, Ir is absorbed by oxyhemoglobin

Front 46

How is SaO2 calculated then?

Back 46

Based on a preprogrammed calibration curve which is based on beers law.

Front 47

When will pulse ox not work?

Back 47

not plugged in or turned on (look for light)
Applied to a thick skin area (thumb)

Patient is moving

Cautery

Non pulsatile area, low rate of perfusion form vasoconstriction, hypothermia, hypotension

Methylene blue

Very anemic patient

With certain room lights

Methemoglobin (impairs unloading)

CO poisioning (abnormal high reading)

fake nails

Front 48

Where to put the sensor

Back 48

Fingers (index)

Ears (right ear most accurate of all places)

Toes

Wherever you can get it to work

Front 49

If you question the result/reading, what should you do?

Back 49

Check the waveform

Front 50

Can you mute the alarm?

Back 50

NO, always have the sound turned on.

Front 51

Agent analyzers

Back 51

Mass spectrometry

Infrared technology
Non dispersive infrared (NDIR)
Dispersive infrared (DIR)

Front 52

Mass spectrometry

Back 52

Compares mass to charge ratio

3 parts
Ion source
Mass analyzer
Detector system

Front 53

Which law of motion applies to the mass spec

Back 53

Newtons second law of motion
Acceleration of the particle is inversely proportjional to the mass
Momentum is the product of mass and velocity

Front 54

Do ions with different weights act differently?

Back 54

Yes

Front 55

What happen as the charged particles move through the magnet?

Back 55

Heavier particles are pulled less than the lighter ones when moving at the same speed.

Front 56

Physics of sector mass analysis

Back 56

Need an ionized gas

Accelerate the ions to high speed

Ions pass throughthe magnet(ic) field (Mag field is perpendicular to the plane of ion flow)

Front 57

Time of flight mass analyzer

Back 57

Electrical field accelerates ions (applies same kinetic energy to each particle)

Ions pass through same potential field

Measures the time it takes for ions to reach detector

Velocity is dependent on KE and M

Front 58

NDIR, Non dispersive infrared

Back 58

Commonly used with anesthesia ventialtors

Identify a specific gas/agent

Front 59

Keys to proper use/function of NDIR

Back 59

must be turned on to the IR absorbtion characteristcs of the individual gas

ltd by number of filters and detectors an anaylzer contains

must e preset with the characteristics of each gas.

Front 60

DIR, Dispersive infrared

Back 60

New technology with single filter and a detector with a diffraction grating which separates different wavelenghts for each agent

Front 61

Advantages to DIR

Back 61

Fast warm up time
Alcohol and acetone detection
Dual agent measurement (important)

Front 62

Why is the agent analyzer really used?

Back 62

To detect amounts of the agent, N2O, and O2, although FiO2, FaO2, and CO2 can also be measured

Front 63

Nerve stimulators (types)

Back 63

Adjustable or Nonadjustable stimulator for monitoring neuromuscular blockade

Electrical stimulators for regional anesthesia

Front 64

Anatomy of the NMJ

Back 64

Impulse transmittd down the motor nerve, ACH released at the NMJ, ACH attaches to the motor end plate causing myo cell contraction

Front 65

Classifications of neuromuscular blockers

Back 65

Depolarizing/Non depolarizing

Front 66

Depolarizing

Back 66

Succinylcholine, causes contractions

Front 67

Non depolarizing

Back 67

all others; they vary in onset and duration, no contraction

Front 68

Depolarizing NMB, Succs

Back 68

Acts like ACH

Attaches to motor end plate and causes depolarization

Rapid onset and short acting

Front 69

Non depolarizing NMB

Back 69

Attaches to same receptor as ACH,
however blocks the action of ACH, no muscle contraction.

Front 70

Function of nerve stimulators

Back 70

Assess the degree/type of block

Locate nerve branches for regional blocks

Front 71

When do you paralyze a patient?

How much paralytic do you normally give?

Back 71

Abd case, knee/tendon repairs

Varies, don't really know how much to give

Front 72

When can you give a reversal agent?

Back 72

When the patient has begun to reverse on there own

Front 73

What does the nerve stimulator do?

Back 73

supplies electrons to depolarize the nerve

Front 74

What is the number of electrons per stimulus called?

Back 74

current

Front 75

What is a muscle contraction called?

How is the strength of the contraction measured?

Back 75

Twitch

Twitch height

Front 76

What part of the nerve is polarized?

Back 76

outside

Front 77

What will adding a negative charge to the membrane do?

Back 77

neutralize the membrane

Front 78

What is the purpose of neutralizing the membrane?

Back 78

Depolarization
Sends impulse to motor end plate

Front 79

Where do you place the negative electrode?

Back 79

Place the negative electrode a near as possible to the nerve you are stimulating. (Black lead needs to be over nerve, red can be anywhere)

Front 80

What nerves are commonly use for stimulation?

Back 80

Ulnar (more closely r/t diaphragm)
See movement of thumb
Adductor pollicis
Facial (faster, more accurate)
Movement of eyelid
Orbicularis oculi
Post tibial
Assess toes

Front 81

Types of stimulation

Back 81

Single twitch
Train of four
Tetany
Double burst stimlation

Front 82

Single twitch

Back 82

Fixed current for a brief second
0.1-1 Hz for .02 sec

Often used prior to giving muscle relaxant

Front 83

Why and when is single twitch best to use?

Back 83

Provides control, you can set it to repeat every so many seconds (lets you know when you can intubate)

Best for induction, intubation, works well with non depol NOT SUCCS!!!

Front 84

Train of four

Back 84

4 twitches at 1/2 sec intervals

Front 85

Which twitch is your control twitch?

Back 85

1st one

Front 86

With NDMR, what occurs?

Back 86

2-4 usually decrease in amplitude

ACH is depleted with each stimulation

Wait >30 sec between testing

Front 87

How are the twitches documented?

Back 87

as x/4 or IIII

EX: 1/4 or IIii

Front 88

When is the patient ready for intubation?

Back 88

@ 1/4 or I

Front 89

When do you see fade?

Back 89

with NDMR, will look like IIIi, IIii, Iiii

Front 90

Train of four after DMR

Back 90

Immediately after admin may be no response to nerve stimulation

Front 91

What might you see after a few minutes?

Back 91

Low intensity, consistent TOF, intensity will gradually increase until returning to pre-induction action

Front 92

With DMR, will there ever be a loss of all four twitches?

Back 92

No, they will always bee seen, however the amplituted changes

IIII iiii iiii IIII

Front 93

What is Tetany? Why is it used?

Back 93

Sustained stimulation (1 second)
50-100Hz
(small sustained stimulation)
Used to measure fade

Front 94

What is post tetanic stimulation?

Back 94

Used to determine the depth of the block when you have a 0/4 TOF

Front 95

Three steps of post tetanic stimulation

Back 95

1. Sustained tetany (50Hz for 5 sec)-loads MEP with ACH

2. wait three secs

3. series of single twitches

Front 96

How many twitches should be elicited when using the method of post tetanic stimulation?

Back 96

no more than 10 twitches should be elicited, at ten twitches your are at approximately a 1/4 TOF

Front 97

Double burst stimulation

Back 97

two twitches seppararted by breif interval

Easier to detect fade

Used at the end of the case to to determine strength

II ii II ii

Front 98

What do the nubers with the TOF mean?

Back 98

1/4= 90% blocked
2/4= 80% blocked
3/4=75% blocked
4/4=<70% blocked

Front 99

Why do we reverse patients?

Back 99

To give them back control of their muscles so that thy can help with breathing

Front 100

What are the two phases of blocks?

Back 100

Phase I, depolarizing
Phase II, nondepolarizing

Front 101

Phase I block

Back 101

Depolarizing

Front 102

Does fasiculation precede the block?

Back 102

Yes

Front 103

Is there fade with phase I

Back 103

No, no fade with succs

Front 104

TOF, Post tet facilitation, ration with phase I block

Back 104

TOF = decreased amplitude without fade

No post tet facilitation

Train of 4 ration >.07

Front 105

Phase II block

Back 105

non-depolarizing

Front 106

Are muscle faciculations seen with Phase II blocks?

Back 106

no

Front 107

Is there a fade response with phase II in regards to tetany and TOF? Is post tetanic facilitation available?

Back 107

Yes, fade is present for both, post tetanic facilitation is available

Front 108

Can you get a Phase II block from succs? Is this good or bad?

Back 108

You can get a phase II block form succs, this is very bad. This type of block can last 2-6 hours and is created form big dose admin or repeated doses with no twitches

Key here is to check twitched between doses as succs

Front 109

How does succs create a phase II block?

Back 109

Blocks the muscle cells ability to repolarize

Front 110

Emergence

Back 110

need at least one twitch befrores can give reversal agent

Front 111

What medication is used for reversal of NMBs?

Back 111

Neostigmine

Front 112

How does Neostigmine work?

Back 112

blocks the acetylcholinesterase, allows for ACH to build back up in the NMJ

Front 113

If a patient has no twitches, is it safe to give neostigmine?

Back 113

No

Front 114

How do locals anesthetic work?

Back 114

Stop the movement of sodium

Front 115

Nerve stimulators for regional anesthesia are used for?

Back 115

locating nerves

Front 116

Is the amplitude fixed or adjustable? What is the range?

Back 116

Adjustable amplitude, 0-5mA

Front 117

How many leads are present?

Back 117

2

Front 118

Where are the leads attached?

Back 118

Negative is attached to the skin, positive to the insulated needle

Front 119

What is the target goal for maximal stimulation?

Back 119

0.5mA

Front 120

When is it safe to inject the regional anesthetic?

Back 120

0.2mA

Front 121

atomic number

Back 121

number of protons in the nucleus of an atom

Front 122

Element

Back 122

matter composed of atoms that all have the same atomic numbers

Front 123

Atom

Back 123

smallest unit of an element to retain all the chemical properties of that element

Front 124

Subatomic particles

Back 124

electrons, protons, neutrons

Front 125

Organic Chemistry

Back 125

came from word organism

Historically, believed that all organic compounds came from living organisms

theroy known as vitalism

Disproved in 1828, urea synthesized from inorg comp

Front 126

Atom

Back 126

Carbon is the key compund

Organic chemistry is the study of carbon and its compounds

Front 127

Organic molecules are classified how?
Why?

Back 127

Functional groups, tell us how they are going to react

Front 128

How many carbon compunds are there?

Back 128

More than all other compounds combined

Front 129

Why is there a greater number of carbon compounds?

Back 129

Carbon can from strong covalent bonds to each other

carbon can form strong bonds with atoms of other non metals

Front 130

Atomic weight

Back 130

number of protons + neutrons

Front 131

What distinguishes the characteristics of an atom?

Back 131

Number of protons and electrons

Front 132

Isotopes

Back 132

Atoms with same number of protons and electrons, with different number of neutrons, have smae characteristics with different atomic weight

Front 133

Electrons have what charge?

How is the arrangement in orbit set up?

Back 133

negative

2 electrons in the 1st, 8 in each additional

Front 134

How do atoms attempt to fill their shell with 8 electrons?

Back 134

may give up an electron, attempt to gain one, or share

Front 135

What is the purpose of a bond between molecules?

Back 135

holds them together

Front 136

What is it that causes bond to form?

Back 136

Opposite charges attrac, the + nucleus of one atom attracts the negative charged electrons of another atom (this attraction is inversely proportional to the distance between the center charge).

Front 137

Do electrons gather up next to one another?

Back 137

No, they spread out in space, they repel each other due to like charges

Front 138

What happens when a bond is formed?

Back 138

reactions occur

Front 139

Are atoms created or destroyed when chemical reactions occur?

Back 139

neither

Front 140

WHat is an exothermic reaction? endothermic?

Back 140

exothermic = releases heat

endothermic = absorbs heat

Front 141

Ionic bond

Back 141

complete transfer of an electron

requires energy

must be favorable, requires a great deal of energy

transfer of the electron forms a cation + and an anion -

Front 142

What is an example of an ionic bond?

Back 142

NaCl (Simple salts)

Na 1+ in outer shell, one ee in outer shell

Cl 1- in outer shell, 7 ee in outer shell

Atoms with a significantly different electronegativity

Na 0.93
Cl 3.16

Creates a full ionized (charged) compound)

Front 143

What is a covalent bond?

Back 143

sharing of electrons

Front 144

Does a covalent bond require more or less energy than ionic bonds?

Back 144

Less, example HCL

Front 145

Are covalent bonds symetrical or polarized?

Back 145

either, depending on the electronegativity

Front 146

What is symmetric covalent bond? How many molecules form complete symmetrical bonds?

Back 146

Net neutral charge

very few

Front 147

What does it mean by polarization?
Give an example?

Back 147

there is a charge present

Example:
carbon (2.55) and chloride (3.96)
electronegativity difference of 1.4, thus polarization

Front 148

What is the purpose behind polarization?

Back 148

Allows simple structural units to form more complex molecules

Front 149

How does a covalent bond work?

Back 149

sharing of electrons by overlap of the individual atomic orbitals

electrons in each atom tend to become attracted to the positive nucleus of the other atom.

Front 150

How does a hydrogen bond work?

Back 150

electrons in the 1s atomic orbital are attracted to the positive nucleus of the other atom.
The atoms will continue to come together until the nuclei begin to repel each other.

The repulsive and attractive forces balance, defiones the bond distance.

Front 151

What is a valence? What are some examples?

Back 151

the number of atoms that are typically bonded to a given atom

Hydrogen - 1

Oxygen - 2

Carbon - 4

Front 152

What is the name of the simplest hydrocarbon?

Back 152

methane, CH4

Front 153

What is methane's most stable configuration?

Back 153

Tetrahedral, looks like a pyramid with the nucleus in the middle and the electrons at the corners (only three corners).

Front 154

When they say something is halogenated, what does this mean?

Back 154

Makes less flammable

Front 155

What is ethane?

Back 155

2 carbon atoms, C2H6

Front 156

Hybridization

Back 156

is the mixing of atomic orbitals to form new orbitals suitable for bonding.

Develop different characteristics

Example: Methane

The 2p and 2s orbitals join together and make up the sp3 orbital.

Front 157

What are some characteristics of carbon, how many bonds can it form?

Back 157

4 electrons in outer shell

Form strongest covalent bonds in nature

Single, double, and triple bonds

Front 158

What is an alkane?

Back 158

simple hydrocarbon, composed of carbon and hydrogen only

can vary in number of molecules and existing bonds between these molecules

Front 159

Alkane chain prefixes/number of carbons

Back 159

Meth 1
Eth 2
Prop 3
But 4
Pent 5
Hex 6
Hept 7
Oct 8
Non 9
Dec 10

Front 160

What is an alkyl group?

Back 160

CH3, a hydrogen on the min chain is replaced by an alkyl group

Front 161

4 carbon attachment terms

Back 161

Primary- attached to one carbon
Secondary-to two carbons
Tertiary-to three carbons
Quaternary- to four alkyl groups
Quats do not pass the BBB as easily

Front 162

Nomenclature

Back 162

Hydrocarbons having no double or triple bond functional groups are classified a alkanes or cycloalkanes (rings).

Aromatic rings are not included as the contain double bonds.

Front 163

Nomenclature cont

Back 163

First define the longest carbon chain

identify/name groups attached to the chain

number chain consecutively, start at the end nearest the substituent group

designate location of substituent group by number/name

Assemble name in alphabetical order

Front 164

What are some simple ethyl groups?

Back 164

CH3- methyl
C2H5- ethyl
CH3CH2CH2- propyl
(CH3)2CH- isopropyl

Front 165

What would 2 methylbutane look like?

Back 165

CH3CHCH2CH3
I
CH3

Front 166

How about 2,2,5-3 trimethylhexane

Back 166

CH3
I
CH3CCH2CH2CHCH3
I I
CH3 CH3

Front 167

What happens when hydrocarbons are saturated?

Back 167

a single bond exists between all carbon atoms, leading to saturation.

H
I
H-C-H
I
H

Front 168

Alkenes/Alkynes-saturated or unsaturated?

Back 168

Both are unsaturated, as either a double bond (kenes) or triple bond (kynes) exists between the carbon atoms.

unsaturated = loose H(s) to form double or triple bond

Front 169

Cyclic compunds

Back 169

C6H6, aromatic rings with double bonds

Front 170

What is an isomer?

Back 170

Organic compound with similar chemical formula but different structure

Same atomic weight, different physical characteristics

Front 171

Where can an isomer occur?

Back 171

in organic compounds that have more that 3 carbon atoms

Front 172

What is a conformational isomer?

Back 172

a isomer that exists in different 3D formations

Front 173

What is a steroisomer?

Back 173

attached in the same sequence but different spatial arrangement

cis=same side
trans=opposite side
optical isomer (see later card)

Front 174

Enantiomers are...

Back 174

mirror image configurations of two molecules that are not superimposeable on one another

Front 175

Diastomers are...

Back 175

not mirror images of one another

Front 176

What is an optical isomer?

Back 176

2 types:

Dextro-isomer (d-isomer) (R-rectus)

Levo-isomer (l-isomer) (S-sinister)

It is an enantiomer, or mirror image
Both forms are isomers in the same compound

Front 177

What is a racemic isomer?

Back 177

equal amounts of the isomers are mixed in the same compound

Front 178

Do both of the enantiomers work the same way?

Back 178

No, each causes a different reaction

Front 179

How do you define a optical isomer?

Back 179

by the action of polarized light as it passes through a substance

EX: only the D form of the drug LSD is psychoactive

Thalomide in its S form asts as a sedative, while in its R form it is associated with congenital abnormalities.

Front 180

Almost all anesthetic agents are?

Back 180

organic compunds

Front 181

Halogenation of hydrocarbons makes?

Back 181

Inhalation gasses

Front 182

What is used for a preservative of these gasses?

Back 182

oxidized alcohols

Front 183

What make up the local anesthetics?

Back 183

amides and esters

Front 184

Alkanes used for inhalation agents have what properties?

Back 184

unstable and flammable

Front 185

What does halogenation of these alkanes do?

Back 185

Creates a highly potent, non flammable gas

hydrogen atom bond is replaced by a halogen atom, i.e. chlorine, fluorine, bromine.

Front 186

Enflurane and isoflurane are?

Back 186

Isomers
Same chemical structure and weight, different physical characterisitics

Front 187

Halothane is?

Back 187

halogenated hydrocarbon (only one that is), an ethane with fluorine, chlorine, and bromine

Front 188

Is nitrous organic or inorganic?

Back 188

Inorganic

Front 189

If halothane is the only halogenated hydorcarbon, what are the rest?

Back 189

Halogenated ethers, have an ether bridge (R-O-R) where R is an alkyl group

Front 190

What is the IUPAC name for isoflurane

Back 190

1-chlor-2,2,2-trifluoroethyl difluoromethyl ether

Front 191

What is an ether?

Back 191

R-O-R configuration, where the R is an alkyl group

Iso, des, and sevo are all methyl ethyl ethers

Front 192

Loacl anesthetics are made up of what?

Back 192

Amides and esters

Front 193

What is an amide? Examples?

Back 193

when a hydrogen group is replaced with a amide group, CONH2

Ex:
Lidocaine
Bupivicaine

Front 194

What is an ester?

Back 194

a molecule with a functional grou pof -COOR where R is the alkyl group

These are broken down by esterases

Front 195

What is the difference between natural and racemic epi?

Back 195

Natural epi-exists in the L isomer and has greater beta 1 (cardiac) than beta 2 (pulmonary) activity

Racemic-kind used in the nebulizer
equal amounts of l and d isomers
get more pulmonary effects with less tachycardia.

Front 196

Since bupivicaine is cardiotoxic, what can be used to get he local effect without the cardiac side effects?

Back 196

Robupivicaine, which is an isomer of bupivicaine

Front 197

What is the structure of isoflurane?

Back 197

Front 198

What is the structure of halothane?

Back 198

Front 199

What is the structure of Desflurane?

Back 199

Front 200

What is the structure of sevoflurane?

Back 200

Front 201

What is the chemical structure of enflurane?

Back 201

Front 202

How is the acid base balance defined?

Back 202

by the measurement of H ions

Front 203

What regulates the balance between intake (production) and net removal of H ions form the body?

Back 203

the body

Front 204

How is the acid base balance measured?

Back 204

pH scale

Front 205

What is the pH scale?

Back 205

power of hydrogen

a measure of the activity of hydrogen ions (H+) in a solution

its acidity or alkalinity

Front 206

Ia a solution more basic or acidic when H+ ions = OH-?

Back 206

neither, it is neutral.

Front 207

What is the pH of water? What are you actually measuring?

Back 207

pH=7

Actually measuring
H3O+ (hydronium)
OH- (hydroxide)

Front 208

What are the two principles of water?

Back 208

Water Eq principle

Addition exponenets of H+ and OH- ion concentration always equal the exponent -14

Both H+ and OH- ions are always present in any solution
Excess H+ = acidic sol
Excess OH- = basic sol

Front 209

What does pH measure?

Back 209

H+ ions in a sol

Front 210

What produces H+ ions?

Back 210

Acids

Acid pH < 7, a rough measure

Reverse logarithmic representation of H+ concentration

Front 211

Explain how pH is figured.

Back 211

pH 7 = H+ ion concentration of 0.0000001

H2O = 0.0000001, or pH 7

HCl has a pH of 2, so 0.01

if the ion concentration is 0.001, then pH = 3

The closer to one the ion concentration is, the more acidic it is.

Front 212

pH

Back 212

units of moles of H+ per liter of sol

1 x 10(zero power) = pH 0
1 x 10(-4 power) = pH4, soda
1 x 10(-9 power) = pH9, NaHCO3

Front 213

What is an acid?

Back 213

any substance that when dissolved in water gives a sol with a pH of < 7.

Front 214

What are two characteristics of an acid?

Back 214

water soluble
sour tasting

Front 215

What are some reactions of an acid?

Back 215

able to give up a proton (H+ ion) to a base

accept an unshared pare of electrons from a base

reacts with a base in a neutralization reaction to form a salt

acids increase the hydronium ion conc in water.

Front 216

What is a salt?

Back 216

an ionic compound that is composed of positively charged cations and negatively charged anions

Neutral charge, no net charged

Ionic bond

Front 217

Salt is a what? Example?

Back 217

a base and an acid

Ammonia and hydrochloric acid = ammonium chloride
NH3 + HCL = NH4CL

Front 218

What is meant by alkaline?

Back 218

A chemical compound that absorbs hydronium ions when dissolved in water (proton acceptor)

bases reduce the concentration of hydronium ions (HCO3+) in water

Front 219

What are some characteristics of bases?

Back 219

less viscous than pure water

bitter taste

soapy to the touch

Front 220

Acids and bases act how in water?

Back 220

An acid in water gives up a H to the water; HCL in H2O = H+ and CL-

A base in water gives up OH to the water: NaOH in H2O = Na+ and OH-

Front 221

What is neutralization?

Back 221

mix an acid/base together

H+ + OH- = H2O

H20 has a pH7

How a salt is formed

Salt = no charge

Front 222

What is hydrolysis?

Back 222

Formation of water and a salt from an acid and base.

EX:
HCl + NaOH = H2O + NaCl (salt)

HBr + KOH = H2O + KBr (salt)

Front 223

An acid and base can also be combine to give a weaker acid and a salt.

Back 223

HCL + NaHCO3 = H2CO3 + NaCl

Hydrochloric acid and sodium bicarb = carbonic acid and sodium chloride

Front 224

What is a conjugate?

Back 224

Each acid has a conjugate base
Each base has a conjugate acid

Conjugate pairs only differ by a proton (either have one more or less H) acids always have one more H, bases one less

The conjugate base of a weak acid is a strong base, and the conjugate base of a strong acid is a weak base.

Front 225

What are some examples of conjugates?

Back 225

H2SO4 Sulfuric acid
HSo4- Hydrogen sulfate(base)

H3O+ Hydronium ion (acid)
H2O Base

NH4+ Ammonium ion (acid)
NH3 Ammonia (base)

Front 226

How do the acid base balances play out when mixed together in regards to pH?

Back 226

Acid Base Salt pH
---------------------------------------------------
Strong Strong pH=7
Strong Weak pH<7
Weak Strong pH>7
Weak Weak Stronger one

Front 227

Buffers are what?

Back 227

solutions that resist change in pH upon addition of small amounts of acid or base

Front 228

How are buffers represented?

Back 228

salt/acid or conjugate base/acid

Front 229

What are buffers useful for?

Back 229

chemical manufacturing

many biochemical processes
present in blood plasma
carbonic acid (H2CO3)
bicarbonate (HCO3-)

Front 230

What are some important values for pH in regards to human life?

Back 230

pH 7.40 neutral

pH < 7.0 is life threatening

pH > 7.8 is morbidity

Front 231

What is the key to pH regulating?

Back 231

hydrogen ion concentration

Front 232

How are hydrogen ions regulated?

Back 232

buffer systems

Front 233

What is the ECF/ICF primarily buffered by?

Back 233

ECF= HCO3 (bicarb) and CO2

ICF= proteins and PO4

Front 234

What are two important acids? Roles?

Back 234

Carbonic acid
H2CO3
Metabolism of carbohydrates and fats; 15,000 mmol of CO2/day

Non carbonic acids
Protien metabolism; 1.5 mmol H+ ions/kg/day.

Front 235

How are buffers classified?

Back 235

Chemical
In cells and body fluids, react immediately (fastest)

Respiratory
CO2, react within minutes (fast)

Metabolic
HCO3-, react within hours (slowest)

Front 236

What are the main three buffer systems in the body?

Back 236

Blood (fastest)

Respiration (CO2)

Kidneys (HCO3-)

Acid base homeostasis centers around regulation of these

Front 237

What are three key features of the HCO3-/CO2 (Carbonic acid-Bicarbonate) buffer system?

Back 237

it is the buffer present at the highest concentrations in the body

its pKa value of 6.1 is close enough to the physiologic pH to make it a good buffer

the major components of the buffer system can be independently regulated by the lungs (CO2) and kidneys (HCO3-)

Front 238

How does dietary intake affect acid/base?

Back 238

normal caloric intake of a non meat based diet produces 20,000 meq of acid/day. CO2 is produced as the end product of carb and fat metabolism.

The CO2 is excreted by the lungs

Front 239

Protein catabolism contributes how?

Back 239

1meq/kg (50-60meq-day) of inorganic acids produced

controlled by kidneys through excretion and HCO3- formation

Front 240

What is the bicarbonate buffer system?

Back 240

H + HCO3 = H2CO3 = CO2 + H2O
(this is a reversible equation)

increased H+ will bind with HCO3-
Need carbonic anhydrase to function properly

then forms carbonic acid H2CO3

Carbonic acid immediately breaks down into CO2 and H2O

Inc H+ leads to inc CO2 and inc resp and depth

Dec H+ leads to dec CO2 and dec resp and depth

(Resp sys compensates by changing resp depth/rate)

Front 241

What is the slowest of the buffer systems?

Back 241

Renal

Front 242

How does the renal buffer system work?

Back 242

Dec pH leads to excretion of H+ ions in urine

Inc pH leads to reabsorbtion of H+ ions back into the urine

takes hours or even days for compensation

Front 243

What does the hemoglobin buffer system do?

Back 243

Prevents drastic changes in the plasma CO2

RBC absorbs CO2, changes it to H2CO3 (carbonic acid) which then quickly disassociates

Front 244

How does the Hgb buffer system work?

Back 244

CO2 + H20 -> HbCO2 or HbO2 -> H+
+ HCO3-

HbCO2 carried to the lungs-CO2
blown off

HbO2 dumps the O2 into tissues

H+ ions bufferd by Hgb (HHb)

Chloride shifts into RBC's, and HCO3- shifts out.

Front 245

What does the respiratory buffer system do?

Back 245

works with the carbonic acid/bicarb system

goes from muscle to blood plasma to lungs

CO2 + H2O -> H and HCO3 -> CO2 and H2O

Front 246

Where is the phosphate buffer system found?

Back 246

ICF and urine

Na2HPO4 <-> 2Na + HPO4 + H

Front 247

How does the body maintain pH?

Back 247

Blood
Carotid and aortic sinuses

CSF (slower to change pH, takes longer to change. For ex, if correct pH in blood, nay not show in CSF for while)
Receptors in medulla oblongata sense pH probs

Changes in rate/depth of resps maintain pH

Front 248

Hoe does the renal sys compensate for acid base imbalances?

Back 248

H+ is secreted into renal tubules and stops at urine pH of approx 4.5; other buffers keep the pH high enough so the secretion can continue

Changes rate of secretion/absorbtion of H+ and HCO3-

Front 249

What is the biggest problem with acid base balance?

Back 249

elimination of excess acid

Front 250

Where do acids come from?

Back 250

Normal metabolism
Ingested acids

Front 251

What are the two forms of acids?

Back 251

Volatile = H2CO3
Non volatile = products of metabolism

Front 252

What is a volatile acid?
How is it eliminated?

Back 252

H2CO3, carbonic acid

Weak acid, doesn't release H+ easily
Needs carbonic anhydrase for dissociation

Eliminated by lungs

Front 253

What is a volatile acid generated from?

Back 253

Normal metabolism of

Fat
Carbs
Some proteins

Front 254

What is a non volatile acid?
How is it eliminated?

Back 254

H2SO4, H3PO4 form metabolism of:

Sulfur containing products
Phosphoproteins


Eliminated by kidneys

Front 255

What are some products of intermediary metabolism of non volatile acids?

Back 255

Lactic acids/ ketoacids

Front 256

When excess acid or or base is introduced into the body, what happens?

Back 256

it is immediately bufferred to minimize changes in the pH

Front 257

A good buffer should maintain a pH of what?

Back 257

7.4

Front 258

What is pKa?

Back 258

A measure of the tendency of a molecule or ion to keep a proton

H+

Acids give up/lose H+

Front 259

Acid Dissociation constant is...

Back 259

the acid ionization constant or Ka

indicates the dissociation of hydrogen ions from an acid

strong acids dissociate practica;ly completely in solution

Front 260

pKa with strong/weak acids

Back 260

Strong
large acidity constants
Close to 1

Weak
do not fully dissociate
acidity constants far less than one

Front 261

Review of acids/pH

Back 261

stronger acids are closer to 1
HCL pH2 = 0.01 (close to 1)

weak acids are farther from 1
Soda pH4 =0.0001

Front 262

All drugs exist in ____ forms? What are they?

Back 262

2

Ionized and non ionized

Front 263

When the pH is 7.4 and the pKa is 7.4, what is the ratio of ionized to non?

Back 263

50/50

Front 264

If the pKa of a drug is 8.1 and the pH is 7.4, is the ratio mentioned above still true?

Back 264

No, there is no longer a 50/50 mix non to ionized drug.

Front 265

Which buffers are the best?

Back 265

Buffers with a pKa closest to 7.4 are the best

Need to be present in large amounts

Front 266

Do H+ ions move freely between the ECF and ICF?

Back 266

Yes

Front 267

How is the movement of H+ into/out of the cell handled?

Back 267

H+ movement must be matched

Negatively charged ion (anion) moving in same direction or positively charged (cation) in the opp direction. So, + and - out or + in and + out.

Inc influx of H+ into the cell elicits an inc move of K+ out of cells into ECF.

H+ in, K+ out

Front 268

What are the most abundant buffers in and out of the cells? Why?

Back 268

Proteins, because have the aa histidine (contains a imidazole ring with pKa of 7.0)

Front 269

Which protein is the best buffer?

Back 269

Hemoglobin, it contains an unusually large number of histidines; 36 per molecule

Front 270

Where are phospate buffers located?

Back 270

present in large amounts inside of the cells

small amounts in the ECF

the pKa of HPO42+/H2PO4- is 6.8, makes a good intracellular buffer

Front 271

With the bicarb/CO2 buffer system, what happens to the acid and base?

Back 271

H+ + HCO3- <--> H2CO3 <--> CO2 + H2O (facilitated by carbonic anhydrase located in the RBC)

The CO2 (acid) is exhaled
Acid is gone, but the base was lost in the transformation

Front 272

How is the bicarb regenerated?

Back 272

Regenerate by bone stores of carbonate (not enough to keep up with loss)

so..

Kidney is able to regenerate new bicarb to replace that which was lost

Front 273

How is the bicarb regen (cont)?

Back 273

Kidneys work like this:

CO2 + H2O <--> H2CO3 <--> H+ HCO3-

H+ is secreted into renal tubule
Buffered by:
HPO4 = Phosphate
NH3 = Ammonia

H+ secreted into urine

HCO3- reabsorbed into plasma

Front 274

Does the Bicarb/CO2 buffer system run in just one direction?

Back 274

no, goes in both directions

respiration's increase/decrease with changes to pH

renal function also changes.

Front 275

The basic action of an anesthetic in the body is largely a function of

Back 275

its chemical structure and the resulting interaction with a cellular receptor complex

Front 276

What plays a major role in modern anesthesia?

Back 276

Gasses

Front 277

Are gasses the only anesthetic used?

Back 277

No, unlike days of old where only one gas may had been used, now many gasses and IV drugs are used

Front 278

How is anesthesia administered?

Back 278

1. Liquid --> Vaporize it

2. Controlled vapor delivery to lungs
--->bloodstream
--->BRAIN-spinal cord
---> other places
i.e. fat tissue

Front 279

What is the major assumption regarding lungs and brain with partial pressure?

Back 279

The partial pressure in the lungs is equivalent to that present in the brain because they are highly lipid soluble and diffusible (I.e. equilibrium is quickly achieved.

Front 280

What is MAC?

Back 280

Minimum alveolar concentration is the concentration necessary to produce lack of movement to 50% upon surgical stimulation

(Due to the high lipid solubility, pressure in the lungs is assumed to be the same as in the brain).

Front 281

How fast is equilibrium achieved between body compartments?

Back 281

quickly, and the faster the lung (brain) concentration rises the faster anesthesia is achieved; the opposite is also true, the faster the concentration falls the quicker the patient emerges.

Front 282

What are some factors that influence the ability of a gas to anesthetize patient?

Back 282

Blood/gas solubility
Oil/gas sol
Ventilation
Concentration
Circulation
Metabolism

Front 283

What is the blood/gas solubility?

Back 283

A coefficient that indicates the speed of uptake and elimination

Reflects the portion of anesthetic that will bind to blood components versus that which will leave the blood for the tissues (2.3:1)

The more sol the drug (high blood gas coef) the slower the brain uptake

Front 284

What is oil/gas sol?

Back 284

Indicator of potency

the higher the oil/gas sol, the more potent the drug

at the tissue level, the lipid sol allows it to penetrate membranes and produce action

Front 285

Principles of ventilation

Back 285

The diffusible drug moves down a concentration gradient

The faster and deeper the patient breathes the faster they are anesthetized (true for emergence as well)

A VQ mismatch or poor lung function hinders administration

The amount of gas in the alveoli is r/t the anesthetic depth

Front 286

Principles of concentration

Back 286

higher conc speeds uptake

over pressuring can speed uptake of more soluble (slower) agents, but is less effective with the faster agents

admin of a slow agent with a faster agent at the same time can speed the uptake of the slower agent (2nd gas effect)

Front 287

What two gasses are used for the 2nd gas effect?

Back 287

Halothane and N2O

Halo
Oil/gas coef 224 (Very potent)
Blood gas coef 2.3 (very blood sol, not much to tissues, takes longer)

N2O
Oil/gas coef 1.4, so not very potent
Blood gas sol is .47, so not ver blood sol

Front 288

WHat is diffusion hypoxia?

Back 288

when one turns off the flow of Nitrous Oxide at the end of anaesthesia, then the concentration in the alveoli is lower than in the blood. Consequently N20 floods in from the blood, usurping the 02 and N2 in the process

Front 289

How can diffusion hypoxia be avoided?

Back 289

admin of 100% O2for 3-5 min upon discontinuation of nitrous

Front 290

Principles of circulation

What is the importance of circulation?

Back 290

without it, the drug would never reach the lungs and brain

Front 291

Is increased cardiac output good or bad when anesthetizing a patient?

Back 291

Inc cardiac output is detrimental, as inc output leads to greater lung perfusion and more of the drug absorbed into the blood, thus slowing rise in the brain concentration.

Front 292

As the length of time an anesthetic is admin, what happens?

Back 292

more anesthetic reaches the vessel poor groups

Front 293

Are gases metabolized in the body?

Back 293

yes, to varying degrees. MOst of the drug is simply blown off

Front 294

What are halothane and sevo associated in regards to toxicity?

Back 294

Halo ---> Hepatotoxicity
Sevo ---> nephrotoxicity

Front 295

What is a Carbon dioxide scrubber? Where are they used?

Back 295

A mixture of chemicals used in granular form in a closed breathing environment

they are used in anesthesia and in submarines

Front 296

What does a CO2 scrubber do?

Back 296

Removes CO2 from breathing gasses to prevent CO2 retention and carbon dioxide posioning

Front 297

What types of Scrubbers exist?

Back 297

Soda Lime
Baralyme
Amsorb
Medisorb
Dragersorb

Front 298

What is the common link between all of the scrubbers?

Back 298

All contain water

Front 299

What is the importance of water in the scrubber?

Back 299

water is needed for the chemical reactions to take place

Front 300

What are some characteristics of the scrubbers?

Back 300

Mesh 4-8
With these systems, there is a compromise between absorbative capacity and resistance to airflow.

Smaller granules allow more surface area, however they pack tighter and increase resistance to flow.

Front 301

How does one know when the granules are bad/scrubber needs replaced?

Back 301

Ethyl violet in the granules changes color to purple/blue indicating need to change

Front 302

If water is dried out or missing, can the scrubber still be used?

Back 302

NO, water is necessary for the chemical reactions. If water is missing, the scrubber gets hotter and hotter-may cause a fire

Front 303

What is the most common absorbent used?

Back 303

soda lime

Front 304

Does soda lime produce an exo or endothermic reaction?

Back 304

exothermic

Front 305

What chemicals are contained in the soda lime?

Back 305

Calcium hydroxide Ca(OH)2 75%
Water (H2O) 20%
Sodium hydroxide (NaOH) 3%
Potassium hydroxide (KOH) 1%
Caustic agents

Front 306

Sevo is unstable in soda lime. What does it produce?

Back 306

Compound A

Front 307

What are some characteristics of compound A?

Back 307

lethal at 130-340ppm
Renal injury has been documented in rats at 25-50ppm (never in humans)

Avoid gas flows of 1L/min for more than 2 MAC hours

Front 308

What is the activator in soda lime?

Back 308

NaOH or KOH

Front 309

Do carbon monoxide problems occur with ethyl methyl ethers?

Back 309

Yes

Front 310

What is the activator in baralyme?

Back 310

Ba(OH)2 Barium hydroxide

Front 311

Is baralyme more or less efficient than soda lime?

Back 311

less efficient (questionable)

Front 312

Where is baralyme most often used? Why?

Back 312

Dry climates, water is in small particles and baralyme is less likely to dry out. (retains water well, desert storm)

Front 313

What is the activator for Amsorb?

Back 313

Ca(OH)2 Calcium hydoxide

Front 314

What is amsorb suitable for?

Back 314

low flow anesthesia.

Front 315

The presence of sodium hydroxide at any level provides the basis for what?

Back 315

Anesthetic agent dehalogenation

Front 316

What are some complications of dessicated (dehydrated) CO2 absorbents?

Back 316

Exothermic reactions
Production of:
Compound A
Carbon Monoxide
Methanol
Formaldehyde

Front 317

What are exothermic reactions associated with?

Back 317

Sevo, enhanced by the type of stong base used
KOH>NaOH

Can also happen with other gasses, however the greatest incidence is with sevo and baralyme (KOH)

Front 318

CO production is greatest with ...

Back 318

dessicated KOH

Front 319

Is the CO produced usually detected by routine monitors?

Back 319

No

Front 320

CO production correlates with...

Back 320

In descending order:
Des
Enflurane
Iso
CHF2 group

Front 321

Compound A is a potential...

Back 321

nephrotoxin

Produced by Sevo and dry or wet CO2 absorbent

Front 322

Can soda lime change back to its original color if it sits long enough?

Back 322

yes

Front 323

Does soda lime change color when it is dried up?

Back 323

No

Front 324

When the container is dried up, what can happen?

Back 324

CO production and exothermic reactions

Front 325

When the container is used up, what can happen?

Back 325

no breakdown of CO2

Front 326

How can complications be prevented with scrubbers?

Back 326

Turn O2 off at the end of each case
Turn machines off at the end of each day
Place date changed on canister
Question temp stickers on canisters

Front 327

What is the soda lime conversion formula?

Back 327

H2O + CO2 = H2CO3 = H+ + HCO3-
then
NaOH +H2CO3 = NaHCO3 +H20
then
2NaHCO3 + Ca(OH)2 = 2NaOH + CaCO3 + H20

Front 328

What is the baralyme converson formula?

Back 328

Ba(OH)2-8 H2O + CO2 --> BaCO3 + 9 H2O + energy
then
9 H2O + 9 CO2 ---> 9H2CO3
then
9 H2CO3 + 9Ca(OH)2 --->CaCO3 + 18H20 + energy

CaCO3 is an insoluble precipitate

Front 329

What are the tank sizes? Amounts?

Back 329

E cylinder
2 feet long, 4 inches diam
Filled to 2200 psi @ ROOM TEMP
660L

H cylinder
4 feet long, 9 inches long
Filled to 2200 psi @ ROOM TEMP
6900L

Front 330

Why/How is N2O different?

Back 330

Needs to be changed @ approx 750psi

Tank holds 1590L of nitous oxide at one atmosphere pressure

Front 331

Can the amount remaining in the N2O cylinder be determined by pressure gauge?

Back 331

No, must be weighed

Subtract the tare weight from weight of empty tank to get remaining

Front 332

What are the tank colors?

Back 332

O2 green
CO2 gray
N20 blue
Cyclopropane orange
Helium brown
Nitrogen black
Medical air yellow

Front 333

After pipelines are installed in an institution, pressure regulators are installed that function to maintain normal outlet pressure. What is that pressure?

Back 333

55 psi (O2)

Front 334

Are O2 tanks ever allowed to be free standing?

Back 334

no

Front 335

What are some cylinder safety characteristics?

Back 335

walls 3/8" thick

Cylinders tested at 1.66 service pressure

Pressure tested every 5 years

Front 336

What is the critical temp of O2?

N2O?

Back 336

-119C

39.5C

Front 337

What is critical temp?

Back 337

Gasses liquify if sufficient pressure is applied and the temp is below the critical value called the critical temp.

A gas can not be liquified if the temp is above the critical temp.

So...

O2 CT is -119C, so will always be a gas at temps -118 or greater

N2O CT is 39.5, so at room temp (20C), it will be liquid.

Below CT = LIquid
Above CT = Gas

Front 338

How does N2O get form a liquid to a gas for patient admin?

Back 338

N2O vapor is vaporized and in EQ over the liquid state

Front 339

Who sets the standards and guidelines for tank safety?

Back 339

OSHA (health and safety of workers)

FDA (standards for med devices and gasses-still a drug)

Pharmacopeia of the US and National formulary (deelops purity specs)

Front 340

Pressure relief valves-are they required?

Back 340

Yes, on aLL MED GAS CYLINDERS

Front 341

What are the three types of pressure relief valves?

Back 341

Fusible plug
Frangible disc assembly
Safety release valve

Front 342

What is the fusible plug?

Back 342

Woods metal, metal alloy that has a low melting point