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All Formulas for Final
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171
Chemistry
Graduate
09/25/2015

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Term
1%
Definition
10mg/mL
Term
1:1000
Definition
1 mg/mL
Term
C
Definition
5/9(F-32)
Term
F
Definition
(9/5C)+32
Term
K
Definition
C +273
Term
BMI
Definition
Kg/M2
Term
BSA
Definition
(Height (cm) x Weight (kg))/3600 then take square root
Term
Partial Pressure
Definition
Percent Concentration x 760 mmHg
Term
Percentage of a Gas
Definition
(Partial Pressure/760 mmHg) x 100
Term
MAP
Definition
(Systolic + 2Diastolic)/3
Term
Systemic Perfusion Pressure
Definition
MAP-CVP
Term
Cerebral Perfusion Pressure
Definition
MAP-ICP
Term
Coronary Perfusion Pressure
Definition
Diastolic Pressure- LVEDP
Term
SVR
Definition
(((MAP-CVP)/CO) x 80
Term
pH
Definition
-log(hydrogen concentration)
Term
Hydrogen Concentration
Definition
10-pH
Term

4-2-1

 

Maintanence Fluids

Definition

4 ml x first 10 kg

 

2 ml x 10 kg

 

1 ml x remainder of weight

Term
MABL
Definition
Weight(kg) x Blood Volume x (Hcto-Hctl)/Hcta
Term
ETT Size
Definition
(Age + 16)/4
Term
ETT Depth
Definition
(Age/2)+12
Term
Size
Definition
(kg/5)0.5
Term
Estimation of Weight in Pediatric Patients
Definition
kg= (Age x 3) +7
Term
Average Atomic Weight
Definition
Percentage of your isotope added together
Term
Osmolarity
Definition
Moles/L of solution
Term
Osmolality
Definition
Moles/kg of solvent
Term
Pressure
Definition
Force/Area
Term
Pascal (Pa)
Definition

1 N


m2

 

Term
100 kPa
Definition
1 bar (0.987 atm)
Term
1 atm
Definition
1.013 bar
Term
Boyle
Definition
PV=P1V2
Term
Charles Law
Definition

V=V1


T=T1

 

Term
Gay-Lussac
Definition

P=P1


T=T1

 

Term
Combined Gas Laws
Definition

PV


T

 

Term
Fick Law
Definition
Rate of gas diffusion is proportional to the gradient
Term
Graham's Law
Definition
States that the rate of diffusion is inversely proportional to the square root of the molecular size
Term
Henry Law
Definition
States that the partial pressure of gas in a liquid is equal to its partial pressure in the gas phase
Term
Dalton Law
Definition
States that total pressure of gases in a liquid is equal to the sum of the partial pressures of the gas overlying the liquid
Term
Ohm's Law
Definition

E=IR

 

or

 

P=QR

Term
Hagan-Poiseuille
Definition

R=8Ln/∏r4

 

Laminar flow

 

Turbulent 

Term
LaPlace
Definition
T=Pr/2
Term
Inward Force
Definition
2∏r x Tension
Term
Outward Force
Definition
∏r2
Term
Percent by weight to Volume
Definition
g per 100 mL
Term
Percent by weight to weight
Definition
g per 100 g of solution
Term
Parts per million
Definition
g of solute/g of solution x 1 million
Term

Solubility 

 

(Henry's Law)

Definition
S= KH x Pgas
Term
Raoults Law
Definition
Change in vapor pressure from the introduction of a solute
Term
Solubility Product
Definition
Ksp= [M+]x[A-]y
Term
LeChatelier's Principle
Definition
Systems always strive to establish equilibrium
Term

K

 

(Equilibirium Constant)

Definition

[D]d[C]c


[A]a[B]b

 

 

aA+bB=cC+dD

 

Term
pKa
Definition
-log(Ka)
Term
pH
Definition
pKa + log[A-]/[HA]
Term
Ohm's Law in Electricity
Definition

E=IR

 

Voltage= Amperage x Resistance 

Term
Impedence
Definition

Frequency x Inductance 

 

or

 

1/(Frequency x Capacitance) 

Term
Circuit Breakers
Definition
15-20 A
Term
Macroshock
Definition
Current flow in excess of 5 mA
Term
1 mA
Definition
threshold of perception
Term
10-20 mA
Definition
Let go current
Term
50 mA
Definition
Pain
Term
100-300 mA
Definition
V-fib
Term
6000 mA
Definition
extensive tissue damage
Term
Line Isolation Monitors
Definition
2-5 mA
Term

GFCI

 

Ground Fault Circuit Interrupter

Definition
>5mA shuts everything off
Term
Upper Limit of Leakage Current
Definition
10 microamps
Term
Unipolar electrosurgical devices
Definition
Should not be used within 15 cm of a pacemaker
Term
Alkanes
Definition
CnH2n+2
Term
Alkenes
Definition
CnH2n
Term
Alkynes
Definition
CnH2n-2
Term
Alcohols
Definition
R-OH
Term
Ethers
Definition
R-O-R'
Term
Amines
Definition
R3N
Term
Aldehydes
Definition
Hydrogen bonded to the carbonyl group
Term
Ketones
Definition
Two Alkyl groups bonded to a carbonyl group
Term
Carboxylic acid
Definition
carbonyl group bonded with a hydoxyl group
Term
Ester
Definition
Product between carboxylic acids and alcohols
Term
Amides
Definition
Carboxylic acids and amines
Term
Carbohydrates
Definition
Cx(H2O)y
Term
Glucose's energy
Definition
4 kcal/gram
Term
Glycerides
Definition
Esters composed of glycerol and fatty acid
Term
Phospholipid
Definition
Phosphate ester group and two fatty acids
Term
Amino Acids
Definition
Carboxylic Acid (negative) and an Amine group (positive)
Term
Zwitterion
Definition
Have positive and negative charges within the same molecule
Term
Nucleic Acids
Definition
Phosphate sugar and a nucleoSide base
Term
Nucleotides
Definition
Phosphate Ester and a nucleoSide
Term
Oxygen E Cylinder
Definition

2000 psi

 

660 L

Term
Critical Temperature of N2O
Definition

36.5 C

 

Therefore N2O exists as a liquid in the tank 

Term
N2O E Cylinder
Definition

90-95% liquid

 

1590 L of gas evolves

 

745 psi 

Term
Air E-Cylinder
Definition

Nitrogen- 78%

 

Oxygen- 21%

 

Argon- 1%

 

2000 psi

Term
Regulators
Definition

Decrease the pressure to 50-60 psi 

 

Converts variable high pressure input to a constant low pressure output 

Term
Gauges
Definition

Bourden Tubes

 

Should be able to read 33% higher than maximum working pressure 

Term
Flush Valve
Definition
35-70 L/min @ 50 psi
Term
Oxygen Fail Safe Valve
Definition

shuts off other gas flow if oxygen pressure falls below 20-25 psi

 

Does NOT prevent a hypoxic mixture 

Term
High Flow Rates in Flowmeters
Definition

Floats acts as a constrictor producing turbulent flow

 

Gas density is the major flow rate factor 

Term
Low FLow Rates in Flowmeters
Definition

Laminar flow is present

 

Viscosity becomes a major factor in gas flow

Term
Helium and Oxygen
Definition
Have simular viscosities and can be changed out at low flows
Term
Carbon Dioxide and Nitrous Oxide
Definition
Have similar densities and can be changed out at high flows
Term
Decreased barometric pressures
Definition
Underestimates gas flows in flowmeters
Term
High barometric pressure
Definition
Overestimates gas flow in flowmeters
Term
Proportioning System
Definition

Equipped to never give gas flow with less than 25% oxygen

 

ONLY control oxygen and nitrous 

Term
MAC
Definition

Concentration of anesthetic that produces immobility in 50% of patients 

 

When expressed as a PARTIAL PRESSURE it is indepedent from atmospheric pressure 

Term
Des Saturated Vapor Pressure @ STP
Definition
91%
Term
Iso Saturated Vapor Pressure @ STP
Definition
31%
Term
Sevo Saturated Vapor Pressure @ STP
Definition
22%
Term
Vaporizer Output
Definition
O= I + (VP/ATM x O)
Term
Agent
Definition
O-I
Term
Pumping Effect is greatest
Definition
at low flow rates and small amounts of liquid in vaporizer
Term
Desflurane Vaporizer
Definition

Fixed output vaporizer

 

Heats agent to 39 C to produce 1500 mmHg of pressure

 

Passes gas flow through a resistance and measuring back pressure to see how much Des to give 

Term
CO2 Absorber Reaction
Definition

CO2 + Ca(OH)2 --> CaCO3 + H2

 

Sodium hydroxide is a catalyst and therefore isnt created or destroyed 

Term
CO2 Absorber Fun Facts
Definition

14 kcal of heat is released with each mole of CO2

 

Resistance is about 10 cmH2O at 60L/min

 

Want intergranular space to be greater than tidal volume- Canisters have about 500 cc of airspace so should be changed when 1/2 exhausted 

 

Watch out for channeling 

 

1000 gram canister can absorb 200L of CO2 

Term
CO2 Absorber and Volatile Agents
Definition

CO2 and Sevo react to form Compound A

 

Des and Iso react with CO2 to form Carbon Monoxide 

Term
Dead Space
Definition

Areas of bi-directional flow 

 

ETT, mask, Y piece 

Term
Coxial or Bain Circuit
Definition
FGF is placed within the expiratory hose
Term
Types of HME
Definition

Hydrophobic- pleated surface, effective for bacterial and viral filters 

 

Hygroscopic- more effective in increasing humidity rather than bacterial/viral effects 

Term
CO2 Production
Definition
200 cc/min
Term
Physiological Dead Space
Definition
33% of tidal volume but increases to 50% in IPPV
Term
O2 consumption
Definition
250 cc/min
Term
Critical Ventilatory Parameters
Definition

TV

 

MV

 

Inspiratory Flow Rate 

Term
Volume Limted Settings
Definition
Are sensitive to air leaks but can overcome changes in compliance and resistance
Term
Pressure Limited Settings
Definition
Are sensitive to changes in compliance and resistance but not to leaks
Term
Minute Volme
Definition
80-100 cc/kg/min
Term
Tidal Volume
Definition

8-10 cc/kg

 

Constant throughout life 

Term
Inspiratory Flow in Adults
Definition
10-50 L/min
Term
Bellows
Definition

Anesthetic gases are contained inside the bellows

 

O2 is pressurizing outside of bellows

 

Actual tidal volume is a combination of FGF and what is inside the bellows (fresh gas flow coupling)- Tidal volumes are considerably larger than what is shown displaced by the bellows 

Term
Fresh Gas Flow Decoupling
Definition

Volume monitoring with tidal volume adjustment

 

Diversion of gas during inspiration by a decoupling valve 

Term
NIOSH Recommendations
Definition

Halogenated agents < 2 ppm

 

Nitrous Oxide < 25 ppm

 

Halogenated agents + N2O < 0.5 ppm

 

10 exchanges per hour of OR air 

Term
N2O pollution
Definition
High pressure leaks is the primary cause of pollution when OR not in use
Term
Savenging System
Definition

19 mm hose

 

Rigid to withstand 10kg/cm pressure

 

Exhaust hose from circuit to ventilator system 

Term
Inspiratory Baseline in Capnography
Definition

Phase I

 

CO2 concentration should be 0

 

later part represents exhaled dead space 

Term
Expiratory Upstroke in Capnography
Definition

Phase II aka Transition Phase

 

Lungs recoil and gas exits through trachea

 

Slanted if airflow is obstructed 

Term
Expiratory Plateau
Definition
Lung units with lower V/Q ratio empty into the sampling site, thus the slight incline
Term
PaCO2 vs. PeCO2
Definition

Usually differ between 3-5 mmHg 

 

Arterial is higher because some dead space is lingering about 

Term
Abnormal Capnographs
Definition

Increased Airway Resistance- flattening of expiratory upstroke

 

Cardiac Oscillation- indicate a very high cardiac output

 

Curare Clefts- sharp down-stroke during the expiratory plateau indicates ventilatory attempts by the patient- neuromusclar blockade warn off

 

Elevated Baseline- indicates rebreathing 

Term
Hypoxia
Definition
PaO2 < 60 mmHg
Term
Oxygen Galvanic Cell
Definition

Ouput voltage is proportional to O2 partial pressure 

 

Voltage produced by the oxygenation of the lead electrode 

Term
Polargraphic Sensors
Definition

Applies current to reduce O2 in hydroxide anion 

 

Change in current is proportional to O2 in solution 

Term
Paramagentic Analyzer
Definition
Applying a magnetic field to a stream of gas changes the pressure of the stream which can be calculated
Term
Incorrectly Assembled Circuit
Definition

FGF- never between patient and expiratory valve

 

APL- never between patient and inspiratory valve

 

Reservoir bag- never between patient and any valve 

Term
CO2 Absorber Failure
Definition

Bypass Valve open

 

Channeling

 

Exhaustion 

Term
Minimum Fresh Gas Flow Requirements
Definition

Mapelson A: 70-100 mL/kg/min for spontaneous ventilation

 

Mapelson D: 70-100 mL/kg/min for controlled ventilation 

Term
Electrical Failure
Definition

30 min of battery backup

 

Takes 16 hrs to recharge battery

 

If power goes out ventilator doesnt have backup- youll have to bag

 

Term
Anesthesia Effect on Temperature
Definition

Causes vasodilation

 

Reduces shivering threshold 2-4 C

 

Affect BMR, sympathetic tone, and vascular tone 

Term
Accurate Core Temperatures
Definition
PA cather, distal esophagus, tympanic membrane, nasopharynx
Term
BP Formula
Definition
BP= CO x SVR
Term
Gravitational Forces on Invasive BP monitoring
Definition
Reduces mean 7.5 mmHg/ 10 cm of height
Term
Invasive BP Monitoring
Definition

When pressure are taken more peirpherally systolic increases and diastolic decreases

 

Vascular disease and vasoconstriction decrease peripheral readings up to 50 mmHg

 

Mean pressure is the area under the waveform 

Term
Arterial Waveform
Definition

Ring= underdampened- results in increased systolic readings 

 

Flattened, dampened peaks= overdampened

 

Crisp upstroke = hyperdynamic circulation

 

Broad Peak= high cardiac output

 

Fast flush should be 1-3 oscillations 

 

Diacrotic Notch= AORTIC VALVE closure 

Term
EKG Paper
Definition

Paper speed 25 mm/sec

 

0.04 sec each box 

 

Each bold line is 0.2 seconds

 

HR can be calculated by dividing 300 by the number of bold vertical lines between the QRSs

 

Horizontal line represents voltage: 1 cm/1mV 

Term
Manual Blood Pressure
Definition

Riva-Rocci

 

 

Systolic pressure is lower and diastolic is higher than with direct monitoring 

 

Oscillometric begins with sytolic and maximum is MAP

Term

Oxygen Content 

 

(CaO2)

Definition

(1.37 x Hgb x O2%/100) + (0.003 x PaO2)

 

Normal is 20 cc/100 mL blood 

Term
Oxyhemoglobin Dissociation Curve
Definition
PaO2 40, 50, 60= 70 %, 80%, 90%
Term
O2 Delivery
Definition
(CaO2 x 10) x CO
Term
O2 consumption
Definition

[1.37 x (Hgb x O2sat/100 - O2venous/100 x Hgb)] x 10 x CO 

 

250 cc/min

Term
Pulse Oximetry
Definition

Based on the assumption that arterial blood is only pulsatile

 

660 oxy 940 deoxy 

 

Beer-Lambert 

 

Does not correlate with peripheral perfusion

Term
EKG Leads
Definition

I- Right arm to left arm

 

II- Right arm to left leg

 

III- Left arm to left leg

 

Augmented leads: aVR, aVF, aVL

 

V4- mid clavicular line 4th-5th intercostal space 

 

V5- anterior axillary 4th-5th intercostal space 

 

V6- Mid Axillary line 4th-5th intercostal space 

 

In precordial system: neutral electrode is formed by standard leads

Term
Modified Chest Leads
Definition

MCL look at single precordial leads

 

MCL 5 is most common to detect lateral wall ischemia

 

MCL 1- MCL 6 

 

Lead II and V5 are the best at detecting ischemia and arrhythmias 

Term
CO
Definition

Amount of injectate/ area of dillution curve

 

Stewart-Hamilton formula

 

When exponential decay reaches 30% it extrapolates to minimize artifacts due to recirculation of the indicator 

 

Errors: reduced volume, slow injectate, warm indicator, tricuspid regurge, assumed precision

Term
Bioreactance
Definition

Measures phase shift in voltage across the thorax

 

Phase shift results in pulsatile flow

 

Amplitude is the magnitude of impedance, phase is the direction of impedance 

 

High frequency 75 kHz sine wave generator and 4 dual electrodes 

 

CO is measured from the average the signals from both sides 

 

Peak rate of change is proportional to peak aortic blood flow during each beat 

Term
LASER
Definition

Light amplification with stimulated emmision of radiation

 

Coherent, columnated, monochromatic

Term
CO2 Laser
Definition

< 0.5 mm penetration

 

Most commonly used b/c limits amount of tissue damage during surgery 

 

Damaged to cornea

 

Can be blocked with any type of glasses 

Term
YAG and Argon
Definition

YAG: dark tissue, 2-6 mm, deepest penetration

 

Argon: 0.5-2mm hemoglobin and melanin

 

Damage to the retina 

Term
Consideration when Using Lasers
Definition

Have goggles and signs

 

FiO2 less than 30%- N2O is flammable 

 

Metallic coated tubes and airway packed with soaked gauze 

 

No NC- if so off 1 min prior 

 

2 syringes available to put out fire 

Term
Primary Response to Airway Fire
Definition

Remove ETT and any flammable/burning material

 

Discontinue all gas flow

 

Pour saline into airway

 

Ventilate with Low FiO2 to prevent smoldering 

Term
X-Rays
Definition

Sudden deceleration of a stream of electrons

 

Heat 99% and x-ray photons 1%

 

30-150 kV

 

Deadman switch must be held throughout exposure

 

X-ray scatter is what healthcare providers need to be conscious of 

Term
Factors Determining X-Ray Scatter
Definition

Energy of x-ray beam kV

 

Size of the part being imaged

 

Duration of the imaging 

 

Stochastic radation is what we are worried about- cancer causing 

Term
Annual Dose Limit of Radiation
Definition

5 rem 

 

(50 mSv)

 

Highest radiation exposure in the OR is from Fluroscopy

 

NORA- CT scans 

Term
Cardinal Principles of Radiation Protection
Definition

Time- short

 

Distance- I1D12=I2D22

 

Shielding- 0.5 mm thick lead minimum 

 

Dosimetry Bag if 1/10 of yearly exposure 

Term
MRI
Definition
Atoms aligned by strong magnetic field and a pulse radiofrequency alters their orientation and the process of energy released forms an image
Term
MRI Hazards
Definition

Ferromagnetic Projectiles

 

Induction of Heat- EKG leads

 

Noise- 125 dB

 

Implanted Objects- pacemakers etc

 

Tattoos and Eye Makeup

 

Cardiac Pacemakers

 

ECG Changes- T wave changes from sumperimposed induced voltage 

Term
MRI Zones
Definition

Zone 1- free access

 

Zone 2- under supervision of personel

 

Zone 3- ferromagnetic objects can result in injury or death

 

Zone 4- MRI scanner magnet room 

Term
Ultra Sound
Definition

Wave travels by compressing and rarefracting matter

 

Measure in frequency: number of cycles per second Hz

 

2.5-10 MHz diagnostic ultrasound

 

High frequency (5-10 MHz) great resolution, poor penetration

 

Low Frequency (2.5-5 MHz) great penetration, poor resolution 

 

Best images when transducer is perpendicular

 

Can be continuous or pulsed

 

B Mode is 2-D images and M-Mode is moving targets  

Term
Doppler Imaging
Definition

Uses low frequency ultrasound waves 

 

Reducing depth and size of the color box and reducing scanning sector will compensation for poor resolution

 

BART: blue away blood flow, red toward blood flow

 

Perpendicular is black

 

Turbulent flow is green or white 

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