Anti-aliasing is all about the tradeoff between image quality and FR.
2X anti-aliasing means if you are running AH in 1024x768, the card internally renders it at 2048x1536 and then reduces it to 1024x768 before displaying it. 4X AA numbers are higher. Rendering at these higher resolutions obviously reduces framerate. Enough to cause a problem? Probably not. Quincunx AA is an alternative method nV uses to approximate 4XAA without actually doing the quadruple render. Supposedly gives similar image quality without as much of a performance hit. I dunno if its true or not.
Try 'em all - max out the quality settings and see what your FR is. IF its acceptible, GO for it. if not, back it off.
Anisotropic filtering affects how clearly the texture maps are displayed as they get farther away from your POV. higher is better. again, pump it all the way up, and see how it affects your framerate.
vsync ties the video card refresh rate to whole number divisors/multipliers of your monitor refresh rate. i.e. if the card can render 90 FPS, but your monitor runs at 75, the game will lock the refresh at 75. If your fr drops below 75 - to say 70, the refresh rate will drop to 75/2, or 37.5. When the vsync is off, the card sends its renderings right to the monitor, without regard to refresh rate, which can result in some frames being only partially displayed by the monitor before the next one gets there. However, the gamer usually doesn't notice it - though it can be evidenced by texture tearing on the terrain or along coastlines. As far as how AH uses it, or whats best.... skuzzy will have to answer that. I know for WB, I personally don't notice a difference on or off, except when I cross one of those vsync boundaries - where I get a momentary pause.
4.13.01.3100 Your drivers are 41.30s

not 4's You're not *that* far behind.

BB