Cardiovascular systeem, ECG, Blood pressure, and Temp Flashcards Preview

Anesthesiology > Cardiovascular systeem, ECG, Blood pressure, and Temp > Flashcards

Flashcards in Cardiovascular systeem, ECG, Blood pressure, and Temp Deck (46):
1

Should low tech monitoring be used even if specialized equipment is being used?

Yes

2

Specialized equipment

ECG, BP (doppler, ocillometric, direct)
Pulse ox, Expiratory.end tidal CO2

3

When should animals be monitored?

Anytime heavy sedation is produced; vigilence depends on how profound the sedation is

Anytime anesthesia is produced; regardless of condition/procedure/duration

4

What equipment can we use to assess heart rate?

1. Auscultation- stethoscope
2. Pulse oximeter- accuracy?
3. Doppler
4. ECG

5

What does the parasympathetic system influence in respect to HR?

1. SA and AV nodes
2. Muscarinic receptors

Increase in parasympathetic tone results in bradycardia

6

What does the sympathetic system influence in respect to HR?

1. SA and AV nodes,
2. Ventricles
3. Alpha-1, Beta-1/2 receptors

Increase in sympathetic tone results in tachycardia

7

What increases parasympathetic tone? (Bradycardia)

Pressure on eyes/viscera
Drugs
Profound anestthetic depth
High serum potassium
SA node disease

8

What causes increases in sympathetic tone? (Tachycardia)

Stimulation/pain
Hypovolemia/blood loss
Very elevated CO2
Hypoxemia
Drugs
Diseases

9

Does the ECG give accurate information about the function of the heart?

No, only the electrical activity

10

ECG for sinus arrhythmia

R-R variation congruent with respiration

11

Why do we monitor ECGs?

Detection of arrhythmias even if there is no history of one as they are common under anesthesia

12

ECG for sinus bradycardia

Regular increased R-R interval

13

Should sinus bradycardia be treated?

Only if HR is low enough to adversely effect CO or BP

14

Is the ECG the only thing that will tell us if we have an abnormal rhythm?

Yes, all other monitoring equipment will likely be normal

15

What is CO a product of?

HR and SV

16

Is CO easily monitored?

No, it requires an invasive catheter placed into the pulmonary artery

17

What are normal BPs?

Systolic= 100-140mmHg
Diastolic= 50-70mmHg
MAP= 65-85mmHg

18

Which BP value best represents systemic perfusion?

MAP

19

MAP should be maintained greather than _____mmHg to maintain renal perfusion

60

20

What are indirect ways to monitor BP?

Doppler ultrasonic flow
Oscillometric

21

What are direct ways to monitor BP?

Arterial catheter and transducer recording system

22

What are some advantages to Doppler?

1. Continuous evaluation of pulse rate
2. Sudden loss of sound may indicate cardiac arrrest
3. Useful in tiny or exotic patients
4. Relatively inespensive

23

What are some disadvantages of doppler?

1. Requires and operator for BP
2. Subjective readings
3. No MAP
4. Difficult to capture if vasoconstriction/hypothermia/poor perfusion

24

In oscillometeric BP measurements, which values are recorded and which ones are calculated.

Calculated: systolic and diastolic
Measured: MAP

25

Advantages of Oscillometric BP monitoring

1. Measure mean and calculates syst/diast
2. Can be set to monitor at certain time intervals
3. Stores values for review

26

Disadvantages of Oscillometric BP monitoring

1. Relatively expensive
2. May not secure pressure at extremes of heart rate in abnormal rhythm
3. May not read if hypotensive
4. No monitoring in between readings

27

What kind of BP is produced if cuff is too small/loose?

Artificially higher

28

What kind of BP is produced if cuff is too large/tight?

Artificially lower

29

What happens to BP if the cuff is below the heart?

Artificially higher

30

Should the limb be straight or flexed for BP measurements?

Straight

31

Which BP measurement type iss most accurate?

Depends on equipment/age/patient

32

Which arteries are used for direct BP measurement?

Small animal: Dorsal pedal, coccygeal, or radial

Large animal: Dorsal metatarsal, facial, caudal auricular, transverse facial

33

Where should the transducer be positioned in direct BP measurement?

Level of the heart

If too low= increased pressure
If too high= decreased pressure

34

What does the shape of the pressure wave tell us?

Narrow wave- vasodilation and low diastolic pressure

Increased slope- low inotropy, SV, CO

35

Electronic invasive BP facts

1. More expensive
2. Provides SAP, DAP, MAP, and waveform
3. Waveforms provides quality of inotropy and venous return

36

Sphygomomanometer invasive BP facts

1. Inexpensive and portable
2. Only provides mean
3. No waveform

37

Causes of Hypotension

1. Bradycardia
2. Vasodilation
3. Poor cardiac function
4. Hypovolemia/shock/sepsis

38

Causes of Hypertension

1. Light anesthesi
2. Pain
3. Drugs (catecholamines/ketamine
4. Disease processes (+ICP, renal/adrenal dz)

39

Why does anesthesia cause hypothermia?

Decrease of muscular activity, metabolism, and hypothalamic activity

Evaporative heat losses and anesthesia induced vasodilation

40

Issues when body temp decreases to 96-97F

Minimal, some shivering may occur

Only an issue for cardiac/pulmonary paitents

41

Issues when body temp decreases to 92-94F

Decreases anesthetic requirement but prolongs recovery

Will not shiver in recovery

42

Issues when body temp decreases to 89-90F

HR/CO decreases and may not respond to tx, may interfere with healing mechanisms and slows recovery

43

Do all animals require heat support?

Heavy coated dogs may become hyperthermic with additional heat support

44

Should temp be monitored through recovery?

Yes, until the animal is normal

45

Heating units

1. Bair huggers
2. Warm water circulating pads/blankets
3. Pads/towels between patient and open surfaces

46

Should traditional heating pads be used?

No, high risk of burns