Hemodynamics/ Cath/ Contrast

Question 1

pulmonary hemodynamics

Answer 1

1. low pressure
2. low O2 content in artery
3. low resistance
4. RV wall is thin

Question 2

systemic hemodynamics

Answer 2

1. high pressure
2. high resistance
3. LV wall is thick
4. high O2 content in artery

Question 3

pulmonary components

Answer 3

1. pulmonary artery
2. arteries
3. capillaries
4. veins

Question 4

systemic components

Answer 4

1. aorta
2. arteries
3. arterioles
4. capillaries
5. veinules
6. veins
7. vena cava

Question 5

arteries

Answer 5

• elastic ,thick walled blood vessels

- expand during systole then recoil during diastole to keep blood moving forward

Question 6

veins

Answer 6

• thin walled blood vessels that collapse easy
• able to expand rapidly to accommodate large volumes of blood
• contain the majority of circulating blood.

Question 7

blood

Answer 7

• 54% of blood is plasma
• 45% of blood is red blood cells( erythrocytes)
• 1% of blood is white blood cells (leukocytes) and platelets (thrombocytes)

Question 8

normal pressures for aorta

Answer 8

120/80

Question 9

normal pressures for PCW

Answer 9

10

Question 10

normal pressures for pulmonary artery

Answer 10

25/10

Question 11

normal pressures for right atrium

Answer 11

8/5

Question 12

normal pressures for right ventricle

Answer 12

20/0/5

Question 13

normal pressures for left atrium

Answer 13

10/12

Question 14

normal pressures for left ventricle

Answer 14

120/0/12

Question 15

normal atrial pressures are about ____ in the RA and ___ in the LA. other than that the right sided pressures are approx. ___ of the left sided pressures.

Answer 15

RA= 6mmHg
LA=10mmHg
right sided pressures are apox1/5th the left sided pressures

Question 16

what is the normal pressures in the pulmonary artery

Answer 16

25/10

Question 17

oxygenated blood

Answer 17

• 95% saturated (pink blood)

- starts in the pulmonary veins and continues to the end of the systemic arteries

Question 18

deoxygenated blood

Answer 18

• 75% saturated (blue blood)

- starts in the systemic veins and continues tot he pulmonary arteries

Question 19

O2 saturation for aorta, LA, and LV

Answer 19

95%

Question 20

O2 saturation for PA, RA, and RV

Answer 20

75%

Question 21

where is the O2 saturation the lowest?

Answer 21

coronary sinus (usually around 40%)

Question 22

O2 saturation in pulmonary veins

Answer 22

95%

Question 23

O2 saturation in pulmonary arteries

Answer 23

75%

Question 24

angiography

Answer 24

contrast medium injected while cineangiography film records results (vessel narrowing, regurg, shunts, EF).

Question 25

LV agiogram is also called

Answer 25

1. ventriculography 2. selective angiography 3. angiocardiography

Question 26

best cathn technique for LV function

Answer 26

LV angiogram

Question 27

cardiac output (two types)

Answer 27

1. flick method | 2. angiographic technique

Question 28

flick method

Answer 28

measures O2 consumption divided by the difference in O2 content between arterial and pulmonary system

Question 29

angiographic technique

Answer 29

multiples the stroke volume by the heart rate

Question 30

oximetry

Answer 30

measures O2 saturation in various chambers (able to ect shunts by changes in O2 saturation)

Question 31

shunt size is calculated by

Answer 31

the difference between pulmonary and systemic blood flow

Question 32

acqure the lt atrial pressure during the rt heart cath via the

Answer 32

pulmonary capillary wedge pressure or the transeptal approach

Question 33

obtain the PCW/PCWP when

Answer 33

a flow directed ballon tip catheter (aka swan-ganz or rt heart cath) is passed from the RV into the pulmonary artery and allowed to float as far as it will go until its wedge into a pulmonary end artery

Question 34

The pressure distal to the wedge when obtaining the PCW/PCWP is an approx.

Answer 34

lt atrial pressure

Question 35

the pressure recorded when the ballon is deflated while trying to obtain PCW/PCWP is

Answer 35

the pulmonary artery pressure

Question 36

what is the pulmonary capillary wedge measuring

Answer 36

lLa pressure

Question 37

to determine AS where are catheters placed?

Answer 37

1. one in the LV and one in the AO 2. one in the LV and "pulled back" across the AoV 3. one catheter with two separate sensors.

Question 38

high gain destroys

Answer 38

resolution

Question 39

``` low frequency (2.5MHz) = high frequency (4.0MHz)= ```

Answer 39

``` low= better penetration high= better resolution ```

Question 40

fundamental imaging

Answer 40

transmit and receive at the same time

Question 41

harmonic imaging

Answer 41

transmit at one frequency and receive at the 2nd harmonic (twice the transmit frequency

Question 42

tissue harmonic imaging results in

Answer 42

thicker valve leaflets

Question 43

apical swirling of echo contrast for LVO is caused by

Answer 43

high MI

Question 44

Trans pulmonary contrast agents

Answer 44

- various companies make echo contrast agents - bubbles are smaller than red blood cells - cross the pulmonary circuit

Question 45

trans pulmonary contrast agents are used for

Answer 45

left ventricular opacification when two or more contiguous segments are not seen from any apical view

Question 46

trans pulmonary contrast agents has various methods for infusion/administration _______ and machine settings for optial imaging______

Answer 46

infusion/admin= 1. bolus 2. continuopus infusion optial imaging 1. low MI 2. focus 3. harmonics

Question 47

swirling in the LV apex is caused by

Answer 47

the MI being too high or the amount of contrast injected is too low

Question 48

attenuation of contrast is caused by

Answer 48

the amount of contrast injected is too high or was injected too fast