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SRNA4TopicsAnesthesia COPY > MONITORING: Cardiac Sidenotes > Flashcards

MONITORING: Cardiac Sidenotes Flashcards

1
Q

In which lung is pulmonary capillary flow continuous and proportional to the arterial venous pressure gradient, and where the pulmonary catheter tip should be ?

A

Zone III

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2
Q

Zone I what pressure dominates

A

PA>Pa>Pv (ALVEOLAR PRESSURE

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3
Q

Zone I is considered

A

pure alveolar dead space

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4
Q

Zone II what pressure dominates

A

Pa> PA> Pv

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5
Q

Zone III what pressure dominates

A

Pa>Pv> PA

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6
Q

Zone III and alveolar perfusion

A

Alveoli well perfused

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7
Q

To obtain accurate PCWP, the reading should be taken

A

At the end of expiration because the pressure within thest chest should be zero.

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8
Q

What is the most common complication of attempted IJ cannulation?

A

Carotid Artery puncture

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9
Q

Left IJ cannulation carries increased risk for

A

pneumothorax and potential damage to the thoracic duct.

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10
Q

When does the “a”waveform represent on CVP tracing?

A

Contraction of RA

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11
Q

Corresponds to contraction of RA

A

A wave

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12
Q

Bulging tricuspid valve into RA during onset of ventricular contraction, after the QRS

A

C wave

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13
Q

Atrial relaxation

A

x descent

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14
Q

Right atrium filling with closed tricupid valve

A

V wave

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15
Q

Opening of tricuspid valve, blood to RV

A

Y descend.

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16
Q

No a wave associated with

A

Afib

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17
Q

Large a wave associated with

A

Tricuspid stenosis
Pulmonary stenosis
Pulmonary HTN

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18
Q

Giant a or CANNON a

A

Right atrium contracts against closed Tricuspid valve,

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19
Q

No X descend

A

TR

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20
Q

LARGE v or cannon v wave

A

Tricuspid regurgitation

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21
Q

What are potential locations for insertion of an arterial line?

A

Radial
ulnar
brachial
femoral
axillary
Dorsalis pedis

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22
Q

Exception of arterial line insertion

A

Subclavian

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23
Q

Which of the following are complications associated with arterial line?

A

Vasospasm
Embolus
Infection
Thrombosis
Hematoma
AV fistula

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24
Q

What are the contour and the area under the arterial waveform representative of?

A

Estimates of body fluid volume

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25
When does the dicrotic notch of the arterial waveform occur?
When the AORTIC VALVE SHUTS (closure)
26
WHat does the dicrotic notch mark?
closure of the aortic valve that mark end of the systole and start of diastole
27
As the arterial waveform moves PERIPHERALLY, the waves become
TALLER>
28
Which of the following is the first upstroke in the arterial waveform an index of?
Inotropic state of LV
29
The transducer will be raised to the ear to approximate
The BP at the brain level (circle of willis) to recognize the pressure being measures is at the level of the trasnducer at the ear not at the level of the aortic root.
30
The ear is about
30cm higher than the brachial cuff
31
Ear is about 30cm higher than brachial cuff therefore if the patients Mean BP is 74mmHg the mean BP of the circle of willis would be
51.5 mmHg MAP - (30cm x 0.75mmHg) =
32
Substract ________ for each cm of high difference from the known Mean BP
0.75mmHg
33
For a patient in a sitting position, you must maintain a mean blood pressure of
> 70 mmHg at the brain level.
34
During a mediastinocopy, compression of the innominate artery can be detected by which of the following method.
Monitoring R radial artery waverform or pulse.
35
During a mediastinoscopy, what can be easily pressed by the score and block blood flow to both the right arm and the right carotid?
Innominate artery (aka Brachiocephalic trunk)
36
The brachiocephalic artery comes off the ________ then divides into
Aorta; subclavian artery and the Right common carotid artery.
37
Which of the following are potential risks associated with use of TEE>
Esophageal perforation Bleeding Pharyngeal abrasions Hoarseness.
38
Does not typically occur due to TEE use
Dysrhythmias
39
A precordial doppler can detect air bubbles as small as
0.25ml
40
2 most sensitive monitors for detecting a VAE
TEE precordial doppler US
41
Which of the following is the most sensitive invasive monitor for detecting a VAE?
TEE
42
The most sensitive NONINVASIVE for detection of VAE
Precordial DOPPLER
43
Most to least sensitive in identifying VAE
TEE > precordial doppler > increased PAP > Decreased EtCo2 > mass spectometry (presense of ETN2)
44
What is your patient's CO if her HR is 70bpm her LVEDP is 18 and her stroke VOLUME is 65ml?
4.6L
45
During EKG monitoring, Lead II typically detects ischemia in which region of the heart?
Inferior wall
46
Detects ischemia to anteroseptal myocardial tissues from the LAD coronary artery?
V1 - V4.
47
Monitor Inferior heart
II, III, avF
48
The lateral EKG leads are
I, avL, V5, V6
49
The lateral EKG leads monitor which artery
left Circumflex artery.
50
Which of the following is a normal mixed venous blood oxygen saturation (SvO2) ?
75%
51
Normal tissue oxygen extraction is
25%
52
Pulse ox is based on which law
Beer-Lambert law
53
State the Beer-lambert Law
States that the concentration of an unknown solute in a solvent can be determined by light absorption.
54
Factors that can reliably affect pulse ox
Low perfusion states Dyshemoglobinemias Methylene blue external light sources
55
Does anemia affect pulse oximetry?
NO because high oxygen levels can be in the hemoglobin that is present.
56
Pulse oximetry utilizes 2 wavelengths of light, the red light at _______and the infrared light
660; 940 nm
57
Analyzed by pulse ox is the
Ratio of absorbed light for each wavelength is analyzed to provide the oxygen saturation of arterial blood.
58
Red light = _____Wavelengths
940nm
59
Red light :
Deoxyhemoglobin absorbs more red light, but not much infrared light
60
Infrared ________wavelengths
660nm
61
Infrared light: IO
Oxyhemoglobin absorted more INFRAred light and deflects red light.
62
Placing an IV in a larger vein is preferred. this is assocaited with which law?
Poiseuille's
63
What does POISEUILLE's LAW STATES?
Doubling the radius results in 16-fold in change in flow
64
Poiseuilles equation
8nl/ PI, r^4,change in P
65
Cuff size should be ____% of the circumference of the extremity
40%
66
A cuff that is too small will give a
Falsely high reading
67
A cuff that is too large will give a
Falsely low reading.

SRNA4TopicsAnesthesia COPY (47 decks)

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