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RUSVM Anesthesiology > Monitoring ECG And BP > Flashcards

Monitoring ECG And BP Flashcards

1
Q

Intra-operatively you should monitor and record your anesthesia parameters how often?

A

Every 5 mins

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2
Q

What are the most important functions to monitor during anesthesia?

A

Circulation
Oxygenation
Ventilation
Temperature

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3
Q

How is pulse pressure determined?

A

Systolic-diastolic pressure

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4
Q

What should you assess when you palpate the pulse?

A

Rate, rhythm, quality

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5
Q

Why should you use a distal artery to palpate a pulse?

A

Affected earlier by hypotension and low CO

-> if it feels strong, likely indicates a good CO

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6
Q

What are common sites of pulse palpation in small animals??

A 
Lingual 
Labial 
Articular 
Digital 
Femoral 
Dorsal pedal 
Metatarsal 
Coccygeal
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7
Q

What are common sites of pulse palpation in large animals?

A 
Auricular 
Transverse facial 
Palatine 
Metatarsal 
Digital 
Coccygeal
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8
Q

T/F: an esophageal stethoscope can be used to asses heart rate/rhythm, and respiratory rate

A

True

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9
Q

T/F: Regular ECG readings indicate the heart is contracting appropriately?

A

False

-indicate electrical activity, not contractility

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10
Q

What are clinical uses of ECG?

A

Determine HR and rhythm

Aid in diagnosis of electrolyte disturbances (hyperkalemia)

Aid in chamber enlargement

Provide clues about myocardial oxygenation and perfusion

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11
Q

Pwave = ?

A

Atrial depolarization

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12
Q

QRS complex =?

A

Ventricular depolarization

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13
Q

T wave = ?

A

Ventricular repolarization

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14
Q

What is type A cardiac innervation?

A

Perkinje fibers excite the endocardium and excitation spread via muscle fibers

Flow is base-> apex (result in a positive R wave)

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15
Q

What is type B cardiac innervation?

A

Purkinje fibers deeply penetrate myocardium and most fibers are excited simultaneously

Apex to base current flow (negative S wave)

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16
Q

What type of animals have a type B cardiac innervation?

A

Horse, ruminant, pig

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17
Q

Using Eintheovens limb leads, in a healthy small animals which lead yields the tallest R wave

A

Lead 2

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18
Q

Using Eintheovens limb leads, in a healthy horses/ruminants which lead yields the tallest R wave

A

Lead 1

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19
Q

What things are you evaluating on an ECG?

A

HR
Rhythm
Complexes and intervals
Mean electrical axis

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20
Q

T/F: normal HR and BP likely indicates adequate CO

A

True

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21
Q

The best way to determine HR is to use the ECG and pulse oximeter

A 
False 
 Can be erroneous due to 
-bad signal quality 
-double counting 
-uneven HR

Best to count yourself

22
Q

What are the most common arrhythmias under anesthesia?

A

Sinus bradycardia and tachycardia

AV block (1st and 2nd degree)

23
Q

Moving central to peripheral arteries, systolic BP becomes ________, diastolic becomes _______, and mean is _________

A

Higher ; lower; same

24
Q

_________ BP represents afterload for the left ventricle

A

Systolic

25
Q

Mean pressure is an average BP over a full cycle and is a determinant of ___________________

A

Tissue perfusion

26
Q

Diastolic pressure is the lowest point of the BP curve and is a determinant of _________________

A

Myocardial perfusion

27
Q

In small animals, they are hypertensive is their mean BP is less than ________ and if their systolic BP is less than ________

A

60mmHg; 80mmHg

28
Q

In large animals, they are hypotensive is their mean BP is less than _______ and their systolic BP is less than _______

A

70mmHg; 90mmHg

29
Q

What does a BP change with respiration indicate?

A

Hypovolemia

30
Q

What does a pressure waveforms provide information about?

A

Inotropy, CO, and the effect of arrhythmias

31
Q

Preload depends on?

A

Circulating volume

32
Q

What three factors does stroke volume depend on?

A

Preload
SVR
Contractility

33
Q

BP can be calculated by??

A

BP = CO x SVR

34
Q

If you have a low HR what should you give?

A

Atropine

35
Q

If you have a low circulating volume, how should you treat

A

Fluid bolus

36
Q

If you have low contractility, how should you treat?

A

Decrease ISO, give inotropes

37
Q

If your SVR is low, how should you treat?

A

Decrease ISO, give vasoconstrictor

38
Q

What drugs can be used to address hypotension during anesthesia

A
  1. Decrease anesthetic
  2. Give fluid bolus
  3. Inotropes (dobutamine, dopamine, ephedrine) OR Vasoconstrictors ( phenylephrine, norepi, vasopressin)
39
Q

How can BP be measured?

A

Invasive (direct): continuously via arterial catheter most accurate, gold standard

Non-invasive (indirect): intermittently using a pressure cuff
-oscillometric and Doppler

40
Q

What type of BP monitor should you use in horses if they are anesthetized for more than 45mins?

A

IBP - arterial catheter

41
Q

Which arteries can you use for IBP in horse??

A

Facial, transverse facial, lateral metatarsal, and auricular

42
Q

Which arteries can be used in dogs for IBP?

A

Dorsal pedal, metatarsal

Femoral, palmar digital

43
Q

What three arteries can be used for IBP in cat

A

Dorsal pedal, coccygeal, and femoral

44
Q

Where should the BP transducer be placed?

A

Point of shoulder in dorsal recumbency

Point of sternum in lateral recumbency

  • this is the point of zero BP at the base of the heart
45
Q

What type of non-invasive BP detects fluctuations in a cuff that generates pressure on arterial flow

A

Oscillometric

46
Q

What type of non-invasive BP measurement uses a probe distal to an inflated cuff to detect BP

A

Doppler

47
Q

The cuff’s width should be about ____% of the circumference of the limb

A

40

48
Q

In small animals where do you place your BP cuff?

A

Distal radius, distal tibial, metatarsus

49
Q

In large animals where do you place your BP cuff?

A

Metacarpus / tail

  • not very accurate for horses
50
Q

T/F: Doppler is an excellent pulse monitor

A

True

51
Q

How does a Doppler flow probe work?

A

Transmit US signal toward an artery and the reflected US wave is sensed by the probe

Reflected wave differed depending on speed of blood

RUSVM Anesthesiology (32 decks)

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