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Cardio #2
Patho
| Question | Answer |
|---|---|
| the heart is located | in the L chest |
| which in worst, cut nerves or compressed nerve | compressed nerve remains mid-line and can't open or close |
| what is the major conducting artery in the system | aorta |
| what is the most important nerve that runs around the aorta and comes back up | recurrent larengeal nerve |
| mechanisms for aneurysm formation | HTN, Aterosclerosis, Deceleration injury, syphilis (#1 cause of ascending aneurysm |
| S/s of ascending thoracic aorta | Trachea:inspir. stridor, esophagus:dysphagia, laryngeal nerve:hoarseness, carotids:occl.,coronary:occl., cardiac tamponade, acute aortic regurg |
| txment of ascending | pulse wave, amplitude, freq. or surg. intervention decrease HR BETA BLOCKERS dimish pulsewave, amplit., freq. |
| preop & post op management of ascending thoracic aorta | L radial aline, EEG, carotid doppler post: HTN, tachycardia, CNS dys, |
| aneurysm of the ascending thoracic aorta | type I and II, usually middle aged |
| aneurysms of the descending thoracic aorta is what type | III , usually asymptomatic, deceleration injury, myocardial contusion, |
| txment of type III dissection | conservation medical managment, surgical intervention |
| a dissection is a | tear in the intimal wall;longer to live if tear media will die quicker |
| type I | arise from the ascending aorta 70% of all cases(syhphilis) |
| type II | arise from the ascending aorta, collagen weakness (Marfans syndrome) |
| type III | begin distal to the L SC artery 20% pts(decel) |
| pt with clavicle and rib fx check for | aortic dissection |
| repairing the anterior ascending aorta | sternum |
| repairing the descending aorta | left side of the chest |
| aortic arch supply bld to | all the bld to the upper chest, head, and upper extrem. |
| do you put a pt to sleep with a tamponade | no; percardialcentesis |
| how do you dx aneurysms | CT, MRI echo doesn't pick up arch of arota |
| what is the innominate artery and what does it branch off of and convert into | innominate/brachicephalic artery branches off R SC artery and R common carotid artery |
| where does the L recurrent laryngeal nerve originate from | vagus nerve |
| where does the descending aorta supply bld to | branching arteries that come back at every thoracic verebrel level, 2 holes at each level |
| what are the 3 different types of aneurysms and what type is common in the aorta | saccular, fusiform(usually found aorta), ruptured:hole thru all 3 layers of the artery, serious, mortality is high 90% |
| mortality rate difference b/n suprarenal AAA and infrarenal AAA | suprarenal has the greater mortality rate and kidneys aren't perfused |
| what are the hemodynamic effects of dissection one of the layers | increase SVR, decreased bld vol |
| which aneury. will there be diff. swallowing | descending |
| where do you place a A/line in a descend. and ascend. | descend.=R ascend=L |
| what's most important during intraop | control BP <120 |
Created by:
melbacs
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