Help
Options
Didn't know it?
click below
click below
Knew it?
click below
click below
Don't Know
Remaining cards (0)
Know
retry
shuffle
restart
0:00
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
HEMODYNAMIC
HEMO
| Question | Answer |
|---|---|
| Swan-Ganz is also called | flow-directed balloon tip catheter |
| pulmonary artery catheter enables medical practitioners to | acquire important hemodynamic info about the cardiovascular system as well as function of the right and left ventricles. |
| Indications for Swan-Ganz catheter | -Measure cardiac output via thermodilution technique -measure hemodynamic parameters associated with central venous pressure and ventricular function -acquire blood samples for mixed-venous analysis |
| Swan-Ganz catheter is approximately how long? | 110cm or 28in |
| Swan-Ganz consists of | -electronic thermistor cable to attach cardiac output monitor -balloon(or cuff) on distal end to inflate and acquire pulmonary capillary wedge pressure (PCWP) -Ports or openings in the catheter |
| Thermistor | temperature sensor imbedded near the tip of the catheter |
| Balloon or cuff | distal end to inflate and acquire the pulmonary capillary wedge pressure (PCWP) |
| Distal port | tip of catheter to measure pulmonary capillary wedge pressure, pulmonary artery pressure and draw blood for analysis |
| Proximal port placed where? | about 30cm from tip of catheter |
| Proximal port measures what? | right atrial pressure or CVP and for injection of iced saline to assess the cardiac output via thermodilution technique. |
| Insertion site flow-directed balloon-tipped catheter (Swan-Ganz) | internal jugular or subclavian veins |
| What technique is used to place catheter? | sterile technique |
| Where should the Pulmonary artery catheter tip enter during insertion? | large vein, into vessels until catheter tip enters the right side of the heart. |
| What happens after entry to the right side of the heart with the pulmonary artery catheter? | Balloon is inflated |
| How much air is used to inflate balloon on pulmonary artery catheter? | .8 to 1.5 depending on size of catheter |
| After balloon inflation what does the catheter do? | floats through the right atrium and right ventricle and into pulmonary artery |
| What does pressure waveforms note during insertion? | indicate position of the catheter |
| Right atrial pressure (RAP) is the same as | Central venous pressure (CVP) |
| Right atrial pressure is measured with | Swan-Ganz catheter in place at the proximal port which lies in the right atrium |
| Normal Diastolic RAP/CVP | 2-6 mmHg |
| Increase or decrease in RAP is most indicative of patients | volume status |
| Normal Systolic RVP pressure | 15-30 mmHg same as systolic PAP |
| Where does diastolic pressure read and what does it indicate? | Reads in right ventricle and indicates right ventricular preload or right ventricular end diastolic pressure (RVEDP) |
| Distention of RVP compared to RAP | RVP will have taller upstrokes reflecting higher pressure in ventricle. |
| Increased RVP may indicate | Decreased RV function ( increased preload; decreased RV ejection fraction) or hypervolemia |
| Decreased RVP indicates | hypovolemia |
| Ventricular preload or end-diastolic pressure | pressure in ventricle prior to contraction, during resting and filling stage. |
| Higher preload is | more blood in ventricle |
| Higher preload indicates one or two things: | -Decreased ventricular function ( |
| Pulmonary artery pressure reflects | RV peak systolic pressure |
| Where is the dicrotic notch located? | downslope of the PAP waveform |
| What does dicrotic notch indicate? | closure of pulmonic valve |
| Normal pulmonary artery pressure (PAP): (MPAP) | 9-18 mmHg |
| Normal pulmonary artery pressure (PAP) systolic | 15-30 mmHg |
| Normal PAP diastolic | 8-15 mmHg |
| Decreased PAP | with hypovolemia or dehydration |
| Increased PAP | with hypervolemia, increased pulmonary vascular resistance, pulmonary embolus, and left ventricular failure (increased pulmonary venous pressure) |
| Where is the pulmonary capillary wedge obtained from (PCWP)? | distal port of catheter with balloon inflated or wedged in place |
| What does the PCWP measure? | "Down-stream" preload or filling pressure of left side of the heart. Left ventricular end-diastolic pressure (LVEDP) |
| PCWP balloon should not be inflated more than | 15 sec during measurement to prevent pulmonary infarction |
| Normal PCWP or pulmonary artery occlusion pressure is | 6-12 mm Hg |
| PCWP sometimes referred to | pulmonary artery wedge pressure (PAWP) but not common. |
| PCWP measurement used to | assess preload in left side of heart |
| Increased left ventricular end-diastolic pressure (LVEDP) or preload | indicates decreased contractility of the left ventricle or fluid overload |
| PCWP in non-cardiogenic pulmonary edema | fairly normal |
| PCWP in cardiogenic pulmonary edema | will be elevated |
| PCWP Increased | -decreased left ventricular function -hypervolemia/ fluid overload -mitral valve stenosis |
| PCWP decreased | - systemic vasodilation -sepsis -hypovolemia |
| Cardiogenic shock | inability of the heart to pump blood adequately due to loss of contractility |
| Cardiogenic shock results of major | Myocardial infarction that destroys heart tissue or left ventricular hyper |
| Diminished left ventricular function characterized by | low cardiac output/ cardiac index, elevated PAP and PCWP, increased SVR (systemic vascular resistance) |
| SVR formula | map-cvp/ QT x80 |
| PVR formula | mpap-pcwp/ QT x 80 |
| MPAP normal | 10-20 mm Hg |
| MAP formula | systolic PAP + 2(diastolic) /3 |
| Normal PVR | 110-250 dynes/sec |
| systole | contraction phase of cardiac cycle. |
| Diastole | resting/ filling phase of cardiac cycle. |
| Mean arterial pressure | pressure propelling blood from LV to RA. |
| Mean arterial pressure related to | overall adequacy of tissue perfusion. |
| Frank Stallings law | greater preload, greater force of contraction, to the point where ventricular failure occurs. |
| preload | prior to contraction |
| Preload assessed by | measuring ventricular end-diastolic pressure |
| Mean arterial pressure normal | 70-105 mmHg |
| Stroke volume influences blood pressure by: | hypervolemia and hypovolemia |
| Arterial compliance influences blood pressure by: | arteriosclerosis |
| Arterial resistance influences blood pressure by: | Vasoconstriction, atherosclerosis, increased blood viscosity (increased hematocrit) |
| Pulse pressure | difference between systolic and diastolic pressure |
| Influences on pulse pressure | Widening (increasing) pulse pressure which indicates stroke volume or cardiac output. Narrowing (decreasing) pulse pressure which indicates decreasing stroke volume or cardiac output. |
| Contractility | inotropic state of myocardium or velocity of myo fiber shortening during systole. STRENGTH |
| Decreased myocardial contractility results to: | reduction in stroke volume and cardiac output leads to decrease perfusion and diminished oxygen delivery to tissues. |
| stroke volume | blood ejected during single ventricular contraction |
| Stroke volume formula | QT/HR x 1000 |
| normal stroke volume | 60-130 mL/ beats |
| cardiac out put (QT) | amount of blood ejected from heart in one min |
| Ejection fraction | percentage of blood pumped from ventricle during single contraction |
| left ventricular ejection fraction | 60-70% healthy, reduced with decreased contractility or valvular disease |
| End diastolic volume | after systole, blood remaining in ventricle |
| EF formula | SV/EDV |
| low EF | reaches about 50% |
| EF treatment | inotropic agents |
| EF decreased when | contractility of heart is impaired |
| oxygen delivery (DO2) | amount of O2 delivered to tissues each mi, primary function of cardiovascular system. |
| Delivery of O2 dependent among | blood flow(QT) and O2 content in arterial blood (CaO2). |
| amount of O2 delivered to tissues in a min | 1000 mL |
| O2 consumption (VO2) in a min | 250 mL/min |
| reserve of O2 | 750 mL |
| O2 content | content or total amount of O2 carried in the blood |
| Normal arterial O2 content (CaO2) | 18-20 mL/dl |
| normal venous O2 content (CVO2) | 14-16 ml/dl |
| O2 content takes into play with | hemoglobin and O2 stat. |
| CaO2 formula: | (Hb X 1.34 X SaO2) + (PaO2 X .003) |
| CVO2 formula : | (Hb X 1.34X SvO2) + ( PvO2 X .003) |
| one gram of hemoglobin combine with O2 is | 1.34 |
| O2 dissolved in every dl of plasma is | .003 mL |
| difference in venous and arterial O2 content | arteriovenous O2 content difference C(a-v) O2 |
| Normal arteriovenous O2 content difference | 3.5-5 ml/dl |
| Increase in arteriovenous O2 content difference indicates | decreased Qt |
| greater blood flow | less O2 removed in blood and smaller C(a-v) O2 |
| smaller the difference equals | greater Qt |
| VO2= | [C(a-v) O2 X 10] x Qt |
| Fick equation: | Qt= VO2/ CaO2 - CvO2 x 10 |
Created by:
Summerj
Popular Respiratory Therapy sets