ANP1 Exam 3
Quiz yourself by thinking what should be in
each of the black spaces below before clicking
on it to display the answer.
Help!
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| how does TEE work | 1. sound waves penetrate tissue to creat 2-3 dimensional images
2. doppler echo uses US scatter from blood cells to measure velocity/direction of blood flow
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| when is TEE probe inserted | after pt anesthetized, ETT secured, OG inserted for decompression of stomach contents
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| how is TEE inserted | 1. mandible displaced anteriorly
2. probe placed into midline post. pharynx
3. inserted into esophagus
4. laryngoscope may be used to displace mandible and beter visualize esoph. opening
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| when does heart come into view | probe is in thoracic esophagus ~ 30 cm
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| TEE pt hx contraindications | 1. dysphagia
2. odynophagia (painful swallowing)
3. mediastinal radation
4. recent upper GI surg or bleeding
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| TEE esophageal pathology contraindications | 1. stricture
2. tumor
3. diverticulum
4. varices
5. esophagitis
6. recent chest trauma
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| TEE complications | 1. dental/oral trauma
2. laryngeal dysfx leading to post op aspiration
3. ETT displacement (R mainstem)
4. upper GI bleeding
5. pharyngeal/esophageal perf (rare)
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| TEE assessment | 1. **regional wall motion abnormalities - most sensitive indicator for cardiac event
2. SV (EF)
3. valve fx
4. intracardiac air
5. effects of AA/surg on cardiac fx
6. adequacy of IV volume
7. eschemic episode 4x more than ECG
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| ASA TEE categories | Category 1 - strongest evidence TEE is helpful
1. *valve repair
2. *congenital heart defects
3. hypertrophic obstructive CM
4. aortic dissection
5. *infective endocarditis
6. unstable, life threatening hemodynamics
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