Alex Final Review Flashcards
On a standard/average size patient, what would you use for a right coronary angiogram?
JR4
On a standard/average size patient, what would you use for left coronary angiogram?
JL4
On an average/standard size patient, what catheter would you use for a patient with a distended aorta?
A catheter larger than a JL4
OM is a branch off of what vessel?
CX
Diagonal is a branch off of what artery?
LAD
What comes off of the RCA?
marginals
What kind of catheters can engage into the RCA?
Williams right, amplatz right, JR4
What angle would be preferable to engage into the ostium of the right or left coronary artery?
LAO
Which view is preferable to cross into the aorta valve?
Choose RAO
Radiation safety
Time
distance
shielding
Thermal dilution catheter - Swan Ganz CO is normally accomplisbed with injection of cool or iced saline into the ______, while the thermister measures blood temp in the _____.
RA, PA
For a pressure transducer to be accurately zeroed and calibrated it must be?
Open to air
On the second day of PA catheter monitoring and RV waveform is observed from the distal catheter port. What do you need to do?
Inflate the balloon 1.5mm of air and advance the catheter.
The normal blood O2 in the right heart is?
70-80%
In Swan Ganz catheter, pullback waveform will be?
PCWP, PA, RV, RA
Swan Ganz is usually inserted using what?
a Sheath, which is inserted using the seldinger technique
Pressure sequence of swan ganz that is RV, PA, PCW is?
advance
What kind of catheter do you need to perform thermal dilution output?
Swan Ganz
Wires that can be used with Swan Ganz are:
J tip .035” 145cm wire
J tip .021” 150cm wire
J tip .021” 260cm wire
J tip .025” 260cm wire
Grossman recommends passing the right heart catheter from RA to RV by gentle forward and backward motion and clockwise rotation of the catheter, while the pt takes a deep breath. If these manuvers fail to pass the tricuspid valve after several attempts Grossman recommends:
insertion of J tip guide wire through the catheter
1 French size is equal to ____
0.33mm
Guide wire diameters are usually measured in?
thousandths of inches
Interventional guide catheters have ______ inner diameter and are more _____ ________ than diagnostic.
larger inner diameter and are more kink resistant
Scalpels?
10 - large curve, for large skin incisions
11 - pointed blade
12 - hooked “eagle beak” for fine slicing
15 - small curve, for smaller skin incisions
French size and colors?
6F Green 2.0mm
7F Orange 2.3
8F Blue 2.64
What needle is used for deep tissue infiltration with local anesthetic before sheath?
22G
What is the inner diameter of a 10F sheath?
3.3mm
10 * .33 =3.3mm
What can fit in a 6F sheath?
6F or smaller. ie. 4F, 5F
Manifold: from distal to proximal
Distal end: pt side (male end) Transducer Saline (waste bag) contrast Proximal end: Control Syringe (female end)
Interventional guiding catheter layers are:
Outside: hydrophilic
middle: mesh, PU (polyurethane), braided steel, or kevlar fibers
Inside: Teflon -because it is low abrasive for the guide catheters to go through it
Curve of Jedkins Left Coronary catheter is measured:
from primary to secondary
Universal presautions in emergency situations:
ALL body fluids of all patients are considered infectious
During catheterization you feel resistance, what do you do?
you stop and tell physician you feel resistance
Preferable view for coronary arteries engagement is?
LAO
The outer diameter of the 6F diagnostic catheter is?
2.0mm
Diagnostic catheters have _______ diameter and are _______ to kink than interventional catheters.
smaller diameter and are easier to kink
When do you need to flush the sheath?
after sheath insertion
every 3 minutes if not in use
after each catheter
Radiation safety is:
everyones responsibility
Pt has atherosclerotic calcified plaque in abdominal aorta. The best way to switch one diagnostic catheter for another one is to:
exchange over the wire
Guide wire diameter are usually measured in?
thousandth of inches
What chemical element in contrast makes it radiopaque (visible) to xray?
iodine
Catheter trackability to follow the guide wire through the?
vascular anatomy
During attempt to get femoral arterial access, non pulsatile dark blood appears from a seldinger needle. Visualized on the right side of the vertibral column. Physician got access into:
vein
There is an opened sheath on the table. You can not see the sheath on the side arm and blue hub. Probably the inner diameter of this sheath is:
2.64mm
