Basic Radiographic Interpretation and Mechanical Circulatory Devices Flashcards
What typically shows up as a white to light gray color on an x-ray of the human body?
Bone
T/F: The left side of the diaphragm is always higher than the right side.
False
Your patient has a tension pneumothorax. Would you expect for the diaphragm to be elevated or depressed on the chest x-ray?
Depressed
In relation to the carina, where would you expect a properly placed endotracheal tube to be on an x-ray?
A properly placed endotracheal tube should be 3-7 cm above the carina
You observe a “steeple sign” on a pediatric x-ray. What condition should you suspect?
Croup
You are transporting a 14-year-old multi-trauma patient that was trampled by a horse. Your patient is intubated and mechanically ventilated. Upon reviewing the patient’s chest x-ray you notice a large black crescent over the apex of the left lung. What should you suspect?
Collapsed left lung
You are participating in monthly quality assurance and you are reviewing run reports. You notice that a crew member described a chest x-ray as having “the presence of cardiomegaly, shaggy appearance around the heart boarder, and the presence of Kerley-B lines”. Based on this description, what condition does this indicate?
Congestive heart failure
On a PA film, the normal heart your be no more than ____% width of the film (otherwise it would indicate cardiomegaly).
50
T/F: On a head CT, black spots typically indicate an infarct or old blood.
True
T/F: On a head CT, white spots typically indicate acute bleeding.
True
T/F: Coronary blood flow increases during systole.
False, coronary blood flow increases during diastole.
_________ is the amount of blood pumped out of the left ventricle during each cycle.
Ejection fraction
What is the equation for calculating cardiac output?
Cardiac output = stroke volume x heart rate
T/F: The primary benefit to the intra-aortic balloon pump (IABP) is that it corrects a supply versus demand mismatch in the heart.
True
Your patient has an intra-aortic balloon pump (IABP). You know that the IABP will __________ this patient’s afterload.
decrease
The proper positioning of the intra-aortic balloon pump (IABP) after insertion is _____cm _________ the subclavian artery.
1 - 2, below
Which of the following patients would be a candidate for an intra-aortic balloon pump (IABP)?
a) A patient with a history of SVT
b) A patient with a congenital heart defect
c) A patient with unstable angina
d) A patient who is in hemorrhagic shock following a motor vehicle accident
c) A patient with unstable angina
Which of the following represents an absolute contraindication for the intra-aortic balloon pump (IABP)?
a) Cardiogenic shock refractory to pressors
b) Cardiac tamponade
c) Patients under the age of 18
d) Severe aortic valve insufficiency
d) Severe aortic valve insufficiency
You observe what appears to be rust in the intra-aortic balloon pump (IABP) tubing. What should you suspect that is?
Blood in the tubing
If the machine fails for an intra-aortic balloon pump (IABP) and the balloon become immobile, it must be inflated by hand every ______ minutes.
5 - 10
How much air or helium should be in the syringe that is used to manually inflate the IABP balloon in the event of failure?
60
What part of the EKG is used by the IABP to determine balloon inflation?
R wave
Which of the following patients would be a candidate for ECMO?
a) A patient waiting for cardiac surgery that has very low cardiac output with end-organ damage
b) A patient with advanced multi-system organ failure
c) A patient in septic shock who is unresponsive to other treatments
d) A patient who is in severe metabolic acidosis with low cardiac output
a) A patient waiting for cardiac surgery that has very low cardiac output with end-organ damage
T/F: In ECMO patients, there should be hourly assessments of neurovascular status in cannulated limbs and hourly assessment of urine output.
True
Which of the following statements best describes the purpose of a ventricular assist device (VAD)?
a) It is designed to replace all the functions of the heart
b) It must only be used in conjunction with a pacemaker
c) it only assists the right ventricle
d) It decreases the workload of the heart while maintaining adequate flow and blood pressure
d) It decreases the workload of the heart while maintaining adequate flow and blood pressure
You are transporting a patient with a ventricular assist device (VAD). As you are auscultating heart tones, you note that the VAD is making a knocking sound. You should suspect that this indicates:
that the patient is hypotensive or that the VAD is in overdrive (suckdown)
T/F: A patient with a ventricular assist device (VAD) can be in a lethal arrhythmia and still be hemodynamically stable.
True
T/F: The loss of peripheral pulses in a patient with a ventricular assist device (VAD) always indicates shock or cardiac arrest.
False
What is the first-line treatment of an unstable ventricular assist device (VAD) patient?
attempt volume resusitation
