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Senior Rotations > Cardiac, Thoracic, and Vascular > Flashcards

Cardiac, Thoracic, and Vascular Flashcards

1
Q

3 arteries that branch from aortic arch?

A

brachiocephalic

left common carotid

left subclavian

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2
Q

4 arteries (2 pairs) that supply blood to the Circle of Willis

A

left and right common carotids

left and right internal carotids

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3
Q

acute arterial disease?

A

occlusion, embolitic disease, plaque rupture, thrombosis

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4
Q

2 options to treat acute arterial occlusion

A

embolectomy

thrombolytic medication (heparin)

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5
Q

six “P’s” that indicate acute arterial occlusion

A

pain

pallor

pulselessness

paresthesia

paralysis

poikilothermia

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6
Q

chronic arterial disease?

A

calcium and cholesterol within the wall of an artery

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7
Q

define arteriosclerosis

A

aging process

hardening/thickening of arteries

too much pressure

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8
Q

define atherosclerosis

A

pathologic process (type of arteriosclerosis)

buildup of fats, cholesterol, plaque

calcification

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9
Q

athero vs. aterio sclerosis

A

arterio - aging, high BP, hardening

athero - pathologic, plaque

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10
Q

define atheroma

A

deposit of plaque in an artery

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11
Q

define aneurysm

A

local abnormal dilation of a blood vessel

structural weakening of the intima

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12
Q

pseudoaneurysm

A

false

disruption of all vessel layers

arterial blood collects in perivascular tissue

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13
Q

dissecting aneurysm

A

tear allowing blood to dissect between vessel layers

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14
Q

fusiform aneurysm

A

spindle shaped

complete circumferential involvement of artery

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15
Q

saccular aneurysm

A

sac with a narrow neck on side of artery

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16
Q

define intermittent claudication

A

muscle cramping during exercise

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17
Q

intermittent claudication indicates?

A

vascular disease in aortoiliac vessels and distal arteries

lower extremity PAD

not enough O2 distal to obstruction

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18
Q

define rest pain

A

pain in the foot at rest

no O2

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19
Q

rest pain indicates?

A

critical ischemia

ulcers

gangrene

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20
Q

CVA

A

cerebrovascular accident

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21
Q

define stroke/CVA

A

infarction of brain tissue due to lack of blood

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22
Q

TIA

A

transient ischemic attack

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23
Q

define transient ischemic attack

A

temporary localized reduction of blood floow (O2) to brain

less than 24 hrs

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24
Q

causes of TIA

A

atheromatous debris

thromboembolism from a carotid

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25
Q

fix TIA?

A

carotid endarterectomy

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26
Q

acute venous disease (DVT)

A

clot in deep venous system (lower extremity)

endothelial injury

venostasis

hyper coagulability

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27
Q

DVT symptoms

A

limb swelling

pain

skin color change

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28
Q

danger of DVT

A

emboli to right ventricle then lungs (fatal)

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29
Q

2 noninvasive imaging procedures to diagnose

A

MRI

doppler/ultrasound

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30
Q

angiography

A

injection of dye into venous and arterial systems

diagnose AV malformation, aneurysm, tumors, stenosis, vascular accidents

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31
Q

arteriography

A

injection of dye in the arterial system

diagnose AV malformation, aneurysm, tumors, stenosis

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32
Q

venography

A

x-ray of veins with dye

diagnose blood clots in legs and abdomen, DVT

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33
Q

why do angiography or venography?

A

diagnose problems in arterial and venous systems intraoperatively

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34
Q

describe doppler

A

change in frequency of echo signals when there is a change in distance

ultrasound beam reflected by moving RBC

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35
Q

why do we use doppler?

A

information by sound, graph, spectral analysis

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36
Q

advantages of doppler

A

available

easy

inexpensive

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37
Q

why use water-soluble gel on intact skin

A

conduction

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38
Q

doppler signal of a healthy artery

A

biphasic or triphasic

systole then early diastole, late diastole

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39
Q

doppler signal of an unhealthy artery

A

low pitched, monophasic

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40
Q

unhealthy doppler indicates?

A

stenosis or occlusion

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41
Q

bruit

A

low pitched blowing sound

heart at points of severe stenosis

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42
Q

bruit indicates?

A

vessel stenosis

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43
Q

CVP lines

A

catheter in the right internal jugular vein

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44
Q

why use a CVP line?

A

assessment of blood volume and vascular tone

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45
Q

umbilical tape/vessel loops in vascular

A

retraction and vessel control

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46
Q

preferred suture material for vascular anastomosis

A

synthetic monofilament nonabsorbable 0 to 10-0

double armed

pledget

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47
Q

preferred suture names in vascular

A

prolene

dacron

polyester

PTFE

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48
Q

why is the preferred suture material used

A

strong

pass through vessel walls easily

little trauma

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49
Q

pledget

A

small piece of teflon used to buttress under suture

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50
Q

why use pledgets?

A

over arteriotomy site

bleeding through needle hole in major vessels

friable tissue

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51
Q

systemic anticoagulation drug

A

heparin

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52
Q

why anticoagulate in vascular?

A

prevents clots

prevents thromboembolitic event before placing a clamp

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53
Q

reverse systemic anticoagulation

A

protomine sulfate

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54
Q

why use hep saline?

A

irrigation of lumen/shunt

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55
Q

drug to prevent spasm in harvested autologous vein grafts?

A

papaverine

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56
Q

why use hemostatic agents?

A

promote adhesion of platelets

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57
Q

absorbable gelatin sponge (Gelfoam)

A

mechanical hemostasis

apply to bleeding surface (forms matrix)

contraindicated in infection

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58
Q

absorbable collagen (Avitene, Hemopad, Helistat)

A

seals anastomosis

chemical/mechanical hemostasis

form fibrin

contraindicated in infection

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59
Q

oxidized cellulose (Surgicel, Oxycel)

A

dry mechanical hemostasis

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60
Q

fibrin glue

A

fibrin patch seals anastomosis

w/cryo, bovine thrombin, calcium chloride

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61
Q

topical thrombin

A

chemical hemostasis

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62
Q

3 most common and serious complications in vascular

A

infection

hemorrhage

thrombi/embolism

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63
Q

3 types of venous conduits for bypass grafting

A

reversed

non-reversed

in-situ

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64
Q

reversed venous conduit

A

valves reversed so blood isnt obstructed

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65
Q

in-situ venous conduit

A

lower extremity

reverses blood flow

disrupts intimal valves

anastomosis distally and proximally

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66
Q

non-reversed venous conduit

A

renal

mesenteric

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67
Q

in-situ vs. reversed vein grafts

A

in-situ: valves need to be stripped (less invasive)

reversed: no stripping of valves

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68
Q

4 synthetic graft materials

A

Dacron knitted polyester: porous allows fibrous tissue to ingrow

Dacron woven polyester: leakproof

filamentous velour: porous, knee joint, crimped or not

PTFE: lattice, cells grow

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69
Q

pros and cons of the 4 graft materials

A

knitted polyester: hypothrombogenic flow surface

woven polyester: leakproof, only for aortic replacement/bypass

filamentous velour: leakproof, antibiotic

PTFE: stable, antibiotic, seeded endothelial cells

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70
Q

which grafts must be preclotted?

A

Dacron: knitted polyester

filamentous velour

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71
Q

why preclot?

A

wall of graft becomes impervious to blood

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72
Q

how to preclot?

A

soak in patient’s own blood before systemic heparinization

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73
Q

PTA

A

percutaneous transluminal angioplasty

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74
Q

percutaneous transluminal angioplasty

A

local/fluoroscopy needle into artery

endovascular device placed

common iliac for stenosis

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75
Q

why perform PTA

A

severe ischemia/claudication

localized or segmental stenosis of common iliac

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76
Q

balloon angioplasty

A

dilation endovascular catheter

displace plaque against walls when inflated

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77
Q

intraluminal stenting

A

stent placed after balloon angioplasty

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78
Q

laser angioplasty

A

laser destroys plaque

supplements balloon angioplasty

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79
Q

atherectomy

A

catheter mounted instruments for transluminal removal of plaque

rotating cam, burr, side cutter

fluoroscopic guidance

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80
Q

emoblectomy/thrombectomy

A

invision into an artery to remove plaque

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81
Q

why perform embolectomy/thrombectomy

A

remove thromboembolitic material and restore blood flow

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82
Q

fogarty balloon catheter

A

inserted proximally

advanced distally past obstruction

inflated and pulled out w/plaque

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83
Q

solution that inflates balloon catheter

A

.5-2ml hep saline

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84
Q

embolus

A

thrombus broken free and moved towards the brain

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85
Q

thrombus

A

solid mass formed locally

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86
Q

thrombolytic therapy

A

bolus or x-ray catheter into vessel with thrombus for 24-72 hrs

breaks up clots

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87
Q

3 agents in thrombolytic therapy

A

streptokinase

urokinase

tissue type plasminogen activator

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88
Q

vena cava filter insertion

A

endovascular filter in right jugular or femoral vein (vena cava)

fluoroscopic placement

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89
Q

purpose of vena cava filter insertion

A

prevent emboli from traveling to the lungs

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90
Q

Mobin-Uddin umbrella and Greenfield filters

A

Mobin: permanent, cone shaped titanium, below renal veins

Greenfield: permanent, clots larger than 3mm, cone shaped titanium, below renal veins

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91
Q

AAA

A

abdominal aortic aneurysmectomy

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92
Q

AAA procedure

A

surgical obliteration of the aneurysm w/ or w/o iliac arteries

graft to maintain continuity

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93
Q

position & incision for AAA

A

supine

midline from xiphoid process to symphysis pubis

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94
Q

2 self-retaining abominal retractors in AAA

A

Bookwalter

Omnitract

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95
Q

3 vascular clamps for aortic occlusion

A

DeBakey

Statinsky

Fogarty

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96
Q

why mark pedal pulses pre-op?

A

rapid access

must be checked intra-op

doppler

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97
Q

Mannitol/Lasix in aortic clamping

A

prevent ischemic renal failure

preserve kidney function

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98
Q

AAA complications

A

hemorrhage

ischemic organs

injury to organs nearby

renal failure

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99
Q

most common cause of AAA

A

atherosclerosis

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100
Q

where are most AAAs found?

A

abdominal aorta

between renal arteries and aortic bifurcation

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101
Q

declamping shock?

A

severe hypotension after declamping aorta

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102
Q

2 methods of graft insertion

A

open inclusion: graft inside aneurysm with the sac closed over it

open exclusion: graft placed beside unopened aneurysm sac

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103
Q

carotid endarterectomy

A

remova of atheroma at carotid bifurcation to increase cerebral perfusion

104
Q

why perform carotid endarterectomy?

A

increase cerebral perfusion

decrease stroke/embolization

105
Q

head position for carotid endarterectomy

A

supine with head turned away from operative site

neck hyperextended

106
Q

2 methods of anesthesia in carotid endarterectomy

A

general: needs EEG

cervical plexus block: patient provides info

107
Q

why use a shunt in carotid endarterectomy?

A

continuous blood flow to brain intra-op

108
Q

2 shunts in carotid endarterectomy

A

Javid

Argyle

109
Q

order of clamp removal in carotid endarterectomy

A

external, common, internal

110
Q

why is there a clamp removal sequence?

A

make sure no debris goes up the internal carotid to the brain

111
Q

self-retaining retractor in carotid endarterectomy

A

weitlaner

112
Q

instrument to make initial arteriotomy

A

11 blade on a #7 handle

113
Q

instrument to extend arteriotomy

A

potts angulated scissors

114
Q

femoral-popliteal and femoral-tibial bypass

A

restore blood flow to leg by bypassing the femoral, popliteal, or tibial arteries

115
Q

position for fem-pop or fem-tib

A

supine

hip externally rotated and abducted

knee flexed

116
Q

self-retaining retractor for groin incisions

A

Gelpi

Garrett

Weitlaner

117
Q

why use a tunneler?

A

tunnel graft under the skin

118
Q

fem-pop in situ

A

bypass femoral artery with saphenous vein

incise venous valves/tributaries

119
Q

fem-pop in situ advantages and contraindications

A

increased graft availability and patency

varicose veins

previous saphenous stripping/ligation

120
Q

instruments used to incise intimal valves

A

microvascular scissors

valvulotome

leather in situ valve cutter

121
Q

femorofemoral bypass

A

extranatomic (unusual) bypass to restore blood to one leg

122
Q

why is femorofemoral bypass performed?

A

when inflow is needed but an aortic procedure needs to be avoided

123
Q

where is a femorofemoral graft placed?

A

subcutaneously acorss the symphysis pubis

124
Q

what graft is used for a femorofemoral graft?

A

Dacron

PTFE

125
Q

what is axillofemoral bypass?

A

subQ placement of a prosthesis

axillary artery to femoral artery on same side

126
Q

define amputation

A

partial or complete removal of a limb

127
Q

why perform amputation?

A

ischemia

gangrene

narcotic, infected tissue

trauma

malignancy

128
Q

2 most frequently performed amputations

A

above the knee

below the knee

129
Q

define fasciotomy

A

cutting away fascia to release pressure

130
Q

why perform fasciotomy

A

decompression to prevent compartment syndrome

after acute ischemia of an extremity

131
Q

describe varicose vein ligation/stripping

A

removing or tying off saphenous vein and branches

132
Q

why perform varicose vein ligation/stripping?

A

remove diseased veins to prevent:

ulcers

edema

pain

fatigue

133
Q

what vein is excised in varicose vein ligation/stripping

A

saphenous

134
Q

instrument used in varicose vein procedures?

A

semiflexible stripping device

135
Q

dressing post-op varicose vein procedure?

A

cotton elastic bandage for compression

136
Q

define AV fistula (native)

A

direct connection w/ patient’s own vessels

137
Q

define AV fistula (bridge)

A

v-shaped for vessels close to each other

dialysis, no maturation

PTFE graft

138
Q

why create AV fistulas?

A

long-term dialysis

allows vein to be punctured with large bore needles

139
Q

Brescia-Cimino fistula

A

anastomosis of radial artery and cephalic vein

140
Q

basic principle governing fistula placement

A

start distal arm and move proximally with following fistulas

141
Q

common vessels for AV fistula

A

radial artery

cephalic vein

ulnar artery-basalic vein

brachial artery-brachial/cephalic

142
Q

define arterialize (mature) a vein

A

thicken wall to withstand pressure

143
Q

how long does it take an AV fistula to mature?

A

3 weeks

144
Q

most common complications with AV fistulas

A

stenosis

venous hypertension

aneurysm

infection

congestive heart failure

145
Q

describe a portosystemic shunt

A

shunt between portal system (liver) and systemic venous systems

146
Q

why create a portosystemic shunt?

A

decompress esophageal varices

prevent hemorrhage

relieve pain

147
Q

goal of portosystemic shunt

A

palliative

reduce portal hypertension/portal venous flow

148
Q

3 types of portosystemic shunts

A

Warren/distal splenorenal

mesocaval

postcaval

149
Q

Warren/distal splenorenal (porto)

A

anastomosis of splenic vein-left renal vein

150
Q

mesocaval (porto)

A

superior mesenteric vein to inferior vena cava

151
Q

postcaval (porto)

A

end to side or side to side of portal vein and inferior vena cava

interposition H graft

152
Q

describe coronary artery disease

A

stenosis or obstruction of coronary arteries

occlusive/ischemic heart disease

myocardial infarction

153
Q

describe angina pectoris

A

ischemic chest pain

fatigue

syncope

dyspnea

154
Q

myocardial infarction

A

heart attack

death or injury to the myocardium resulting from occlusion or atherosclerotic lesions

155
Q

describe coronary artery bypass grafting

A

arterial bypass on cardiopulmonary bypass

156
Q

common vessels for CABG

A

internal mammary artery

greater saphenous vein

radial artery

157
Q

percutaneous transluminal coronary angioplasty

A

fluoroscopy w/ image intensification balloon dilation of coronary arteries

significant atheroscletoric plaque

158
Q

percutaneous transluminal coronary artery stenting

A

stent pushes plaque against the wall

permanent

159
Q

why use induced hypothermia in open-heart

A

reduction in O2 consumption

myocardial protection in long cases

160
Q

define cardioplegia

A

reduce O2/energy needs

potassium

161
Q

define cerebroplegia

A

protection by infusing O2 blood to the brain

antegrade into right common carotid

retrograde in superior vena cava

162
Q

describe circulatory arrest

A

all blood flow stopped, cooled to 18C, bypass turned off

creates a dry field when the aorta can’t be clamped off

163
Q

heart-lung bypass process

A

oxygenation and circulation

systemic heparinization

cannulas

lungs deflated and immobilized

164
Q

cannula placement for CPB

A

venous in superior and inferior vena cava

to machine

back in ascending aorta or femoral artery

165
Q

semi-lunar valves

A

aortic-left ventricle to aorta

pulmonary-right ventricle to pulmonary artery

166
Q

atrioventricular valves

A

mitral/bicuspid-left

tricuspid-right

167
Q

blood flow through heart

A

right atrium > tricuspid > right ventricle > pulmonary valve > lungs > pulmonary veins > left atrium > mitral > left ventricle > aortic > aorta > systemic

168
Q

systole and diastole

A

systole: contracts to pump blood into arteries
diastole: relaxes to allow chambers to fill

169
Q

3 primary coronary arteries

A

left anterior descending

circumflex

right coronary artery

170
Q

describe the coronary sinus

A

posterior coronary sulcus empties in right atrium

cardiac venous blood return

171
Q

impulse conduction in heart

A

SA node (perkinje) > AV node > bundle of His

AV node is atrium to ventricle communication

172
Q

epicardium

A

visceral pericardium: outermost slippery serous mesothelium

173
Q

myocardium

A

middle layer, thickest, 95%

cardiac muscle functional syncytium

174
Q

endocardium

A

innermost endothelium

lines valves and chambers

minimize friction and prevents blood clots

175
Q

pericardial sac

A

anchors, protects, friction free movement

fibrous, serous: parietal, visceral

176
Q

ribs in thoracic cage?

A

12 pairs

7 true

5 false

177
Q

parts of the sternum

A

manubrium

gladiolus

xiphoid process

178
Q

4 most common thoracotomy incisions

A

posterolateral

thoracoabdominal

anterolateral

median sternotomy

179
Q

posterolateral incision

A

nipple to ribs to spine

180
Q

thoracoabdominal incision

A

axillary to abdomen

181
Q

anterolateral incision

A

below breast to axillary line

182
Q

median sternotomy

A

vertical suprasternal notch to xiphoid process

183
Q

3 chest spreaders/rib retractors

A

Burford

Finochietto

Baily spreader

184
Q

baily rib approximator

A

post thoracotomy to help close ribs

185
Q

define hemoptysis

A

coughing up blood from lungs/airway in sputum

186
Q

define hemothorax

A

blood in pleural cavity

187
Q

define pneumothorax

A

collapsed lung, air in pleural space

188
Q

define atelectasis

A

collapse of part or all of the lung

189
Q

pericardectomy

A

partial excision of thick, adhered pericardium to relieve constriction

restricts diastolic filling

190
Q

thoracentesis

A

remove fluid from pleural space

needle in chest wall w/ ultrasound

191
Q

bronchoscopy

A

visualize trachea, bronchi, lungs

diagnostic, remove foreign body, small tumor, biopsy

192
Q

bronchoscopy position

A

supine or sitting

head to right to see left

head to left to see right

193
Q

3 lobes or 2 lobes? (lungs)

A

right has 3

left has 2

194
Q

define empyema

A

pus in pleural cavity

195
Q

define pleural effusion

A

buildup of fluid in pleural cavity

196
Q

treat chronic empyema/pleural effusion

A

thoracentesis

thoracostomy

197
Q

describe talc pleurodesis/poudrage

A

using chemical sclerosing agent to remove the space

fusion of pleural layers prevents serous production and accumulation

198
Q

describe pulmonary decortication

A

membrane stripping removes a restrictive layer over lung

re-expand lung and fill space after drainage

199
Q

why use a double-lumen ET tube in thoracic

A

expand unaffected lung

collapse surgical lung

200
Q

define vital capacity

A

max air expelled after max inhalation

3-5 liters

201
Q

define tidal volume

A

resting respiration

air inhaled OR exhaled

.5 liters

202
Q

define residual volume

A

air in lungs after max exhalation

cannot expel

1.2 liters

203
Q

describe the thoracic outlet

A

manubrium anteriorly, 1st rib anterolaterally, 1st thoracic vertebra posteriorly

subclavian artery/vein, vertebral artery, brachial plexus pass through

204
Q

thoracic outlet syndrome

A

change in anterior/middle scalene muscle causes intermittent pressure/pain/paralysis of an upper extremity

205
Q

treat thoracic outlet syndrome

A

scalenectomy

scalenotomy

rib resection

206
Q

pectus excavatum

A

funnel chest: deep depression of the chest

posterior displacement of sternum

207
Q

pectus carinatum

A

pigeon chest: protrusion of the chest over the sternum

208
Q

patent ductus arteriosus

A

fetal ductus anteriosus doesn’t close (connects pulmonary artery to aorta)

ligation

division of the ductus

209
Q

atrial septal defect/ventricular septal defect

A

ASD: hole in interatrial septum

VSD: hole in intraventricular septum

primary closure

synthetic patch

bovine patch

210
Q

coarctation of the aorta

A

localized constriction of the aortic arch

hypertension up

hypotension down

211
Q

treat coarctation of the aorta

A

anastomosis w/ resection

pericardial or synthetic patch

212
Q

tetralogy of Fallot

A

anterior malalignment of the infundibular septum w/ muscular septum

VSD, right ventricular hypertrophy, subpulmonic stenosis, aortic override of the ventricular septum

213
Q

myasthenia gravis

A

autoimmune neuromuscular

removal of thymus

214
Q

define dyspnea

A

painful/difficult breathing

215
Q

pneumonectomy

A

excision of an entire lung for malignant neoplasm or extensive unilateral pulmonary disease

posterolateral incision

216
Q

lobectomy

A

one or more lobes removed

neoplasm confined to lobe

posterolateral incision

217
Q

segmental resection

A

removal of individual bronchovascular section

pathologic process confined or acute hemorrhage

218
Q

wedge resection

A

remove a wedge with no concern about lobes

benign lesion, margins or peripheral lobe

219
Q

mediastinoscopy

A

mediastinal lymph nodes for biopsy

assessment of resectability for patients w/ bronchogenic carcinoma or lesions

220
Q

mediastinum

A

heart

esophagus

thymus/thoracic duct

trachea, bronchi, lymph nodes

221
Q

principle complication with mediastinoscopy

A

major bleeding

222
Q

ICD implantation

A

transvenous/endoacardial implanted in subQ pocket in chest wall (generator)

epicardial in abdomen

223
Q

ICD

A

electrodes sense ventricular tachycardia or fibrillation

shock to normal rhythm

224
Q

cardiac resynchronization therapy

A

leads placed in right atrium and ventricle

left ventricle pacing done with an electrode in coronary sinus/vein to left heart

r+l ventricles pump and AV node is synchronized

225
Q

valve replacement surgery

A

mechanical valve mimics human valve leaflets

insufficiency

lifetime anticoagulation

226
Q

rheumatic fever

A

untreated streptococcal infection antibodies attack heart valves

leaflets inflamed

stenosis or leaky valve

227
Q

valve annuloplasty

A

reduction of a dilated annulus

device pulls leaflets together

228
Q

valve commissuotomy

A

separation of the fused, adherent leaflets of the mitral valve

229
Q

heparin

A

anticoagulant prevents clotting

230
Q

protamine sulfate

A

reverses heparin

231
Q

papaverine

A

vasodilation reduces vasospasm

232
Q

lungs

A

respiration and excretion

soft, spongy, conical

bilateral in thoracic cavity/mediastinum

233
Q

base/apex of lungs

A

apex is superior most

base is broad and flat

234
Q

hilum of lungs

A

concavity on mediastinal surface

pulmonary root enters/exits

235
Q

pleural cavity

A

potential space between pleura

negative pressure vacuum

prevents lung collaspe

236
Q

parietal/visceral pleura

A

parietal: serous lining inner chest wall
visceral: serous lining outer surface of each lung

237
Q

pulmonary root

A

primary bronchus

lymphatic vessels/nerves

bronchial arteries/veins

pulmonary arteries/veins

238
Q

lung lobe

A

individual units of a lung

239
Q

bronchopulmonary segment

A

smaller units of a lobe

10 in right

8 in left

240
Q

bronchus

A

convey air into and out of the lungs

241
Q

Matson rib stripper/elevator

A

double-ended

cutting and dissection

scrape periosteum from ribs before cutting with a shear

242
Q

Duval lung forceps

A

grasping and holding (lung tissue)

angled or straight w/ triangular tips and horizontal serrations

243
Q

Doyen rib raspatories

A

cutting and dissecting

scrape periosteum from ribs before cutting

c-shaped curve at the end

244
Q

Farabeuf raspatory

A

Alexander: cutting and dissecting

scrape periosteum from ribs

double-ended blade, straight and curved

245
Q

endocardial/myocardial leads

A

endocardial/transvenous: no thoracotomy, fluoroscopy

epicardial: thoracotomy/stenotomy in ventricular myocardium

246
Q

transvenous pacemaker insertion

A

artial, ventricular, or both contraction

for complete heart block or bradydysrhythmias

247
Q

2 types of pacemaker generators

A

artial

ventricular

lithium battery

248
Q

mitral valve stenosis

A

narrowing of orifice that impedes forward blood flow

rheumatic fever

limit blood flow to l. ventricle and rise in pressure/dilation of l. atrium

249
Q

mitral valve regurgitation

A

leaflets don’t close

blood back into l. atrium during ventricular systole

250
Q

types of valve implants

A

mechanical: tilting disk
bio: porcine (pig), bovine (cow), equine (horse)

aortic allograft

251
Q

mechanical valve

A

complete closure with slight regurgitation

lifetime anticoagulation

252
Q

porcine valve

A

aortic valve from pig sutured to dacron stent/or no stent

no anticoagulation

253
Q

bovine valve

A

pericardial onto dacron ring

no anticoagulation

254
Q

equine valve

A

pericardial into tube into ring

no anticoagulation

255
Q

select valve prosthesis

A

hemodynamics

thromboresistance

anatomic stability

256
Q

mitral stenosis problems

A

pulmonary hypertension

right ventricular hypertrophy

tricuspid valve regurgitation

Senior Rotations (8 decks)

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