Cardiopulmonary Part Four Flashcards
where would there be loss of hair for intermittent claudication
loss of hair over anterior tibial area
procedure for ABI
pt in supine at rest for 5 minutes
BP cuff inflated to occlude flow temporarily then deflated
examiner listens to return of flow
how to interpret venous filling time
delayed filling (over 15 seconds) is indicative of venous insufficiency
for rubor of dependency, when is arterial insufficiency indicated
changes that take longer than 30 seconds
what does ABI assist in
finding risk for cardiovascular disease
what blood test is the primary measure of MI
rise and fall of cardiac troponin
what other enzymes will be elevated following MI
CK or CPK
concomitant elevation of CK-MB
with intermittent claudication, when may leg cramps be a thing
diuretic use with hypokalemia
how to perform Trendelenburg Test
patient in supine with legs elevated to 60
tourniquet is placed on proximal thigh
patient asked to stand
examiner notes whether veins fill in normal pattern
purpose of Doppler Ultrasound
determines blood flow within a vessel
what is ankle brachial index
the ratio of LE pressure divided by UE pressure
what lymph nodes should be palpated
cervical
axillary
epitrochlear
superficial inguinal
what is air plethysemography
pneumatic device calibrated to measure patency of venous system volume
when is intermittent claudication test stopped
with clauditory pain
how long should veins take to fill for Trendelenburg Test
30 seconds
what is echocardiogram
noninvasive test that uses ultrasound to assess internal structures
where does the central line (Swan-Ganz) catheter insert
through vessels into right side of heart
how to interpret rubor of dependency
with insuffificiency, pallor develops in elevated position
how to perform percussion test
in standing, palpate one segment of vein while percussing vein approximately 20 cm or higher
purpose of chest x-ray
abnormalities of lung fluids
overall cardiac shape and size
aneurysm
what can Doppler ultrasound measure in LEs
systolic BP
Subjective Ratings of Pain with intermittent Claudication
Grade 1: Minimal discomfort or pain
Grade II: Moderate discomfort or pain; patient’s attention can be diverted
Grade III: intense pain; patient’s attention cannot be diverted
Grade IV: Excrutiating and unbearable pain
when is Doppler Ultrasound most useful
venous and arterial diseases
purpose of venous filling time
examine time necessary to refill veins after emptying
what tests helps determine ejection fraction
cardiac catheterization
procedure for rubor of dependency
examine color changes in skin during elevation of foot followed by dependency (seated, hanging position)
serum lipids (lipid panel) is used to determine
coronary risk
what peripheral system should ALWAYS be tested first and why
venous
venous insufficiency can invalidate some arterial tests
test for intermittent claudication procedure
have patient walk on level grade, 1 mile/hour (treadmill)
the rise and fall of troponin must accompany what in order to indicate MI:
symptoms of ischemia
new or presumed new ST changes on EKG
development of pathological Q waves on EKG
new loss of viable myocardium and/or new wall motion abnormality on imaging
evidence of intracoronary thrombus via catheterization or autopsy
an ABI over 1.40 indicates
non-compliant arteries
rubor of dependency tests veins or arteries
arteries
what arteries are used for ABI
UE: brachial
LE: poterior tibial and dorsalis pedis
purpose of myocardial perfusion imaging
ischemic heart disease
MI
what are normal values for ABI
1.00-1.40
what is cardiac catheterization
passage of a tiny tube from brachial or femoral artery through aorta into blood vessels with introduction of a contrast medium into coronary ateries and subsequent x-ray
how to perform venous fill time
patient supine, passively elevate LE to 45 for 1 min
place in dependent position
what does central line (Swan-Genz) catheter do
measures central venous pressure
pulmonary artery pressure
pulmonary capillary wedge pressure
how to interpret percussion test
if pulse wave is felt by lower hand, the intervening valves are incompetent
procedure for air plethysmography
cuff is inflated around calf, attached to a pressure transducer and microprocessor
when does CK or CPK peak after an MI
12-24 hours
purpose of percussion test
determines competence of greater saphenous venin
purpose of Trendelenburg Test
determines competence of communicating veins and saphenous system
