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Anesthesiology > Cardiovascular systeem, ECG, Blood pressure, and Temp > Flashcards

Cardiovascular systeem, ECG, Blood pressure, and Temp Flashcards

1
Q

Should low tech monitoring be used even if specialized equipment is being used?

A

Yes

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2
Q

Specialized equipment

A

ECG, BP (doppler, ocillometric, direct)

Pulse ox, Expiratory.end tidal CO2

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3
Q

When should animals be monitored?

A

Anytime heavy sedation is produced; vigilence depends on how profound the sedation is

Anytime anesthesia is produced; regardless of condition/procedure/duration

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4
Q

What equipment can we use to assess heart rate?

A
  1. Auscultation- stethoscope
  2. Pulse oximeter- accuracy?
  3. Doppler
  4. ECG
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5
Q

What does the parasympathetic system influence in respect to HR?

A
  1. SA and AV nodes
  2. Muscarinic receptors

Increase in parasympathetic tone results in bradycardia

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6
Q

What does the sympathetic system influence in respect to HR?

A
  1. SA and AV nodes,
  2. Ventricles
  3. Alpha-1, Beta-1/2 receptors

Increase in sympathetic tone results in tachycardia

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7
Q

What increases parasympathetic tone? (Bradycardia)

A 
Pressure on eyes/viscera
Drugs
Profound anestthetic depth
High serum potassium
SA node disease
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8
Q

What causes increases in sympathetic tone? (Tachycardia)

A 
Stimulation/pain
Hypovolemia/blood loss
Very elevated CO2
Hypoxemia
Drugs
Diseases
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9
Q

Does the ECG give accurate information about the function of the heart?

A

No, only the electrical activity

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10
Q

ECG for sinus arrhythmia

A

R-R variation congruent with respiration

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11
Q

Why do we monitor ECGs?

A

Detection of arrhythmias even if there is no history of one as they are common under anesthesia

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12
Q

ECG for sinus bradycardia

A

Regular increased R-R interval

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13
Q

Should sinus bradycardia be treated?

A

Only if HR is low enough to adversely effect CO or BP

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14
Q

Is the ECG the only thing that will tell us if we have an abnormal rhythm?

A

Yes, all other monitoring equipment will likely be normal

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15
Q

What is CO a product of?

A

HR and SV

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16
Q

Is CO easily monitored?

A

No, it requires an invasive catheter placed into the pulmonary artery

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17
Q

What are normal BPs?

A 
Systolic= 100-140mmHg
Diastolic= 50-70mmHg
MAP= 65-85mmHg
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18
Q

Which BP value best represents systemic perfusion?

A

MAP

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19
Q

MAP should be maintained greather than _____mmHg to maintain renal perfusion

A

60

20
Q

What are indirect ways to monitor BP?

A

Doppler ultrasonic flow

Oscillometric

21
Q

What are direct ways to monitor BP?

A

Arterial catheter and transducer recording system

22
Q

What are some advantages to Doppler?

A
  1. Continuous evaluation of pulse rate
  2. Sudden loss of sound may indicate cardiac arrrest
  3. Useful in tiny or exotic patients
  4. Relatively inespensive
23
Q

What are some disadvantages of doppler?

A
  1. Requires and operator for BP
  2. Subjective readings
  3. No MAP
  4. Difficult to capture if vasoconstriction/hypothermia/poor perfusion
24
Q

In oscillometeric BP measurements, which values are recorded and which ones are calculated.

A

Calculated: systolic and diastolic
Measured: MAP

25
Q

Advantages of Oscillometric BP monitoring

A
  1. Measure mean and calculates syst/diast
  2. Can be set to monitor at certain time intervals
  3. Stores values for review
26
Q

Disadvantages of Oscillometric BP monitoring

A
  1. Relatively expensive
  2. May not secure pressure at extremes of heart rate in abnormal rhythm
  3. May not read if hypotensive
  4. No monitoring in between readings
27
Q

What kind of BP is produced if cuff is too small/loose?

A

Artificially higher

28
Q

What kind of BP is produced if cuff is too large/tight?

A

Artificially lower

29
Q

What happens to BP if the cuff is below the heart?

A

Artificially higher

30
Q

Should the limb be straight or flexed for BP measurements?

A

Straight

31
Q

Which BP measurement type iss most accurate?

A

Depends on equipment/age/patient

32
Q

Which arteries are used for direct BP measurement?

A

Small animal: Dorsal pedal, coccygeal, or radial

Large animal: Dorsal metatarsal, facial, caudal auricular, transverse facial

33
Q

Where should the transducer be positioned in direct BP measurement?

A

Level of the heart

If too low= increased pressure
If too high= decreased pressure

34
Q

What does the shape of the pressure wave tell us?

A

Narrow wave- vasodilation and low diastolic pressure

Increased slope- low inotropy, SV, CO

35
Q

Electronic invasive BP facts

A
  1. More expensive
  2. Provides SAP, DAP, MAP, and waveform
  3. Waveforms provides quality of inotropy and venous return
36
Q

Sphygomomanometer invasive BP facts

A
  1. Inexpensive and portable
  2. Only provides mean
  3. No waveform
37
Q

Causes of Hypotension

A
  1. Bradycardia
  2. Vasodilation
  3. Poor cardiac function
  4. Hypovolemia/shock/sepsis
38
Q

Causes of Hypertension

A
  1. Light anesthesi
  2. Pain
  3. Drugs (catecholamines/ketamine
  4. Disease processes (+ICP, renal/adrenal dz)
39
Q

Why does anesthesia cause hypothermia?

A

Decrease of muscular activity, metabolism, and hypothalamic activity

Evaporative heat losses and anesthesia induced vasodilation

40
Q

Issues when body temp decreases to 96-97F

A

Minimal, some shivering may occur

Only an issue for cardiac/pulmonary paitents

41
Q

Issues when body temp decreases to 92-94F

A

Decreases anesthetic requirement but prolongs recovery

Will not shiver in recovery

42
Q

Issues when body temp decreases to 89-90F

A

HR/CO decreases and may not respond to tx, may interfere with healing mechanisms and slows recovery

43
Q

Do all animals require heat support?

A

Heavy coated dogs may become hyperthermic with additional heat support

44
Q

Should temp be monitored through recovery?

A

Yes, until the animal is normal

45
Q

Heating units

A
  1. Bair huggers
  2. Warm water circulating pads/blankets
  3. Pads/towels between patient and open surfaces
46
Q

Should traditional heating pads be used?

A

No, high risk of burns

Anesthesiology (27 decks)

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