CVP Terms and Definitions Flashcards
Volume pumped out of heart per beat is?
SV, Stroke volume
Preload
How much blood is in the ventricle prior to contraction/end of diastole
Afterload
*Pressure needed to open aortic valve in order to be pumped through rest of the body
What is Atelectasis?
a complete or partial collapse of a lung or lobe of a lung — develops when the tiny air sacs (alveoli) within the lung become deflated. It’s a breathing (respiratory) complication after surgery.
What is ARD’s?
occurs when fluid builds up in the tiny, elastic air sacs (alveoli) in your lungs. The fluid keeps your lungs from filling with enough air, which means less oxygen reaches your bloodstream. This deprives your organs of the oxygen they need to function.
What is angioplasty?
surgical repair or unblocking of a blood vessel, especially a coronary artery.
What is systole?
Systole is the last stage of a heart beat. It happens right after diastole, when the heart refills with blood. During systole, the heart’s two ventricles contract (squeeze).[1] (The ventricles are the largest parts of the heart, which pump blood to the body and lungs.)
What is diastole?
Diastole is the time during a heart beat when the heart fills with blood after a contraction. The contraction of the heart is called systole and is the opposite of diastole. This means expanding or opening.
Two types of diastole?
Ventricular diastole is the time when the two lower chambers of the heart called the ventricles are relaxing to let the blood to flow in.
Atrial diastole is the time when the two upper chambers of the heart called the atria are relaxing to allow the blood to flow in.
In a BP of 120/80 what would be systole and what would be diastole?
if a person’s blood pressure is 120/80, 120 is the systolic pressure, and 80 is the diastolic pressure.
Define dyspnea
Labored or troubled breathing
What is septicemia?
Blood poisoning, especially that caused by bacteria or their toxins. (commonly seen in junkies)
Describe the Coronary Ostia and locations
The coronary arteries originate as the right and left main coronary arteries, which exit the ascending aorta just above the aortic valve (coronary ostia). There are three cusps of the aortic valve: the non-coronary cusp, which contains no ostia, the right coronary cusp, which contains the ostia of the right coronary artery, and the left coronary cusp, which contains the ostia of the left (main) coronary artery. The ostia of the left and right coronary arteries are located just above the aortic valve, as are the left and right sinuses of Valsalva.
Oxygenated blood is pumped into the aorta from the left ventricle; it then flows into the coronary artery ostia. Blood flow into the coronary arteries is greatest during ventricular diastole
((**picture looked like the two ostial buttons are above the aortic valve and beginning of RCA and LCA))
Definition of precipitous
Dangerously high or steep
Describe pulmonary atresia
Pulmonary atresia is a form of heart disease in which the pulmonary valve does not form properly. It is present from birth (congenital heart disease). The pulmonary valve is an opening on the right side of the heart that regulates blood flow from the right ventricle (right side pumping chamber) to the lungs.
In pulmonary atresia, the fused valve leaflets form a solid sheet of tissue where the valve opening should be. This blocks normal blood flow to the lung. Because of this defect, blood from the right side of the heart cannot go to the lungs to pick up oxygen.
Where to you look to see retrograde cardioplegia pressure? Which range should it be in? What should flow be?
On the CDI monitor, 35-50 roughly. The flow should be roughly 200 and come up slowly so you do not rupture the coronary sinus
3 ways to deliver cardioplegia?
Retrograde, antegrade, ostial (very small tip, can take awhile so surgeon may not prefer this method if it takes awhile)
Difference between duel stage and triple stage? When would you use it? Where does the cannula sit?
Would be an extra set of holes on triple stage. Used mainly for procedures where you don’t need to go through the right side. It sits in the chamber of the right atrium. ((Wouldn’t work if they needed to work on pulmonary or tricuspid valve bc you would have nothing but air, RA is open))
Procedures you would use duel stage or triple stage?
- Aortic valves
- Coronaries
- Even in a dissection (bc you won’t be doing anything on the right hand side of the heart)
- Anything on left side of the heart
Use axillary cannulation when?
When there is a problem suspected with the aorta. When they suspect something may need to be done with the aortic root. May do axillary so it takes cannulation out of their way.
Want correct flow through a cannula, arterial we are looking for a _____ pressure drop an a _____ pressure drop with venous
Arterial-100mm
Venous-40mm
(gradient between the line pressure and patient pressure) (Check graph and say you need 5L go over to 5L and over to 100 for arterial.
Why would you move your reservoir up or down during the case?
Could use gravity to assist you in getting more drainage, could decrease your flow that way
*What ratio is del nido solution given at?
*(means are final review questions from greg)
1 part crystalloid, 4 parts blood
*In pH stat blood gas management, what are the changes in the pH and co2 when measured at 37 deg. C?
*pH will decrease & co2 will increase
*Normal p50 described in oxyhemoglobin dissociation curve is?
27 mmHg
When would you use pH stat? Temp corrected y/n?
Use pH stat during cooling
yes, temp corrected
When would you use alpha stat? Temp corrected y/n?
Use alpha stat during rewarming @37
no, not temp corrected
Main substitute for heparin?
Bivalurudin
______ type of cannulation is used for aortic valve?
*Duel stage
What type of surgery is for mitral valve prolapse?
Annuloplasty (annulus is the ring around valve)
What type of vent is used with AVR?
LV vent to not have blood accumulating
In tricuspid valve surgery _____ is used as a vent?
Drop sucker/floppy sucker
Pressure drop referring to cannulas is the difference between pressure ____ cannula and ____ cannula
- entering cannula
* leaving cannula
Where is LV vent placed?
Right superior pulmonary vein
What is the most commonly used cannula?
Duel stage
What type of cannula is used for total bypass?
Single stage
What 3 places would triple stage drain into?
IVC, SVC, RA
What does the arterial cannula cause? And why can this be bad?
- Jetting
* Can cause intimal lumen damage to aorta and hemolysis
Antegrade cardioplegia can be given where?
- aortic root
* or directly through the ostia
In retrograde cardioplegia flow is forced ________ through coronary veins, capillaries and arteries
Backwards
*Which of these sites is NOT appropriate for cannulation for veno venous (v-v) bypass? A)Femoral artery/carotid artery B)Femoral vein/internal jugular vein C)Internal jugular alone D)Right atrium directly
A) Femoral artery/carotid artery
(cause its arteries alone in this answer not veins)???
*Which of the following is true about diffusion?
A) Diffusion is a key factor in providing the exchange of gases, substrates and waste products between the capillaries and tissues
B) Movement of lipid soluble molecules is limited by pore size
C) Movement of lipid insoluble molecules is not restricted by pore size
D) Water soluble materials such as amino acids pass freely through the lipid membrane
A) Diffusion is a key factor in providing the exchange of gases, substrates and waste products between the capillaries and tissues
*Which of the following is true about the PR interval?
A) It’s measured from the end of the P to the beginning of the QRS complex
B ) It’s measured from the beginning of the P to the end of the QRS complex
C) It’s measured from the beginning of the P to the beginning of the S wave
D) It’s measured from the beginning of the P to the beginning of the QRS complex
?????? @ 6:30 mark
*While on CPB what is the only way to independently increase your pao2 levels?
B) Increase the fio2 which increases the concentration of o2 in the ventilating gas mix
*Which vessels offer the greatest resistance to flow?
D) Arterioles
*Patients weight is 187 lbs and he is 6’ 2” what’s his BSA?
187/2.2=85kg
6’ 2”=74” * 2.5cm=185 cm
kg*cm/3600 and square root
Answer= 2.1 BSA
*Which of the following factors shift the oxy hemoglobin curve to the left?
A) An increase pH and decreased blood pCo2
*What is true about the middle layer of an arterial wall?
D) Thickest layer and provides compliance of the artery
*What statement is TRUE about coumidin therapy?
B) Coumidin therapy prolongs the PT by antagonizing vitamin k dependent factors
*What mechanism is responsible for binding of platelets to damaged endothelium?
B) Formation of a platelet ligand matrix
*Which is FALSE about the coagulation cascade?
B) The activation of the extrinsic pathway is activated by the activation of kilikikren (intrinsic)
*The role of factor Vll (7) in the coagulation cascade is to?
D) Accelerate the conversion of factor 10 to 10a (X to Xa)
*Which of the following statements is FALSE about HIT?
B) Should be suspected in patients who experience 50% or greater increase in platelet count while on unfractionated heparin for more than 5 days (thrombocytopenia would be lower platelets not increased)
*Vitamin K dependent factors include..
Proconvertin and stewart factor
(proconvertin aka stabilizing factor aka Vll (7)
stewart factor= X (10)
*Which of the following is TRUE about a patient with arterial stenosis?
C) Patients may present with dyspnea and on exertion angina (chest pain)
*Which of the following is a contraindication for use of the intra aortic balloon pump?
C) Severe aortic insufficiency
*Donor recipient matching is critically important if one is to ensure a proper match, which of the following statements is FALSE regarding matching?
A) ABO barriers may be crossed
*During the zero phase of action potential which of the following occurs?
A) Influx of sodium ion and efflux of potassium ion
Influx=Inflow
Efflux=Flowing out
*Which of the following is FALSE about innervation of the heart?
B) Sympathetic stimulation slows the heart negative chronotrope
*Which of the following statements is TRUE about the regulation of the heart beat?
C) Parasympathetic tone predominates in both the SA and AV nodes
*The interior of normal cardiac cell at rest maintains a transmembrane potential of?
C) -80 to -90 milivolts
*Which of the following is an indication for placing a neonate on ECMO?
A) Respiratory failure sufficiently severe to be life threatening
Indications for DHCA w/ selective cerebral perfusion include?
C) acute disection of aorta and transverse arch
Indications for DHCA w/ selective cerebral perfusion include?
C) acute dissection of aorta and transverse arch
