hemodynamics Flashcards

1
Q

What is normal Intracranial pressure (ICP)

A

0-15 mmHg

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2
Q

What is cerebral blood flow

A

the amount of blood that flows through the brain. 15% of resting cardiac output.
1000L/24 hrs

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3
Q

Contraindications for ICP monitoring

A

-CNS infection
-coagulations defect
-coagulopathy
-scalp infection
-severe midline shift with ventricular displacement.
-cerebral edema resulting in ventricular collapse

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4
Q

What are the indication for ICP monitoring

A

-severe TBI
-intracranial hemorrhage
-cerebral edema
-post craniotomy
-space-occupying lesion
-Reye syndrome
-encephalopathy
-meningitis/encephalitis
-GCS of less than 8 or positive CT

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5
Q

What is cerebral perfusion pressure

A

-responsible for the movement of blood through the brain
-is the difference between MAP and ICP

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6
Q

What are the indications for central venous lines

A

-rapid fluid replacement
-medication administration
-rapid access to central circulation
-invasive monitoring

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7
Q

What are the contraindications for central venous lines

A

-significant coagulopathy
-local trauma to the site of insertion
-infection at the site of insertion

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8
Q

How to zero a arterial line

A

1- ensure cable is connected
2-close the stop cock to the pt and open to air
3- press the zero button on the monitor
4- close the stop cock to air and open to pt.

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9
Q

What is the pressure range for central venous lines

A

normal is 0 to -2 mmHg
critical is 2-6 mmHg

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10
Q

What is the phlebostatic axis for arterial lines

A

4th intercostal space mid chest position.

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11
Q

What is the Allen test

A

-hand above head with a clenched fist and the radial and ulnar arteries compressed.
-hand is then lowered and the fist is opened. pressure remains on the radial artery but released on the ulnar artery. color should return to hand

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12
Q

What are the contraindications for arterial lines

A

-ischemia of the extremity
-infection at the puncture site
-Raynaud’s disease
-prior vascular operation in the area of the insertion site.

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13
Q

what are the indications for arterial lines

A

-any patient in shock, who isn’t rapidly responding to therapy.
-pt’s who require constant blood pressure measurements.

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14
Q

what is the difference between ICP and Cushing’s Triad

A

ICP
-HTN with widening pulse pressure
-tachycardia
-Cheyne-stokes respirations.

Cushing’s Triade
-HTN with widening pulse pressure
-bradycardia– compression of the mid brain.
-Cheyne-stokes respirations.

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15
Q

what does the dicrotic notch indicate

A

The closure of the Aortic valve and the diastolic phase

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16
Q

What is the anacrotic notch

A

closure of the pulmonic valve

17
Q

how much O2 uptake and consumption is there in the body

A

VO2= 180-280 mL/min

18
Q

how much O2 is delivered each minute

A

DO2= 700-1400 ml/min

19
Q

what is the normal PCWP pressures

A

8-12 mmHg

20
Q

what is normal PA pressures

A

S- 15-25 mmHg
D- 8-15 mmHg

21
Q

What is normal Rv pressures

A

S-20-30 mmHg
D- 0-5 mmHg

22
Q

what is normal CVP pressure

A

2-6 mmHg

23
Q

What is normal CI (cardiac index)

A

2-4 L/min

24
Q

What is the normal CO.

A

Q= 4-8 L/min

25
Q

what is normal SVR pressure

A

800-1200 dynes/cm2

26
Q

what is normal MAP pressure

A

70-100 mmHg

27
Q

how do you determine coronary perfusion pressure

A

DBP-PCWP

28
Q

hemodynamic response to shock
(sepsis)

A

CVP is low
CI is low
SVR is low
PCWP is low

29
Q

hemodynamic response to shock
(obstructive)

A

CVP is high
CI is low
SVR is high
PCWP is high

30
Q

hemodynamic response to shock
(neurogenic)

A

CVP is low
CI is normal
SVR is low
PCWP is low

31
Q

hemodynamic response to shock
(cardiogenic)

A

CVP is high
CI is low
SVR is high
PCWP is high

32
Q

hemodynamic response to shock
(hypovolemia)

A

CVP is low
CI is low
SVR is high
PCWP is low

33
Q

hemodynamic response to shock
(right ventricle failure)

A

CVP is high
CI is low
SVR is high
PCWP is low