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Concepts in Critical care > Hemodynamics > Flashcards

Hemodynamics Flashcards

1
Q

Define blood pressure

A

Amount of pressure exerted against the inside walls of the arteries as blood travels through the systemic and pulmonary circuits

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2
Q

What are the factors that determine blood pressure mathematically?

A

Flow x resistance = pressure

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3
Q

What determines flow in blood pressure?

A

Cardiac output

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4
Q

What determines resistance in blood pressure?

A

Vascular tone

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5
Q

What are the three components that ultimately control blood pressure?

A

Heart
Blood
Vessels

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6
Q

How does the heart affect blood pressure?

A

Controls cardiac output

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7
Q

How does the blood affect blood pressure?

A

Amount of fluid in the circulatory system will affect blood pressure
Thickness of said blood will also affect blood pressure

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8
Q

How do the vessels affect blood pressure?

A

Vessel diameter affects the pressure required to move blood through them

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9
Q

Define systolic blood pressure

A

Pressure exerted against the walls of the arteries when the heart contracts during systole

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10
Q

Define diastolic blood pressure

A

The pressure exerted against the walls of the arteries when the heart relaxes during asystole

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11
Q

What is the normal difference between systolic and diastolic blood pressure?

A

40 mmHg

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12
Q

When the difference between systolic and diastolic BP is less than 40, what is that called?

A

Narrowed

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13
Q

When the difference between systolic and diastolic BP is greater than 40, what is that called?

A

Widened

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13
Q

What is the difference between diastolic and systolic BP called?

A

Pulse pressure

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14
Q

What is pulse pressure used for?

A

Good indicator of cardiovascular events

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15
Q

What does an increased pulse pressure indicate?

A

More stress on artery
More stress on left ventricle
Potential limitation in coronary perfusion

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16
Q

What does a decreased pulse pressure indicate?

A

Cardiac tamponade
Decrease in left ventricular stroke volume

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17
Q

What can cause a strong pulse?

A

Increased stroke volume
Hypertension

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18
Q

What can cause a bounding pulse?

A

Aortic insuffiency
Atherosclerosis

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18
Q

What can cause a weak/thready pulse?

A

Decreased contractility
Hypovolemia
Low systemic vascular resistance

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19
Q

What does a bounding pulse feel like?

A

rapid/strong initial pressure follow by a quick fall off

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20
Q

What can cause pulsus alternans?

A

CHF

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21
Q

What can cause pulsus paradoxus?

A

Severe airway obstruction
Cardiac tamponade

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22
Q

What does pulsus alternans feel like?

A

Pulse strength alternates from beat to beat

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23
What blood pressure indicates hypotension?
<90/60
24
What blood pressure indicates hypertension
>140/90
25
What are the risks associated with a significantly low MAP?
Shock Failure to perfuse vital organs
26
What is the minimum MAP required to perfuse vital organs?
60
27
What is a normal PAP?
25/8
28
What is the normal range for diastolic PAP?
15-5
28
What is the normal range for systolic PAP?
30-15
29
What is a normal mean PAP?
14 mmHg
30
What is the normal range for cardiac output?
4-8 liters per minute
31
How can we measure PAP?
Pulmonary artery catheter Echocardiogram Transesophogeal echocardiogram
32
Define preload
The stretch or wall stress within the myocardium at the end of systole
32
What is the normal range for cardiac index?
3-4 liters/minute/meter^2
33
What is preload a measure of?
The pressure of blood in the ventricle at the end of diastole
34
How do we determine preload in the right heart?
Central venous pressure Right atrial pressure
35
What is normal preload in the right heart?
2-6 mmHg
36
What is the preload in the right heart in ICU patients?
6-12
37
How do we determine preload in the left heart?
Pulmonary capillary wedge pressure
38
What is the normal preload in the left heart?
4-12 mmHg
39
What factors affect afterload?
Diameter of blood vessel Volume of blood being ejected from the ventricle Compliance of the vasculature Mass of blood
39
What is the normal preload in the left heart in ICU patients?
12-18 mmHg
40
Describe afterload
The amount of resistance offered by the vasculature to the outflow of blood as it tries to leave the heart from the ventricles
41
What is the formula for calculating pulmonary vascular resistance?
(Mean PAP-PCWP) / Cardiac output x 80
41
What is the afterload the right heart experiences called?
Pulmonary vascular resistance
42
What is the afterload the left heart experiences called?
Systemic vascular resistance
43
What is the formula for calculating systemic vascular resistance?
(MAP-Central venous pressure) / Cardiac output x 80
44
What are the normal value for afterload for the right heart?
PVR = 0-250 dynes/sec/cm^2
45
What are the normal values for afterload of the left heart?
SVR = 800-1400 dynes/sec/cm^2
46
What is the gist of the frank starling law?
The greater the venous return to the heart, the greater the end diastolic stretch (preload) and the greater the cardiac output
47
What factors does the frank starling law take into consideration?
End diastolic volume Preload Stroke volume
48
Describe contractility
The strength of the contraction of the myocardium
49
What is the equation for PAO2?
PAO2 = (713)FiO2 -(PaCO2/.8)
50
What ion plays an important role in cardiac cell contraction?
Ca++
51
What is the equation for CaO2?
(Hgb x 1.34 x SaO2) + (PaO2 x 0.0031)
52
What is the equation for CvO2?
(Hgb x 1.34 x SvO2) + (PvO2 x 0.0031)
53
What is the equation for Ficks Cardiac output?
CO = VO2 / (C(a-v)O2) x 10
54
What is the equation for VO2
Cardiac output x C(a-v) x 10
55
What is the equation for Qs/Qt?
CcO2 - CaO2 / CcO2 -CvO2

Concepts in Critical care (7 decks)

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