Lecture 11: Diagnostic and Surgical Intervention Flashcards
Diagnostic tools: Cardiac:
* Chest X-ray (primary imaging when pathology expected)
* Electrocardiogram (EKG = one of first diagnostic tools)
* Exercise & Stress Testing
* Echocardiograph
* Cardiac Imaging
* Invasive Monitoring
Pulmonary:
* Chest X-Ray
* CT
* Pulmonary arteriography
* Ventilation/Perfusion scans (V/Q scans)
* Blood gas analysis - arterial blood drawn and paO2 and paCO2 are anaylzed
Most common radiograph used for cardiac and pulmonary disease. Easy to determine heart size, lungs, blood vesseks and pulmonary vasculature
Chest X-ray
Electrical activity of the heart in voltage versus times
* 3 types
ECG (EKG)
1) Rhythm strips
2) Twelve lead
3) Holter monitoring - those that have to have extensive ecgs have - these can be 24 hours+ just to catch any arrythmias
Measure physiological stresses of increased workload
Exercise and Stress testing
basically just how the heart can handle stress
* Can be done through exercise stress test or nuclear stress test (chemicals injected to increase HR and see how well the heart reacts under stress)
Chest X rays
Identifying structures
we can see that the heart is actaully resting pretty low
The guy is wearing an holter monitor
* You cant get it wet, so you can’t shower w/ it on
* Has several leads placed on you (5)
* Should go through normal activities - looking to see if you have arrythmias over time
* If they have any symptoms there a button they push - it basically just markers that area - but its recording continuously
One on the right is a 12 lead one (I think)
* each one of them takes a picture of the heart from a different angle (except for grounding electrodes are - they don’t do this)
* Snow over Grass, Smoker over Fire
Echocardiagram:
Often called an echo
Just like an ultrasound
Uses sound waves to have an image of the heart
can use infrared setting and see bloodflow through heart
* can see the heart pumping in live videos (BF through heart)
A good way to get eh ejection fraction before surgery (get cleared for surgery)
* transthoracic echo most common type
* Patient lies in different positions and has this done
theres also one that goes internally (camera through mouth / esophagus so you can look at the valves a little bit better)
-ectomy
to remove
-oplasty
to reconstruct
-ostomy
to make an opening
-otomy
to cut into
-scopy
to examine by inserting a scope
EX:
* mastectomy
* tracheostomy
* Angeioplasty
* Lobeectomy
* Sternotomy
* Bronchoscopy
Cardiac surgeries
* Thoractomy
* Sternotomy
* Chest Tube placement
* Percutaneous revascularization procedures
* Automatic implantable cardioverter defibrillator
* Defibrillator
* Coronary artery bypass
* Minimally incasive, robotic surgery
* Extracorporeal life support
* Ventricular Assist Devices
What is this
Thoracatomy
cutting into the thoracic acvity
* may be used for a lung transplant (just some way to get into the thoracic cavity)
KNOW:
* We are there to provide splinting for pain, splinted cough techniques, incentive spirometer, functional mobility to increase chest expansion and airway clearance (good way to do this is to get them out of bed)