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RUSVM Anesthesiology > Monitoring ECG And BP > Flashcards

Monitoring ECG And BP Flashcards

1
Q

Intra-operatively you should monitor and record your anesthesia parameters how often?

A

Every 5 mins

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2
Q

What are the most important functions to monitor during anesthesia?

A

Circulation
Oxygenation
Ventilation
Temperature

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3
Q

How is pulse pressure determined?

A

Systolic-diastolic pressure

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4
Q

What should you assess when you palpate the pulse?

A

Rate, rhythm, quality

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5
Q

Why should you use a distal artery to palpate a pulse?

A

Affected earlier by hypotension and low CO

-> if it feels strong, likely indicates a good CO

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6
Q

What are common sites of pulse palpation in small animals??

A 
Lingual 
Labial 
Articular 
Digital 
Femoral 
Dorsal pedal 
Metatarsal 
Coccygeal
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7
Q

What are common sites of pulse palpation in large animals?

A 
Auricular 
Transverse facial 
Palatine 
Metatarsal 
Digital 
Coccygeal
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8
Q

T/F: an esophageal stethoscope can be used to asses heart rate/rhythm, and respiratory rate

A

True

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9
Q

T/F: Regular ECG readings indicate the heart is contracting appropriately?

A

False

-indicate electrical activity, not contractility

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10
Q

What are clinical uses of ECG?

A

Determine HR and rhythm

Aid in diagnosis of electrolyte disturbances (hyperkalemia)

Aid in chamber enlargement

Provide clues about myocardial oxygenation and perfusion

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11
Q

Pwave = ?

A

Atrial depolarization

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12
Q

QRS complex =?

A

Ventricular depolarization

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13
Q

T wave = ?

A

Ventricular repolarization

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14
Q

What is type A cardiac innervation?

A

Perkinje fibers excite the endocardium and excitation spread via muscle fibers

Flow is base-> apex (result in a positive R wave)

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15
Q

What is type B cardiac innervation?

A

Purkinje fibers deeply penetrate myocardium and most fibers are excited simultaneously

Apex to base current flow (negative S wave)

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16
Q

What type of animals have a type B cardiac innervation?

A

Horse, ruminant, pig

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17
Q

Using Eintheovens limb leads, in a healthy small animals which lead yields the tallest R wave

A

Lead 2

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18
Q

Using Eintheovens limb leads, in a healthy horses/ruminants which lead yields the tallest R wave

A

Lead 1

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19
Q

What things are you evaluating on an ECG?

A

HR
Rhythm
Complexes and intervals
Mean electrical axis

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20
Q

T/F: normal HR and BP likely indicates adequate CO

A

True

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21
Q

The best way to determine HR is to use the ECG and pulse oximeter

A 
False 
 Can be erroneous due to 
-bad signal quality 
-double counting 
-uneven HR

Best to count yourself

22
Q

What are the most common arrhythmias under anesthesia?

A

Sinus bradycardia and tachycardia

AV block (1st and 2nd degree)

23
Q

Moving central to peripheral arteries, systolic BP becomes ________, diastolic becomes _______, and mean is _________

A

Higher ; lower; same

24
Q

_________ BP represents afterload for the left ventricle

25
Mean pressure is an average BP over a full cycle and is a determinant of ___________________
Tissue perfusion
26
Diastolic pressure is the lowest point of the BP curve and is a determinant of _________________
Myocardial perfusion
27
In small animals, they are hypertensive is their mean BP is less than ________ and if their systolic BP is less than ________
60mmHg; 80mmHg
28
In large animals, they are hypotensive is their mean BP is less than _______ and their systolic BP is less than _______
70mmHg; 90mmHg
29
What does a BP change with respiration indicate?
Hypovolemia
30
What does a pressure waveforms provide information about?
Inotropy, CO, and the effect of arrhythmias
31
Preload depends on?
Circulating volume
32
What three factors does stroke volume depend on?
Preload SVR Contractility
33
BP can be calculated by??
BP = CO x SVR
34
If you have a low HR what should you give?
Atropine
35
If you have a low circulating volume, how should you treat
Fluid bolus
36
If you have low contractility, how should you treat?
Decrease ISO, give inotropes
37
If your SVR is low, how should you treat?
Decrease ISO, give vasoconstrictor
38
What drugs can be used to address hypotension during anesthesia
1. Decrease anesthetic 2. Give fluid bolus 3. Inotropes (dobutamine, dopamine, ephedrine) OR Vasoconstrictors ( phenylephrine, norepi, vasopressin)
39
How can BP be measured?
Invasive (direct): continuously via arterial catheter **most accurate, gold standard** Non-invasive (indirect): intermittently using a pressure cuff -oscillometric and Doppler
40
What type of BP monitor should you use in horses if they are anesthetized for more than 45mins?
IBP - arterial catheter
41
Which arteries can you use for IBP in horse??
Facial, transverse facial, lateral metatarsal, and auricular
42
Which arteries can be used in dogs for IBP?
Dorsal pedal, metatarsal Femoral, palmar digital
43
What three arteries can be used for IBP in cat
Dorsal pedal, coccygeal, and femoral
44
Where should the BP transducer be placed?
Point of shoulder in dorsal recumbency Point of sternum in lateral recumbency - this is the point of zero BP at the base of the heart
45
What type of non-invasive BP detects fluctuations in a cuff that generates pressure on arterial flow
Oscillometric
46
What type of non-invasive BP measurement uses a probe distal to an inflated cuff to detect BP
Doppler
47
The cuff’s width should be about ____% of the circumference of the limb
40
48
In small animals where do you place your BP cuff?
Distal radius, distal tibial, metatarsus
49
In large animals where do you place your BP cuff?
Metacarpus / tail - not very accurate for horses
50
T/F: Doppler is an excellent pulse monitor
True
51
How does a Doppler flow probe work?
Transmit US signal toward an artery and the reflected US wave is sensed by the probe Reflected wave differed depending on speed of blood

RUSVM Anesthesiology (32 decks)

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