Perfusion

Question 1

What is perfusion?

Answer 1

The flow of blood through arteries and capillaries delivering nutrients and oxygen to cells and removing cellular waste products.

Question 2

What is central perfusion?

Answer 2

Force of blood movement generated by cardiac output 
Requires adequate cardiac function, blood pressure, and blood volume
Cardiac output (CO) = Stroke volume × heart rate

Question 3

What is tissue or local perfusion?

Answer 3

Volume of blood that flows to target tissue

Requires patent vessels, adequate hydrostatic pressure, and capillary permeability

Question 4

How to check for pretibial edema?

Answer 4

Check for pretibial edema
Firmly depress skin over tibia or medial malleolus for 5 seconds and release
Normally your finger should leave no indentation, although a pit commonly is seen if person has been standing all day or during pregnancy
If pitting edema is present, grade it on following scale:

1+ Mild pitting, slight indentation, no perceptible swelling
2+ Moderate pitting, indentation subsides rapidly
3+ Deep pitting, indentation remains, leg looks swollen
4+ Very deep pitting, indentation lasts long time, leg very swollen

Question 5

Auscultation
Identify auscultatory areas where you will listen; these include four traditional valve “areas”
Valve areas are not over actual anatomic locations of valves but sites on chest wall where sounds produced by valves are best heard
Sound radiates with blood flow direction; valve areas are
Aortic
Pulmonic
Tricuspid
Mitral/PMI

Answer 5

Aortic (2nd RICS — just right of sternum)
Pulmonic (2nd LICS — just left of sternum)
Tricuspid (4th LICS —just left of sternum)
Mitral/PMI (5th LICS — midclavicular line; apex)