Quiz 4, Part 2- Hemodynamic Measurements

Question 1

CO =

Answer 1

HR x SV

Question 2

CO is ____ related to area under the curve

Answer 2

inversely

Question 3

Poor CO has a ___ area under the curve

Answer 3

large

Question 4

Dicrotic notch represents

Answer 4

Aortic valve closing

Question 5

Excessive dampening

Answer 5

underestimated systolic and overestimated diastolic

Question 6

Underdampening

Answer 6

overestimated systolic and underestimated diastolic

Question 7

CVP: A wave

Answer 7

RA contraction/ CVP waveform

Question 8

CVP: C wave

Answer 8

Tricuspid cusp elevation into RA

Question 9

CVP: V wave

Answer 9

Back-pressure wave from blood filling RA

Question 10

In a healthy individual with disease-free arteries, does systolic blood pressure increase or decrease in the leg relative to the proximal aorta?

SBP, DBP, PP, MAP

Answer 10

As the pressure pulse travels away from the aorta:

Systolic increases
Diastolic decreases Therefore, pulse pressure increases
MAP should stay the same (or decrease only slightly)

Question 11

What is damping in an arterial line tracing?

Answer 11

How quickly those vibrations - the harmonic oscillator, “bouncing” a couple of times before coming to rest

Question 12

What is ringing in A-line

Answer 12

Exaggerated systolic component of an arterialwaveform.

Affects MAP

Question 13

Once you see the dicrotic notch you are back in the

Answer 13

Pulmonary Artery

Question 14

Patients with a left to right shunt can display this type of CO measurement:

Answer 14

high- falsely elevated d/t warm L sided blood going through septal wall to R side and reads as high CO

Question 15

One of the most common problems with obtaining accurate cardiac output measurements is:

Answer 15

improper injectate administration

Question 16

Wedge wave looks like

Answer 16

caterpillar around 10mmHg

like CVP of L heart

Question 17

When you’re in the RA looks like

Answer 17

CVP

around baseline

Question 18

When you’re in the PA looks like

Answer 18

High Systolic (same), 
Increased Diastolic (around 10) and dicrotic notch

Question 19

When you’re in RV looks like

Answer 19

Systolic increased and Diastolic = CVP

staircase?

Question 20

Normal PVR

Answer 20

100-300

Question 21

RA

Answer 21

0-10

Mean 5

Question 22

RV

Answer 22

15-30/ 0-8

Mean 25/5

Question 23

PA

Answer 23

15-30/ 5-15

Mean 25/10

Question 24

LA/ LVEDP

Answer 24

4-12

Mean 8

Question 25

LV Systolic

Answer 25

90-140

Mean 130

Question 26

Aortic pressure

Answer 26

120/80

Question 27

SV=

Answer 27

EDV-ESV

Question 28

Normal SVR

Answer 28

700-1600

Question 29

Direct measurements from a Swan

Answer 29

• Central venous pressure (CVP)
• R intracardiac pressures (RA, RV)
• Pulmonary arterial pressure (Pap)
• Pulmonary capillary occlusion/wedge pressure (PCOP/PCWP)
• Cardiac Output
• Mixed venous oxyhemoglobin saturation

Question 30

Indirect measurements from a Swan

Answer 30

• Systemic Vascular Resistance (SVR)
• Pulmonary Vascular Resistance (PVR)
• Cardiac Index
• Stroke Volume Index
• Left Ventricular Stroke Work Index (LVSWI)
• R ventricular stroke work index (RVSWI)
• Oxygen delivery
• Oxygen uptake

Question 31

Fick Principle for measuring CO?

Answer 31

Measurement of O2 use based on consumption, using mixed venous blood and systemic arterial blood

Question 32

2 steps of “zeroing” a transducer?

Answer 32

1) Establish 0mmHg reference point of atmospheric pressure

2) Level transducer to RA

Question 33

What is the thermodilution method of measuring CO?

Answer 33

Uses temperature to calculate CO

• cold injectate instilled to RA and indicator reads temperature as it changes back to warm baseline.
• temperature measured as change over time on curve to calculate CO