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54 Cards in this Set

  • Front
  • Back
What percentage of pts undergoing central venous catheterization suffer complications?
more than 15%
Three categories of central venous complications
mechanical, thromboembolic, infectious etiologies
what is the most common immediate mechanical complication?
unintended arterial puncture
serious complication of carotid artery puncture?
arterial thromboembolism
what may happen if prolonged cannulation of carotid artery happens?
areritis, thrombus formation, cerebral emolization
most common minor complication from cvc?
localized hematoma or injury to venous valves
what is the most important life-threatening vascular complication of cvc?
cadiac tamponade
what can cause cadiac tamponade?
perforation of intrapericardial superior vena cava, rt. atrium,rt ventricle,
symptoms of cardiac tamponade
severe hypotension,cardiac arrhythmias
two most common comp of subclavian
pneumothorax, arterial puncture
what is cardiac contraction directly proportional to?
end diastolic muscle fiber length at any given level of intrinsic contractility or inotropy.
muscle length fiber or preload is proportionall to
end-diastolic chamber volume
can one assume that given measured change in cardiac filling pressure =prop. change in ventricular preload?
no; depends on the portio of the pressure volume curve over which pts ht is operating
what is preload?
pressure stretching the ventricle of the heart, after atrial contraction and subsequent passive fill of vent
How does a cardiac filliling pressure of 10mmHg compare to ambient atmospheric pressire?
higher by 10mmHg
What is transmural pressure?
diff between chamber pressure and juxtacardiac or pericardial pressure.
what does transmural pressure determine?
ventricular preolad,end-diastolic volume or fiber lenght
what is CVP, strictly speaking?
pressure at junction of venacava and rt. atrium; reflects driving force for filling rt atrium and ventricle
Does CVP provide both a measure f the functional capacity of rt atriu. amd circ. volume?
no; of rt ventrficle and cric. volume
How many phasic events does the CVP wave form consist of?
5
Name the three peaks and two desents of the CVP wave form
peak: a,c,v
descent:x, y
which is the most prominent wave form? What phase/mechanical event does it represent?
a: end diastolic; atrial contraction
When does the a wave happen in the EKG?
after P wave
This wave increases atrial presssure and provides the atrial kick to fill the rt ventricle thru the open tricuspid valve
a wave (end diastloe, atrial contraction, most prominent wave form, after P wave)
which wave "interupts" a wave's descent?
c wave
What is the cardiac phase of the c wave?
early systole
what is the mechanical event of the c wave?
isovolumic ventricular contration, tricuspid motion toward the right atrium
This wave is a transient increase in atrial pressure
c wave
The c wave always follows which ECG wave?
R wave
what happens to atrial pressure during ventricular systole?
continues to decline b/c of atrial relaxation
During what phase is the x decent?
midsystole
What mechanical event happens during x descent?
atrial relaxation;descent of base,systolic collapse
when does the x descent happen?
after c wave
What is normal cvp?
1-7mmHg
What is the last atrial pressure peak?
v
this wave is caused by venous filling of the atrium during late systole when the tricuspid valve remains closed.
v
when does the v wave happen in comparison to the EKG?
just after the t wave
what is the cardiac phase of the v wave?
late systole
what is the mechanical event of the v wave?
systollic filling of the atrium
This desent happens as the tricuspid valve opens and flood flows from the atrium to ventricle
y descent
what cardiac phase is associated w/ y desent
early diastole
what mechanical event occurs with y descent?
early ventricular filling, diastolic collapse
when is h wave seen?
not normally; only when h.rate is slow and venous pressure elevated
h wave correspond to which cardiac phase
mid to late diastole
mechanical event of h wave
diaslolic plateau
this wave results from atrial contraction
a
this wave results from tricuspid closure and isovolumic ventricular contraction
c
this wave results from ventricular ejection, which drives venous filling of atrium
v
what are the systolic components of the CVP wave form
c wave, x descent, v wave
what are the 2 diastolic components of the CVP wave form?
a wave, y descent
what causes changes in the cvp?
heart rate changes and conduction abnormalities
What does a short EKG PR interval do to CVP wave form?
fuses a and c wave forms
what does tachycardia do to cvp wave form?
reduces length of diastole and duration of y descent, which causes v and a waves to merge
what does bradycardia do to cvp waveform?
each waveform becomes more distinct; separate x and xprime visible and more prom h wave