Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
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
|