HSCI LAB FINAL

What are the main differences between EKG and Echocardiogram

• EKG Electrical, Echo mechanical

• EKG produces a wave diagram, Echo produces a picture

• EKG has eelctrodes that connect to a machine

• Echo: cool gel on chest + transducer that releases sound waves

  • Sound waves echo back and produce picture

What are the main types of Echocardiogram

• TTE (Transthoracic Echocardiogram)

• TEE (Transesophageal Echocardiogram

• Stress Echo

What is TTE and what can it be used for

Transthoracic echocardiogram

• most common type, minimally/noninvasive

Used to

• Check the health of heart valves

• determine how well the heart is pumping blood

• measure blood pressure

• measure the size and shape of the heart chambers

What is TEE and what is it used for

Transesophageal Echocardiogram

• invasive, has to slide an endoscope down esophagus

  • photos within the body

  • up to 90 minutes

Used to

• Follow up a TTE to help diagnose/manage heart prolem

• Useful in emergency and critical care

• check for blood clots before a procedure

• successful surgery confirmation

• real-time imaging for some catheter-based procedures

What is a stress echo and what is it used for

Used to assess heart’s function while beating fast

What are the different options for echos?

Two dimensional vs three dimensional

Doppler vs color doppler

Strain imaging vs contrast imaging

What is the difference between two-dimensional and three-dimensional ultrasounds?

• Two dimensional ultrasound

  • Slices on a computer screen

  • can be stacked to be 3d

• Three dimensional ultrasound

  • Allows to view heart from different angles

  • shows how well heart pumps blood

What is the difference between a doppler ultrasound and a color doppler

Doppler: shows how fast blood flows and in what directions

Color doppler: same thing but uses different colors to highlight the different directions of blood flow

What is the difference between strain imaging and contrast imaging

Strain: shows changes in how the heart muscle moves

Contrast: substance is injected into vein, helps show details of the heart

What are the different types of tranducers?

Linear, Curvilinear, phased array

When is a linear transducer used for?

Looking at arteries and veins

what is a curvilinear transducer used for?

Looking at the abdominal aorta

What is a phased array transducer for

echocardiography

how does a tranducer work

produces soundwaves that bounce off body tissues and make echoes. send them to a computer to create a sonogram

How would you get a sagittal plane view of the heart?

transducer placed over the chest

indicator points to patient’s head

How would you get a transverse plane of the heart

transducer placed subcostally (below the rib cage

indicator points toward the right side of transverse plane

how would you get a coronal plane of the heart

transducer is placed along the mid-axillary line

indicator on the transducer is pointing toward the patient’s axillary region

When is a long axis/short axis used for

when structures do not lie in the classic planes

how does the ultrasound beam shine

near field to far field

what view is this

Parasternal long axis

what view is this

parasternal short axis

what view is this

apical 4 chamber

what view is this

subcostal 4 chamber

how is the transducer placed for parasternal long axis view

placed to left of the sternum in the 3rd, 4th, or 5th intercostal space

indicator towrds right clavicle (11’oclock)

what does plax allow you to see

everything but the right ventricle

what does parasternal short axis view allow you to see

shape and size of the ventricles

how is the transducer placed on psax

3 4 5 ics

but rotated 90 of the plax

how should the ventricles look like in psax

lv is round

rv is d

what can the a4c see and identify

pericardial effucion

what is pleural effusion

buildup of fluid between the lungs and pleural membrane

can occur due to inflammation or CHF

what is pericardial effusion

buildup of fluid between heart and pericardial membranes

can occur due to pericarditis

what is cardiac pericardial tamponade

pericardial effusion puts pressure on the heart which prevents it from filling properly

causes blood pressure to drop

how do you calculate ejection fraction

(Stroke Volume/End Diastolic Volume) * 100

What is normal rate for Ejection Fraction

>50%

what is a moderately depressed ejection fraction

30-50%

what is congestive heart failure

occurs when heart cannot pump or fill adequately

what can a leftsided chf lead to

left ventricle dysfunction, results in a decreased af

what can cause a decreased Ef

left sided chf

aortic regurgitation

mitral valve stenosis

what is a patent foramen ovale?

a hole in the interatrial septum separating the two atrium

what is atherosclerosis

plaque within the arteries

what are some risk factors for atherosclerosis

hyperlipidemia, hypertension, smoking

how can atherosclerotic plaques be detected

in a carotid artery scan

what is a bicuspid aortic valve

aortic valve contains two cusps

what can a bav lead to

aortic regurgitation

aortuc stenosis

both lead to heart failure

what vessel is used for measuring blood pressure

brachial artery

what are the five phases of korotkoff sounds

1: appreance of faint tapping sound (systolic)

2: louder + swishing

3: distinct loud

4: sound becomes muffled and softer

5: sound dissappears

what phases do you listen for while the person is at rest

phase one, phase five

what phases do you listened to while the person is in motion

phase one, phase four

what happens if the cuff is too big/loose

erroneously low blood pressure

what happens if the cuff is too small/tight

systolic blood pressure increases

what happens if a cuff is too wide

underestimate bp

what happens if the cuff is too narrow?

overestimate bp

what is normal blood pressure

<120/<80

what is elevated blood pressure

120-129/<80

what high blood pressure stage one

130-139/80-89

what is range of high blood pressure stage 2

>140/>90

what is hypertensive crisis

>180/>120

what is the treatment for high blood pressure

healthy diet and exercise

diuretics

ace inhibitors

beta blockers

vasodilators

what is the normal bp response to exercise

systolic elevates, dyastolic remains the same/decrreases

what is an abnormal bp responses to exercise

systolic fails to elevate, diastolic elevates

what does a 0 rating pulse quality mean

no pulse

what does a 1+ pulse rating mean

weak pulse

what does a 2+ pulse quality mean

normal pulse

what is a 3+ pulse quality

bounding pulse

what can an irregular pulse indicate

cardiac disease

what is a normal respiratory rate for an adult

12-20 minutes

what can labored preathing lead to

respiratory muscle fatigue→ respiratory failure

what is a heart rate over 100 bpm called

tachycardia

what is the term for a heart rate below 60bpm

bradycardia

what can a white skin color indicate

vasoconstriction, blood loss, shock, heart attack, fright, anemia, fainting, emotional distress

what can pale cool and clammy skin indicate?

inadequate oxygenation, hypoxia, hypoxemia

what does a blue skin tone mean

inadeqyate oxygenation/perfusion/ inadequate respiration, suffocation, hypoxia, hypoxemia, heart attack, or poisoning

what does a red skin color mean

heat exposure, peripheral vasodilation, carbon monoxide poisoning

what does a yellow skin color indicate

liver disease

what does a geay skin color indicate

shock patients/ blood poolingwhat

what could a longer capillary refill time indicate

shock

what could a <90% SpO2 reading indicate

hypoxia

What are the Different levels of consciousness from least concerning to most

alert

verbal stimulus

painful stimulus

how would you apply a central painful stimulus

trapezius pinch or sternal rub

how would you apply a peripheral painful stimulus

thumb, index finger pinch

what does perla stand for

pupils equal, responsive to light, accomodating

what can dilated pupils be a symptom of

cardiac arrest

drug use (LSD, amphetamines, cocaine

what could constricted pupils be a symptom of

CNS disorder

narcotics

what could unequal pupils be a symptom of

stroke, head injury, brain trauma

what could nonreactive pupils be a symptom of

cardiac arrest, brain injury, drug overdose

what does the markle test assess

abdominal pain

stand on ballf of foot, drop onto heels

what is the babinski reflex

firmly stroking the plantar surface of foot

what is a positive markle?

if they grimace in pain

what is a positive babinski

if toes fan out

what is a normal babinski response

negative for adults

positive for infants

what can a positive babinski be a symptom of (for an adult)

cns disorders

what coulda. pronator arm drift be a symptom of

stroke

what questions would u ask to assess an individuals pain

who: do they have pain (acute/chronic)

what: how bad is it (1-10)

where: location of the pain

when: when did it start

why: what were they doing

how: characteristics/qualities, does anything make it worse/better

how would you calculate minute ventillation

tidal volume x breaths ina minute

what is the average minute ventilation for an adult

500ml * 12/min = 6000ml/min

what is alveolar ventilation

amount of air moved in and out of alveoli in a minute

how would you calculate alveolar ventilation

(TV-Dead Space) * Breaths in 1 min

what has a greater effect on inspiration: tidal volume or breath rate?

tidal volume, breathing rate short term but, respiratory muscles are weak

what is the range of borg rating of perceived exertion (RPE) scale

6-20

what are the average values in adults at rest for

respiration

heart rate

blood pressure

RPE

Respiration: 12-20 breaths/min

heart rate: 60-100 beats/min

blood pressure: systolic 120 mmHg/80mmHg

RPE: 6