Physio B Lab - Exam 2

what does this photo show?

patent foramen ovale (PFO)

what does this photo show?

subcostal 4 chamber view

what is this image?

Parasternal Long Axis (PLAX) View

pericardial effusion

Parasternal Short Axis (PSAX) View w/

Mitral Valve (fish mouth)

Bicuspid Aortic Valve (BAV)

Apical 4 Chamber (A4C) View

Parasternal Short Axis (PSAX) View w/

Aortic Valve (Mercedes Benz sign)

Atherosclerotic Plaque

Pericardial Effusion in

Subcostal 4 Chamber View

Pleural Effusion in

Parasternal Long Axis View

subcostal 4 chamber view

apical 4 chamber view

parasternal short axis view -PSAX fish mouth

parasternal long axis view

normal axis

all leads positive

right axis deviation

lead I - negative, Lead II and III - positive

right axis deviation can mean…

normal in children or tall and thin adults; or a thoracic/spinal deformity, or enlarged heart

left axis deviation can mean…

normal in short stocky people; emphysema, hyperkalemia, tricuspid atresia

left axis deviation

lead I - positive, lead II and III - negative

PR interval

beginning of P wave to beginning of QRS complex

normal range for pr interval (range and num boxes)

0.12 - 0.20 s; 3-5 small boxes

what does a prolonged pr interval mean

heart block

what does a shortened pr interval mean

reduced ventricular filling/blood flow and reduced cardiac output

korotkoff sounds - 1

faint tapping - systolic pressure

korotkoff sounds - 2

louder, swishing sound

korotkoff sounds - 3

distinct, loud sounds

korotkoff sounds - 4

softer, muffled - diastolic pressure

korotkoff sounds - 5

sound disappears

normal BP (systolic, diastolic)

less than 120; less than 80

elevated BP

120-129; less than 80

high bp - hypertension - stage 1

130-139; 80-89

high bp - hypertension - stage 2

140+; 90+

hypertensive crisis

180+; 120+

problems caused by hypertension

stroke, blood vessel damage, heart attack, heart failure, kidney failure

treatments for hypertension

healthy diet and exercise, diueritics, ace inhibitors, beta blockers, vasodilators

normal patterns during exercise

• systolic pressure goes up —> lv wall stretch and stronger pump

• diastolic pressure goes down —> arterial vasodilation

abnormal patterns during exercise

• systolic pressure fails to increase or decreases with greater workload —> heart disease impairs the contraction

• diastolic pressure increases as workload increases —> vessel pressure stays high during diastole

normal respiratory rate

12-20 breaths per minute

pulse/heart rate

60-100 bpm

sp02

97-100%

blood pressure

120/80 mmHg

temperature

98.6 +- 1

cap refill

2 seconds

shallow breaths

slight expansion of chest/abdomen

labored

using accessory muscles, abnormal sounds

central pulse sides

carotid, femoral

peripheral pulse sites

radial, brachial, popliteal, dorsalis pedis, posterior tibial

what peripheral pulse do you check for someone older than 1 yr

radial pulse

what peripheral pulse do you check for someone younger than a year

brachial

thready pulse

weak, rapid

bounding

strong

0 - pulse rating

absent

1+ pulse rating

weak/difficult to palpate

2+ pulse rating

normal

3+ pulse rating

bounding/abnormally strong

pallor

white - vasoconstriction, blood loss, shock, heart attack, fright, anemia

cyanosis

blue/grey - serious impaired oxygenation/perfusion

jaundice

yellow - liver diseases

flushing

red - heart, peripheral vasodilation, late carbon monoxide poisoning

mottled skin

shock states/peripheral pooling

diaphoresis

profuse sweating

wet skin

shock/poisoning, heart, cardiac and diabetic emergencies

extremely dry

severe dehydration/spinal injury

what does a pulse ox below 90% mean

definite hypoxia

levels for distress

none, mild, moderate, severe

how to assess orientation?

PPPT

what do the ABCs stand for?

airway, breathing, circulation

what is the markle test

stand on balls of feet and drop onto heels; pain means a positive sign

normal specific gravity for adult urine

1.005 - 1.030

normal range for eGFR

>90

formula for eGFR

eGFR cr = 142 min (Scr/k1)^a max (Scr/k1)^-1.2 × 0.9938^age * sex

sex multiplier for female and male

f - 1.012; m - 1.000

k value for female and male

f - 0.7

m - 0.9

a value for female and male

f = -0.241

m = -0.302

stage 1 eGFR

>= 90; possible kidney damage with normal kidney function

stage 2 eGFR

60-89; mild loss of kidney function/damage

stage 3a

45-59; mild to moderate loss

stage 3b

30-44; moderate to severe loss

stage 4

15-29; severe loss

stage 5

<15; kidney failure

what does an ecg measure

electrical activity produces a waveform tracing

what does an echo measure

high frequency ultrasound; measures mechanical pumping function + movement of chambers and valves

transthoracic echo

tte

transesophageal echo (TEE)

endoscope; clots prior to cardioversion

doppler ultrasound

shows how fast blood flows and in what direction

color doppler ultrasound

shows blood flow, uses color to show direction

strain ultrasound

tracks changes in heart muscle motion

contract ultrasound

contrast agent injected into the vein to show the anatomy

transducer

device that produces sound waves and shows the echo

what transducer do we use

phased array transducer

saggital plane

slices heart in saggital plane, like stabbing someone with a sword

transverse plane

below pec, slice top and bottom

coronal plane

placed along the mid axillary line; slice front and back