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RCIS Board Exam Study Notes Based On Glowacki And Sommers MP3
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RCIS Board Exam Study Notes BasedOn Glowacki And Sommers MP3
What is the pressure as blood enters the right atrium? ✔️Ans - 5mmHg
What organ system in the body acts on the blood in the vessels to make a
pressure of 5mmHg? ✔️Ans - Deep skeletal muscle pump system
What pressure is the blood under as it goes from the RA through the tricuspid
valve? ✔️Ans - 5mmHg
The bigger the diameter of the valve the __________ pressure is needed to move
blood across it. ✔️Ans - Less
The smaller the diameter of the valve the _________ pressure is needed to move
blood across it. ✔️Ans - more
What is the largest valve in the heart? ✔️Ans - tricuspid valve
What is the normal right ventricular systolic pressure? ✔️Ans - 25mmHg
How much smaller is the pulmonic valve than the tricuspid valve? ✔️Ans -
5x smaller. It takes 5mmHg to get across the tricuspid valve and 25mmHg to
get across the pulmonic valve.
Which valve has a bigger diameter, the tricuspid or pulmonic valve? ✔️Ans -
Tricuspid
Which valve requires more pressure to move across it, the tricuspid or the
pulmonic? ✔️Ans - pulmonic
Valve A requires 5mmHg to move blood and valve B requires 30mmHg. Which
valve has a smaller diameter? ✔️Ans - Valve B
What is the right ventricular diastolic pressure? ✔️Ans - 5mmHg
What is the RV EDP? ✔️Ans - 5mmHg
,Why is the RV EDP not zero? ✔️Ans - Because some blood is not ejected
out. The heart is not a perfectly efficient pump.
What is a normal RV ejection fraction? ✔️Ans - 55-60%
What is EDP? ✔️Ans - End Diastolic Pressure. An efficient heart has an
ejection fraction of 55-60%, this leftover blood in the ventricle is under a
resting (diastolic) pressure.
What is a normal diastolic pressure in the pulmonary artery? ✔️Ans - 7-
12mmHg
What is the normal left atrial pressure? ✔️Ans - 7-12mmHg
What is the normal O2 concentration of a RBC leaving the lungs? ✔️Ans -
98%
What is the normal O2 concentration of a RBC when it returns to the RA?
✔️Ans - 70%
How much O2 is a RBC able to give up to the organs? ✔️Ans - 30% of its O2
True/False: If someone has a higher EDP there is less damage to the heart.
✔️Ans - False, the higher the EDP the more damage. More blood is being left
and not pumped out.
What is a normal wedge pressure? ✔️Ans - 7-12mmHg
If the RBCs go through the lungs faster than 7-12mmHg what happens?
✔️Ans - The RBCs have less time to get the O2 needed to fill them up fully.
True or False: The higher the wedge pressure the faster the RBCs go through
the lungs and the less O2 they are able to acquire. ✔️Ans - True.
COPD is elevated wedge pressure. True or False ✔️Ans - True. 30-40mmHg
is not unusual. RBCs move so fast that they come out of the lungs with much
less than 98% O2.
,COPD O2 sats can be in the low to mid 80's. True or false ✔️Ans - True.
Why is the wedge pressure indicative of the LA pressure? ✔️Ans - Because
there are no valves in between, just the lung system. Since no valves the
pressure in the LA should be the same. When the leaflets open up on the
mitral valve it is possible to see into the left ventricle.
When the mitral valve leaflets open up and the wedge catheter is able to see
into the LV what is the pressure that it sees? ✔️Ans - LV EDP
What is a normal LV EDP? ✔️Ans - 7-12mmHg
If the LV EDP goes up and the LA pressure goes up, what other pressure would
you expect to rise? ✔️Ans - The wedge pressure
What would increase your right atrial pressure? ✔️Ans - tricuspid stenosis
Where would you see a high RA pressure demonstrated on a patient? ✔️Ans
- Jugular vein distention
If a person has an RV MI will the RV systolic pressure be affected? ✔️Ans -
No matter how big the MI the systolic pressure will not change. The RV EDP
will increase as the RV is not as able to push the blood out as effectively as
before the MI.
Would an RV MI affect the diameter of the pulmonic valve or the diameter of
the pulmonic arteries? ✔️Ans - No
If a person has an RV MI would the RV EDP be affected? ✔️Ans - Yes. If the
muscle fibers are dead the heart's ability to squeeze is impacted so more
blood is left behind.
What would cause the LV systolic pressure to increase? ✔️Ans - Aortic
stenosis. (What would prevent a RBC from moving forward from the RV?)
What would cause your LVEDP to increase but not increase your LV systolic
pressure? ✔️Ans - LV MI would increase the LV EDP because the heart is
less effective as a pump. As the LV is able to eject less blood, the end diastolic
pressure gets higher.
, The systolic pressure does not need to increase because that is the pressure to
get the blood past the aortic valve.
As the EF (ejection fraction) goes down the EDP (end diastolic pressure)
_________ ___________. ✔️Ans - Goes up
What is the RV systolic pressure of pulmonic stenosis? ✔️Ans - Any
pressure higher than 25mmHg is pulmonic stenosis. The narrower the valve
the ore pressure is needed to move across it. The muscle fibers need to
generate more pressure to get RBCs past the stenotic valve.
What happens to the pressure in the RA in the case of tricuspid regurgitation?
✔️Ans - The RA pressure increases.
Blood likes the path of less pressure. It will go back across the tricuspid valve
when there is less pressure due to regurgitation. This causes the RA to carry
more blood because it continues to fill with blood from the IVC and SVC in
addition to the blood flowing back from the RV through tricuspid
regurgitation.
What is the PA pressure in COPD? ✔️Ans - Wedge pressure is elevated in
COPD and this causes a backflow of pressure to the PA.
What is the special protective factor of the LA? ✔️Ans - The LA has a
protein that senses volume. If the volume increases because of MS or MR then
the LA will sense that and allow the muscle fibers to get longer in the LA. The
LA gets bigger to hold the volume and to prevent the pressure from rising in
the lungs.
What is the PA pressure in someone with mitral stenosis? ✔️Ans - The
pulmonary artery pressure will eventually increase because the pressure in
the LA will increase, which will cause the wedge pressure to increase, which
will ultimately lead to an increas in the pulmonary arteries
What is the pulmonary artery pressure in someone with mitral regurgitation?
✔️Ans - This increases the volume of blood in the LA which increases the
pressure there. The LA is unique and protective, but eventually this will lead
to an increase in pulmonary artery pressure.
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