Lynn Shared "Perfusion 2005" - 14 Picmonics
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Perfusion 2005
Peripheral Artery Disease (PAD)
- Mechanism
- Atherosclerosis
- Assessment
- Intermittent Claudication
- Pain with Exercise
- Paresthesias
- Arterial Ulcers
- Critical Limb Ischemia
- Amputation
- Consideration
- Ankle-Brachial Index (ABI)
2 mins
Types of Strokes
- Warning Signs
- Transient Ischemic Attack (TIA)
- Reversible Ischemic Neurologic Deficit (RIND)
- Types
- Ischemic
- Thrombotic
- Atherosclerosis
- Embolic
- Atrial Fibrillation
- Hemorrhagic
- Severe Hypertension
3 mins
Stroke Management
- 1) Non-contrast CT
- A) If hemorrhagic:
- Keep BP below 160/105
- Nitroprusside
- Reverse anticoagulation
- Consult neurosurgery
- NIH Stroke Scale
- Supplemental O2
- 2) Ischemic stroke/TIA
- Keep below 220 over 120
- Pressors MAP under 60 or SBP under 90
- Decide if tPA indicated
- IF tPA contraindicated, give aspirin/clopidogrel
- Long-term treatment
- Workup/management (within days of stroke)
- 1) EKG
- If AFIB present
- Warfarin or LMWH
- 2) Echocardiogram
- Heparin-warfarin bridge if thrombus present
- 3) Carotid artery ultrasound
- If over 70 percent occluded AND symptomatic
- OR just 80 percent occlusion
- Carotid endarterectomy
- Aspirin for everyone (long term)
- Statin (everyone)
- Labetalol, nicardipine
Ischemic stroke management
- <3 hrs tx. is thrombolytics
- tPA (tissue plasminogen)
- > 3hrs tx. anti-platelets
- Aspirin + dipyridamole
- Clopidogrel (Plavix)
Right Hemisphere Stroke Assessment
- Opposite Side Weakness (Hemiplegia)
- Poor Proprioception
- Disoriented to Person, Place, Time
- Can't Recognize Faces (Prosopagnosia)
- Loss of Judgement and Awareness
- Impulsiveness
- Personality Changes
- Tonal Hearing Loss
2 mins
Left Hemisphere Stroke Assessment
- Opposite Side Weakness (Hemiplegia)
- Side to Side Discrimination
- Aphasia
- Agraphia
- Slow Performance
- Aware of Deficits
- Anxiety
- Depression
2 mins
Myocardial Infarction Assessment
- Assessment
- Substernal Chest Pain
- Crushing or Dull Sensation
- Arm, Jaw, and Neck
- > 20 Minutes
- Unrelieved by Nitro
- Palpitations
- Diaphoresis
- Fear of Impending Doom
- Nausea and Vomiting
- Shortness of Breath
- Considerations
- Monitor for Arrhythmias
2 mins
Myocardial Infarction Diagnosis
- Diagnosis
- 12 Lead ECG
- ST Elevation
- Q Wave
- T Wave Inversion
- Troponin T and I
- CK-MB
- Considerations
- Early ECG
- Cardiac Stress Test
2 mins
Myocardial Infarction Interventions
- MONA
- Morphine
- Oxygen
- Nitrates
- Aspirin
- Thrombolytics (tPA)
- Invasive Procedures
- Cardiac Catheterization
- Stent Placement
- Angioplasty
- Coronary Artery Bypass Grafting (CABG)
- Considerations
- Decrease Modifiable Risk Factors
- Resuming Activity (Physical, Sexual)
2 mins
Coronary Artery Bypass Grafting (CABG)
- Indications
- ST-Segment Elevation Myocardial Infarction (STEMI)
- Cardiovascular Disease (CAD)
- Uncontrolled Angina
- Considerations
- Internal Mammary Artery
- Saphenous (Leg) Vein
- Transient Limb Edema
- Closely Monitor Patients
- Venous Thromboembolism (VTE) Prophylaxis
- Incentive Spirometer
2 mins
Cardiac Catheterization
- Considerations
- Fluttering Sensation
- Contrast Media
- NPO 6-12 Hours
- After Procedure
- Bed Rest
- Assess Circulation
- Assess for Bleeding
- Monitor Vital Signs
2 mins
Evolution of Myocardial Infarction and Complications
- Hours to Days
- Arrhythmia
- Before 7 Days
- Fibrinous Pericarditis
- Papillary Muscle Rupture
- Interventricular Septum Rupture
- Before 14 Days
- Ventricular Pseudoaneurysm
- Ventricular Free Wall Rupture
- After 14 Days
- True Ventricular Aneurysm
- Dressler Syndrome
- Other
- Left Ventricular Failure
2 mins
Coronary Arteries
- Aortic Root
- Right Coronary Artery (RCA)
- Right (Acute) Marginal Artery
- Posterior Descending Artery (PDA)
- Left Coronary Artery (LCA)
- Left Anterior Descending (LAD) Artery
- Circumflex Artery
- Left Marginal Artery
1 min
Atherosclerosis
- Very common. Disease of elastic arteries and large- and medium-sized muscular arteries.
- A form of arteriosclerosis caused by buildup of cholesterol plaques
- Progression is in separate picmonic
- LOCATION
- Abdominal aorta > coronary artery > popliteal artery > carotid artery
- RISK FACTORS
- Modifiable: smoking, hypertension, hyperlipidemia (Increased LDL), diabetes.
- Nonmodifiable: age, sex (Increased risk in men and postmenopausal women), family history.
- SYMPTOMS
- Angina
- Claudication
- Can be asymptomatic
- COMPLICATIONS
- Aneurysms
- Ischemia
- Infarcts
- Peripheral Vascular Disease
- Thrombus
- Emboli
