RCIS BOARD EXAM STUDY NOTES BASED ON
GLOWACKI AND SOMMERS MP3
What is the pressure as blood enters the right atrium? - Answers - 5mmHg
What organ system in the body acts on the blood in the vessels to make a pressure of
5mmHg? - Answers - Deep skeletal muscle pump system
What pressure is the blood under as it goes from the RA through the tricuspid valve? -
Answers - 5mmHg
The bigger the diameter of the valve the __________ pressure is needed to move blood
across it. - Answers - Less
The smaller the diameter of the valve the _________ pressure is needed to move blood
across it. - Answers - more
What is the largest valve in the heart? - Answers - tricuspid valve
What is the normal right ventricular systolic pressure? - Answers - 25mmHg
Why is the RV EDP not zero? - Answers - Because some blood is not ejected out. The
heart is not a perfectly efficient pump.
What is a normal RV ejection fraction? - Answers - 55-60%
What is EDP? - Answers - 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? - Answers - 7-12mmHg
What is the normal left atrial pressure? - Answers - 7-12mmHg
What is the normal O2 concentration of a RBC leaving the lungs? - Answers - 98%
What is the normal O2 concentration of a RBC when it returns to the RA? - Answers -
70%
How much O2 is a RBC able to give up to the organs? - Answers - 30% of its O2
True/False: If someone has a higher EDP there is less damage to the heart. - Answers -
False, the higher the EDP the more damage. More blood is being left and not pumped
out.
,What is a normal wedge pressure? - Answers - 7-12mmHg
If the RBCs go through the lungs faster than 7-12mmHg what happens? - Answers -
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. - Answers - True.
COPD is elevated wedge pressure. True or False - Answers - 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 - Answers - True.
How much smaller is the pulmonic valve than the tricuspid valve? - Answers - 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? - Answers -
Tricuspid
Which valve requires more pressure to move across it, the tricuspid or the pulmonic? -
Answers - pulmonic
Valve A requires 5mmHg to move blood and valve B requires 30mmHg. Which valve
has a smaller diameter? - Answers - Valve B
What is the right ventricular diastolic pressure? - Answers - 5mmHg
What is the RV EDP? - Answers - 5mmHg
Why is the wedge pressure indicative of the LA pressure? - Answers - 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? - Answers - LV EDP
What is a normal LV EDP? - Answers - 7-12mmHg
If the LV EDP goes up and the LA pressure goes up, what other pressure would you
expect to rise? - Answers - The wedge pressure
What would increase your right atrial pressure? - Answers - tricuspid stenosis
,Where would you see a high RA pressure demonstrated on a patient? - Answers -
Jugular vein distention
If a person has an RV MI will the RV systolic pressure be affected? - Answers - 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? - Answers - No
If a person has an RV MI would the RV EDP be affected? - Answers - 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? - Answers - 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? -
Answers - 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) _________
___________. - Answers - Goes up
What is the RV systolic pressure of pulmonic stenosis? - Answers - 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? -
Answers - 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? - Answers - 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? - Answers - 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? - Answers - 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? - Answers -
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.
Which chamber of the heart is larger LV or RV? - Answers - The chamber of the RV is
larger because the LV has more muscle to push past the aortic valve to the body.
Can your PA pressure ever be greater than your RV systolic pressure? - Answers - No.
The pulmonary artery pressure cannot be greater because the RV would have to
increase to allow the blood to flow to the PA. Blood cannot flow up a gradient.
What is the PCWP of mitral regurgitation? - Answers - In a chronic situation, because
the LA is protective, the PCWP will be elevated above the normal.
What is the PCWP of mitral stenosis? - Answers - In a chronic situation, because the LA
is protective, the PCWP will elevate.
What is the PCWP of an LV MI? - Answers - The EDP goes up, the LA pressure will go
up. This will cause the PCWP to increase.
What is a normal RVEDP? - Answers - 5mmHg
What is a normal LVEDP? - Answers - 7-12mmHg
EDP represents ________? - Answers - The amount of blood left after systole
When we measure CO in a patient, which ventricle are we measuring it out of? -
Answers - The Right Ventricle. It is assumed to be the same as the LV.
True or False: The RV and LV have the same number of muscle fibers, but the LV works
harder and therefore gets bigger in diameter. - Answers - True
What is a normal RV systolic pressure? - Answers - 25mmHg
What is the normal systolic LV pressure? - Answers - 120mmHg
GLOWACKI AND SOMMERS MP3
What is the pressure as blood enters the right atrium? - Answers - 5mmHg
What organ system in the body acts on the blood in the vessels to make a pressure of
5mmHg? - Answers - Deep skeletal muscle pump system
What pressure is the blood under as it goes from the RA through the tricuspid valve? -
Answers - 5mmHg
The bigger the diameter of the valve the __________ pressure is needed to move blood
across it. - Answers - Less
The smaller the diameter of the valve the _________ pressure is needed to move blood
across it. - Answers - more
What is the largest valve in the heart? - Answers - tricuspid valve
What is the normal right ventricular systolic pressure? - Answers - 25mmHg
Why is the RV EDP not zero? - Answers - Because some blood is not ejected out. The
heart is not a perfectly efficient pump.
What is a normal RV ejection fraction? - Answers - 55-60%
What is EDP? - Answers - 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? - Answers - 7-12mmHg
What is the normal left atrial pressure? - Answers - 7-12mmHg
What is the normal O2 concentration of a RBC leaving the lungs? - Answers - 98%
What is the normal O2 concentration of a RBC when it returns to the RA? - Answers -
70%
How much O2 is a RBC able to give up to the organs? - Answers - 30% of its O2
True/False: If someone has a higher EDP there is less damage to the heart. - Answers -
False, the higher the EDP the more damage. More blood is being left and not pumped
out.
,What is a normal wedge pressure? - Answers - 7-12mmHg
If the RBCs go through the lungs faster than 7-12mmHg what happens? - Answers -
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. - Answers - True.
COPD is elevated wedge pressure. True or False - Answers - 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 - Answers - True.
How much smaller is the pulmonic valve than the tricuspid valve? - Answers - 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? - Answers -
Tricuspid
Which valve requires more pressure to move across it, the tricuspid or the pulmonic? -
Answers - pulmonic
Valve A requires 5mmHg to move blood and valve B requires 30mmHg. Which valve
has a smaller diameter? - Answers - Valve B
What is the right ventricular diastolic pressure? - Answers - 5mmHg
What is the RV EDP? - Answers - 5mmHg
Why is the wedge pressure indicative of the LA pressure? - Answers - 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? - Answers - LV EDP
What is a normal LV EDP? - Answers - 7-12mmHg
If the LV EDP goes up and the LA pressure goes up, what other pressure would you
expect to rise? - Answers - The wedge pressure
What would increase your right atrial pressure? - Answers - tricuspid stenosis
,Where would you see a high RA pressure demonstrated on a patient? - Answers -
Jugular vein distention
If a person has an RV MI will the RV systolic pressure be affected? - Answers - 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? - Answers - No
If a person has an RV MI would the RV EDP be affected? - Answers - 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? - Answers - 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? -
Answers - 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) _________
___________. - Answers - Goes up
What is the RV systolic pressure of pulmonic stenosis? - Answers - 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? -
Answers - 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? - Answers - 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? - Answers - 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? - Answers - 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? - Answers -
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.
Which chamber of the heart is larger LV or RV? - Answers - The chamber of the RV is
larger because the LV has more muscle to push past the aortic valve to the body.
Can your PA pressure ever be greater than your RV systolic pressure? - Answers - No.
The pulmonary artery pressure cannot be greater because the RV would have to
increase to allow the blood to flow to the PA. Blood cannot flow up a gradient.
What is the PCWP of mitral regurgitation? - Answers - In a chronic situation, because
the LA is protective, the PCWP will be elevated above the normal.
What is the PCWP of mitral stenosis? - Answers - In a chronic situation, because the LA
is protective, the PCWP will elevate.
What is the PCWP of an LV MI? - Answers - The EDP goes up, the LA pressure will go
up. This will cause the PCWP to increase.
What is a normal RVEDP? - Answers - 5mmHg
What is a normal LVEDP? - Answers - 7-12mmHg
EDP represents ________? - Answers - The amount of blood left after systole
When we measure CO in a patient, which ventricle are we measuring it out of? -
Answers - The Right Ventricle. It is assumed to be the same as the LV.
True or False: The RV and LV have the same number of muscle fibers, but the LV works
harder and therefore gets bigger in diameter. - Answers - True
What is a normal RV systolic pressure? - Answers - 25mmHg
What is the normal systolic LV pressure? - Answers - 120mmHg
