RCIS Exam Study Guide Questions With Verified Answers | Latest Updates

RCIS Exam Study Guide Questions With Verified Answers | Latest Updates What is the pressure as blood enters the right atrium? - ANSWER 5mmHg What organ system in the body acts on the blood in the vessels to make a pressure of 5mmHg? - ANSWER Deep skeletal muscle pump system What pressure is the blood under as it goes from the RA through the tricuspid valve? - ANSWER 5mmHg The bigger the diameter of the valve the __________ pressure is needed to move blood across it. - ANSWER Less The smaller the diameter of the valve the _________ pressure is needed to move blood across it. - ANSWER more What is the largest valve in the heart? - ANSWER tricuspid valve What is the normal right ventricular systolic pressure? - ANSWER 25mmHg How much smaller is the pulmonic valve than the tricuspid valve? - ANSWER 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? - ANSWER Tricuspid Which valve requires more pressure to move across it, the tricuspid or the pulmonic? - ANSWER pulmonic Valve A requires 5mmHg to move blood and valve B requires 30mmHg. Which valve has a smaller diameter? - ANSWER Valve B What is the right ventricular diastolic pressure? - ANSWER 5mmHg What is the RV EDP? - ANSWER 5mmHg Why is the RV EDP not zero? - ANSWER Because some blood is not ejected out. The heart is not a perfectly efficient pump. What is a normal RV ejection fraction? - ANSWER 55-60% What is EDP? - ANSWER 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? - ANSWER 7-12mmHg What is the normal left atrial pressure? - ANSWER 7-12mmHg What is the normal O2 concentration of a RBC leaving the lungs? - ANSWER 98% What is the normal O2 concentration of a RBC when it returns to the RA? - ANSWER 70% How much O2 is a RBC able to give up to the organs? - ANSWER 30% of its O2 True/False: If someone has a higher EDP there is less damage to the heart. - ANSWER False, the higher the EDP the more damage. More blood is being left and not pumped out. What is a normal wedge pressure? - ANSWER 7-12mmHg If the RBCs go through the lungs faster than 7-12mmHg what happens? - ANSWER 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. - ANSWER True. COPD is elevated wedge pressure. True or False - ANSWER 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 - ANSWER True. Why is the wedge pressure indicative of the LA pressure? - ANSWER 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? - ANSWER LV EDP What is a normal LV EDP? - ANSWER 7-12mmHg If the LV EDP goes up and the LA pressure goes up, what other pressure would you expect to rise? - ANSWER The wedge pressure What would increase your right atrial pressure? - ANSWER tricuspid stenosis Where would you see a high RA pressure demonstrated on a patient? - ANSWER Jugular vein distention If a person has an RV MI will the RV systolic pressure be affected? - ANSWER 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? - ANSWER No If a person has an RV MI would the RV EDP be affected? - ANSWER 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? - ANSWER 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? - ANSWER 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) _________ ___________. - ANSWER Goes up What is the RV systolic pressure of pulmonic stenosis? - ANSWER 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? - ANSWER 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? - ANSWER 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? - ANSWER 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? - ANSWER 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? - ANSWER 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? - ANSWER 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? - ANSWER 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? - ANSWER In a chronic situation, because the LA is protective, the PCWP will be elevated above the normal.