A transesophageal echocardiogram, or TEE, is an alternative way to perform an echocardiogram. A specialized probe containing an ultrasound transducer at its tip is passed into the patient's esophagus. This allows image and Doppler evaluation which can be recorded. It has several advantages and some disadvantages compared with a transthoracic echocardiogram.
Our concepts of heart disease are based on the enormous reservoir of physiologic and anatomic knowledge derived from the past 70 years' of experience in the cardiac catheterization laboratory.
As Andre Cournand remarked in his Nobel lecture of December 11, 1956, the cardiac catheter was the key in the lock.
By turning this key, Cournand and his colleagues led us into a new era in the understanding of normal and disordered cardiac function in huma
The Norwood procedure is the first of three surgeries required to treat single-ventricle conditions such as hypoplastic left heart syndrome (HLHS). Because the left side of the heart can’t be fixed, the series of surgeries rebuilds other parts of the heart.
The Norwood procedure is performed in the baby’s first or second week of life.to redirect the blood flow.
Three goals for the Norwood procedure:
1, Build a new aorta.
2, Direct blood from the right ventricle through the new aorta and on to the rest of the body.
3, Direct the right ventricle to pump blood to the lungs until the next surgery.
A transesophageal echocardiogram, or TEE, is an alternative way to perform an echocardiogram. A specialized probe containing an ultrasound transducer at its tip is passed into the patient's esophagus. This allows image and Doppler evaluation which can be recorded. It has several advantages and some disadvantages compared with a transthoracic echocardiogram.
Our concepts of heart disease are based on the enormous reservoir of physiologic and anatomic knowledge derived from the past 70 years' of experience in the cardiac catheterization laboratory.
As Andre Cournand remarked in his Nobel lecture of December 11, 1956, the cardiac catheter was the key in the lock.
By turning this key, Cournand and his colleagues led us into a new era in the understanding of normal and disordered cardiac function in huma
The Norwood procedure is the first of three surgeries required to treat single-ventricle conditions such as hypoplastic left heart syndrome (HLHS). Because the left side of the heart can’t be fixed, the series of surgeries rebuilds other parts of the heart.
The Norwood procedure is performed in the baby’s first or second week of life.to redirect the blood flow.
Three goals for the Norwood procedure:
1, Build a new aorta.
2, Direct blood from the right ventricle through the new aorta and on to the rest of the body.
3, Direct the right ventricle to pump blood to the lungs until the next surgery.
Percutaneous Balloon Mitral Valvuloplasty (PBMV) is a procedure to dilated the mitral valve in the setting of rheumatic mitral valve stenosis. A catheter is inserted into the femoral vein, advanced to the right atrium and across the interatrial septum. Then the mitral valve is crossed with a balloon and it is inflated to relieve the fusion of the mitral valve commissures effectively acting to increase the mitral valve area and reduce the degree of mitral stenosis. Mitral regurgitation is a potential complication and thus PBMV is contraindicated if moderate or severe regurgitation is present. The Wilkins score examines mitral valve morphology and is determined via echocardiography to assess the likelihood of using PBMV based on certain echocardiographic criteria.
Percutaneous Balloon Mitral Valvuloplasty (PBMV) is a procedure to dilated the mitral valve in the setting of rheumatic mitral valve stenosis. A catheter is inserted into the femoral vein, advanced to the right atrium and across the interatrial septum. Then the mitral valve is crossed with a balloon and it is inflated to relieve the fusion of the mitral valve commissures effectively acting to increase the mitral valve area and reduce the degree of mitral stenosis. Mitral regurgitation is a potential complication and thus PBMV is contraindicated if moderate or severe regurgitation is present. The Wilkins score examines mitral valve morphology and is determined via echocardiography to assess the likelihood of using PBMV based on certain echocardiographic criteria.
Basic theory of accelerometer, gyroscope and magnetometer. Newton’s law
of Classical Mech. Inertial and non inertial reference system: centrifugal,
Coriolis and Euler forces. IMU hardware description. Static IMU’s Noise
evaluation: mean and std deviation in all axis w.r.t. data sheet. Drift effect
in MATLAB. Sit-to-stand experiment with 2 IMUs: development of an
algorithm able to estimate the duration of stand-up, sit-down and variation
of the bending angles.
central venous pressure and intra-arterial blood pressure monitoring. invasiv...prateek gupta
central venous pressure and intra-arterial blood pressure monitoring. various sites for cvp and Ibp insertion. working principle for cvp and ibp. indication and complication. various waveform of cvp and ibp
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
3. Definition:
Hemodynamic waveforms are “maps” of the pressure
changes that take place within a given vessel or
chamber.
All of the waveforms obtained from arterial lines,
pulmonary artery catheters, or during cardiac
catheterization can be recognized by recalling 3 basic
waveform morphologies.
4. These waveform shapes include:
1) Atrial
2) Arterial, and
3) Ventricular waveforms.
Because both atria fill, empty and contract in the
same sequence during systole and diastole, the
right atrial and left atrial waveforms have similar
patterns.
Similar changes occur between the pulmonary
artery and aorta, and the right and left ventricles.
5. pulmonary artery catheter (Swan Ganz)
Standard PAC is 7.0, 7.5 or
8.0 French in circumference
and 110 cm in length divided
in 10 cm intervals.
The catheter tip if properly
inserted, rests in a pulmonary
arteriole.
Patency of the Distal lumen is
achieved by maintaining a
continuous flow of
heparinized saline at a rate of
3cc/hour.
Developed by Swan Ganz and
colleagues in 1970
6. pulmonary artery catheter (Swan Ganz)
PAC has 4-5 lumens:
Temperature thermistor located
proximal to balloon(blue arrow) to
measure pulmonary artery blood
temperature (yellow line)
Proximal port located 30 cm from
tip for CVP monitoring, fluid and
drug administration (blue line)
Distal port at catheter tip for PAP
monitoring (black arrow)
+/- Variable infusion port (VIP) for
fluid and drug administration
Balloon at catheter tip
9. Indications:
Diagnosis of shock
Assessment of fluid volume status
Measurement of cardiac output
Monitoring and management of haemodynamically
unstable patients
Assess diagnosis of primary pulmonary
hypertension, valvular disease, intracardiac shunts,
cardiac tamponade, and pulmonary embolus
11. Measuring central venous pressure
1- Water manometers 2-Electronic pressure transducer
In contrast to electronic transducer water manometers
overestimate CVP by 0.5-5cm H2O
12. CVP Recording
The phlebostatic axis is the point where the fourth intercostal
space and mid-axillary line cross each other regardless of
head elevation.
13. Measuring CVP using a manometer
1. Line up the manometer
arm with the phlebostatic
axis .
2. Move the manometer
scale up and down to
allow the alignement with
zero on the scale. This is
referred to as 'zeroing the
manometer
14. 3. Turn the three-way tap off to
the patient and open to the
manometer.
4. Move the manometer scale up
and down to allow the bubble
to be aligned with zero on the
scale. This is referred to as
'zeroing the manometer'.Open
the IV fluid bag and slowly fill
the manometer to a level
higher than the expected CVP
Measuring CVP using a manometer
15. 5. Turn off the flow from
the fluid bag and open
the three-way tap from
the manometer to the
patient
6. The fluid level inside the
manometer should fall
until gravity equals the
pressure in the central
veins
Measuring CVP using a manometer
16. 7. When the fluid stops
falling the CVP
measurement can be
read. If the fluid moves
with the patient's
breathing, read the
measurement from the
lower number
8. Turn the tap off to the
manometer
Measuring CVP using a manometer
17. Measuring CVP using electronic transeducer
The electronic transducer is a device that converts
mechanical energy into an electrical waveform that is then
displayed on the monitor as a waveform.
These waveforms represent changes in pressure and are the
result of physiological events, such as contraction of the heart.
In order for the transducer to the supply the monitor with
information that is clinically relevant to the monitor the
transducer must be zeroed correctly and leveled at a known
reference point.
18. 1. The CVC will be
attached to intravenous
fluid within a pressure
bag. Ensure that the
pressure bag is inflated
up to 300mmHg.
2. Place the patient flat in a
supine position if
possible. Alternatively,
measurements can be
taken with the patient in
a semi-recumbent
position.
Measuring CVP using electronic transeducer
19. 3. Tape the transducer to
the phlebostatic axis or
as near to the right
atrium as possible.
4. Turn the tap off to the
patient and open to the
air by removing the cap
from the three-way port
opening the system to the
atmosphere.
Measuring CVP using electronic transeducer
21. 5. Press the zero button
on the monitor and
wait while calibration
occurs.
Measuring CVP using electronic transeducer
22. 6. When 'zeroed' is
displayed on the
monitor, replace the
cap on the three-way
tap and turn the tap
on to the patient.
Measuring CVP using electronic transeducer
23. 7. Observe the CVP
trace on the monitor.
The waveform
undulates as the
right atrium
contracts and
relaxes, emptying
and filling with
blood. (light blue in
this image)
Measuring CVP using electronic transeducer
24. Waveform recognition:
1. Atrial pressure waveforms (right atrial,
PAWP):
Waveforms obtained from the right and left atria have
similar morphologies. Thus, CVP (right atrial) and left atrial
pressure tracings have similar shapes.
Pulmonary artery wedge pressure waveforms (PAWP) are
indirect measurements of the left atrial pressure. Thus, CVP
and PAWP waveforms have similar shapes.
The right-sided pressures are slightly lower than the left.
25. Atrial pressure waveforms
CVP shows three positive
waves (a, c, v), and two
descents (x, y).
a wave represent
increase in atrial
pressure as a result of
atrial contraction and
pumping of blood in
right ventricle.
Begins in the PR interval
and QRS on the ECG
26. Atrial pressure waveforms
c wave result from
increase of right atrial
pressure as a result of
closure of tricuspid
valve.
Observed in ST segment,
may or may not present.
v wave is the rise in
atrial pressure as it
refills during ventricular
contraction.
V wave correlates with T
wave in ECG.
27. Atrial pressure waveforms
Following contraction, the
atria begin to relax, and the
atrial pressures once again
fall.
This fall in atrial pressures
is identified by the down
slope of the “a” waves. This
is referred to as the “X”
descent.
Opening of tricuspid and
mitral valves during early
diastole produce rapid
decline in atrial pressure
represented by “Y” descent.
28. Correlation to ECG
First locate the “v” wave. It will
appear immediately after the “T”
wave on a CVP waveform,
however, it will be .08-.12 seconds
after the T wave on a PAWP
tracing.
If the patient has a sinus rhythm,
an “a” wave should be in the PR
interval for a CVP. It is later in
the PAWP.
If present, the “c” wave is
generally within the QRS for a
CVP. It will be after the QRS for a
PAWP .
29. Measuring CVP and PAWP
Normal CVP 0-8 mmHg,
normal PAWP 8-12mmHg.
Measure atrial pressure at
end diastole which identified
by mean of the highest and
lowest “a” wave.
Another way is Z-line(line
from end of QRS to atrial
tracing) it is delayed 0.08-
0.12 sec from QRS for PAWP.
Z line
30. Normal Value 8-12
mmHg.
The average of the
highest and lowest
value of a wave.
Using z line which
delayed 0.08-0.12sec
after QRS.
Measuring PAWP
31. PEEP and PAWP
PAWP is not affected by PEEP pressures less than
10cm H2O. With PEEP pressures greater than 10, the
pulmonary vasculature is compressed and the alveolar
and intrathoracic pressure increased, thereby affecting
the accuracy of the PAWP measurement.
Calculation of PAWP with high levels of PEEP:
1. Convert the applied PEEP from centimeters of water to
millimeters of mercury (1.36 cm H2O = 1 mm Hg)
2. Subtract half the applied PEEP in millimeters of mercury
from the measured PAWP
32. 2-Ventricular pressure wave forms:
During early diastole, the ventricles relax and
stretch so the pressure in the ventricles remain
very low.
In late diastole, atrial contraction forces a
“bolus” of blood into the ventricles, which can
causes a small rise in the ventricular pressure.
At the end of diastole ventricles begin to
depolarize and ventricular pressure exceed
atrial pressure, AV valves close while
pulmonary and oartic valves also
closed(isovolumetric contraction) with sharp
rise in ventricular pressure.
33. 2-Ventricular pressure wave forms:
As soon as the ventricles contract, blood leaves
the ventricles, causing the ventricular pressures
to begin to fall
At end systole, the ventricles begin to stretch
and relax, and the ventricular pressures fall to
the their lowest point.
Detection of right ventricular pressure rise
using PAC is delayed after QRS in comparison
to direct detection which occur with QRS
complex.
34. Measuring RV pressure
Normal Value 15-25/0-8
mmHg.
Systole measured at the
peak which occurs after
the QRS
Diastole measured just
prior to the the onset of
systole
35. Arterial waveforms
As the ventricles contract, they eject blood
into the pulmonary artery and aorta. This
causes an immediate rise in the arterial
pressure.
Late in systole, the rate of ejection slows as
the pressure gradient between the
ventricles and arteries narrow, so the
pressure begins to decline. This causes the
early downslope in the arterial tracing
36. Arterial waveforms
The ventricles begin to relax, causing the
ventricular pressures to drop below the
pressures in the great vessels. This causes
the pulmonic and aortic valves to close,
producing a dicrotic notch.
Following closure of the semi-lunar valves,
the pulmonary artery and aortic pressures
continue to fall as blood leaves the great
vessels to perfuse the tissues and lungs.
37. Measuring pulmonary artery pressure
Normal Value 15-25/8-15
mmHg.
Systole measured at the
peak of the wave
Diastole measured just
prior to the upstroke of
systole (end of QRS)
Higher than RV diastolic
pressure
38. Differentiating the Right Ventricle and
Pulmonary Artery Waveforms
The wave looks taller.
The systolic pressure equals the previously
recorded pulmonary artery systolic pressure.
The diastolic pressure matches the right atrial
diastolic pressure.
Inflation of the balloon fails to produce a
PAWP waveform.
The waveform is symmetrical in shape.
There is no dicrotic notch.
A small preliminary rise in late diastole is
present prior to the main rise in the pressure
waveform.
The new pressure is closer to the QRS than the
previous pulmonary artery tracing.
RV waveform
PA Waveform