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Perfusion

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by

Anthony Podbielski

on 16 February 2014

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Transcript of Perfusion

Perfusion
RCA (Right Coronary Arteries)
Right marginal artery
Posterior descending artery

LCA (Left Coronary Arteries)
Circumflex
Left Anterior Descending (LAD)
AKA the "widow maker"

4 Chambers of the heart
Right Atrium
Right Ventricle
Left Atrium
Left Ventricle
Right Atrium --> Right Ventricle --> Lungs
Lungs --> Left Atrium --> Left Ventricle
Left Ventricle --> Your whole body
Don't forget those Korotkoff Sounds
What is Perfusion?
Blood flow to tissues and organs in order to supply oxygen and nutrients, while removing waste products.
There are
miles
of veins and arteries in our bodies....
What does blood pressure really mean???
Systolic blood pressure?
- represents pressure on the arteries during contraction

Diastolic blood pressure?
- represents pressure in the arteries when the heart rests

What about Pulse Pressure??

Pulse pressure is the difference between the systolic and diastolic pressure

BP 120/80 = Pulse pressure of 40
Does cuff size
really
matter?
Yes!

If the cuff is too large for the patient
- False low reading

If the cuff is too small for the patient
- False high reading


So, size does matter folks!
The path of blood....
- Deoxygenated blood flows into the Right Atrium
- The Right Atrium dumps into the Right Ventricle
- The Right Ventricle pumps the deoxygenated blood out to the lungs
- Oxygenated blood returns to the Left Atrium
- The Left Atrium pumps the oxygenated blood into the Left Ventricle
- The Left Ventricle pumps the oxygenated blood out to the body
What should you be assessing when we talk about perfusion?
- BP
- Apical & Peripheral Pulses
- Capillary refill
- The patient's orientation
Perfusion starts with the heart right?
...so what "feeds" the heart?
4 Arteries that "feed" our heart
Our heart needs oxygen too!
But how does it flow??
P-wave
Represents atrial depolarization
or
atrial systole

This is when the atria are contracting
QRS Complex
Represents ventricular depolarization
or
ventricular systole

This is when the ventricles are contracting
T-Wave
Represents ventricular repolarization
or
ventricular diastole

This is when the ventricles are relaxed
ECG Strip
Oh....and atrial diastole (the atria relaxing) occurs during the QRS Complex, so you won't normally see it.
How do you check for adequate peripheral tissue perfusion?



Check the patient's capillary refill

Refill in less than 2 sec = good perfusion
- Tapping
- Swishing
- Knocking
- Muffling
- Absence of sound
Cardiac Output
Cardiac Output (CO) is the amount of blood pumped by the heart every minute

CO = HR X SV

Normal CO for a resting adult?
3.5 - 8 L/min
Electrical Impulse begins at the SA (Sinoatrial Node)
located in the Right Atrium
Then the impulse travels to the AV (Atrioventricular) Node
The impulse pauses here briefly to allow time for the atria to contract fully.

This is known as "atrial kick".
Now the impulse travels to the bundle of His, and into its right and left bundle branches






This causes ventricular contraction
The impulse then finally enters the Purkinje fibers that extend throughout the ventricular muscle
Full transcript