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Exam of 5 pages for the course Perfusion at Perfusion (Perfusion Test)
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Perfusion TestDefine and describe the concept of perfusion. - answer The flow of blood through
arteries and capillaries delivering nutrients and oxygen to cells and removing cellular
waste products.
3 mechanisms of the heart - answer3 mechanisms of the heart
1. the contracting skeletal muscles milk the blood proximally, back toward the heart.
2. the pressure gradient caused by breathing, in which inspiration makes the thoracic
pressure decrease and the abdominal pressure increase.
3. The intraluminal valves ensure unidirectional flow
Unoxygenated blood flow - answer Unoxygenated blood drain from the head and the
rest of the body into the right atrium
•From the right atrium the venous blood travels through the tricuspid valve to the right
ventricle
•From the right ventricle the blood flows through the pulmonic valve to the pulmonary
artery to the lungs
Oxygenated blood flow - answer•The lungs oxygenate the blood and the "fresh" blood is
returned to the left atrium via the pulmonary vein
•From the left atrium the arterial blood travels through the mitral valve to the left
ventricle
•From the left ventricle the blood travels through the aortic valve to the aorta (general
circulation)
•S1 - answerFirst heart sound. Signals the beginning of systole and correlates with the
carotid artery pulse
Loudest at the apex
•Occurs with closure of the AV valves
•The mitral component slightly precedes the tricuspid component
•Signals beginning of systole
s2 - answer•S2
•Loudest at the base
•Occurs with closure of the semi lunar valves
•The aortic component of the 2nd sound slightly precedes the pulmonic component
•Signals end of systole
Ischemia - answerAn insufficient flow of oxygenated blood to the tissues that may result
in hypoxia and subsequent cellular injury and death.
, Infarction - answerDeath of tissue with an inability to regenerate.
Anoxia - answerTotal lack of oxygen in body tissues.
Central perfusion - answer•Force of blood movement generated by cardiac output.
•Requires adequate cardiac function, blood pressure and blood volume.
•This central perfusion propels blood to all organs & their tissues from patent arteries
thru capillaries & returns the blood to the heart thru patent veins.
•When central perfusion is impaired the entire body is affected.
Tissue/Local - answer∙ The volume of blood that flows to target tissue.
•Requires patent vessels, adequate hydrostatic pressure (pressure exerted by the
blood/fluid) and capillary permeability.
•This perfusion is supplied by blood flowing from arteries to capillaries, which are
surrounded by smooth muscles. The force of ventricular contractions creates a
pressure, called capillary hydrostatic pressure, which pushes blood thru capillaries into
the interstitial spaces allowing delivery of O2, fluid and nutrients to cells.
Impaired Central Perfusion - answer•Impairment of central perfusion occurs when
cardiac output is inadequate
•Reduced cardiac output results in a reduction of oxygenated blood reaching the body
tissues (systemic effect)
▪ If severe, associated with shock which occurs when blood supply to tissues is
impaired because of inad- equate cardiac output, significant blood loss, or vasodilation
throughout the body.
▪ If untreated, leads to ischemia, cell injury and cell death
Symptoms of adequate tissue perfusion - answerPeripheral tissue perfusion is present
when
-the patient's extremities are warm with color appropriate for race
-radial and dorsalis pedis pulse rates are between 60 and 100 beats per minute with
regular rhythm, easily pal- pable upstroke, and smooth, rounded
-the capil- lary refill time is less than 2 seconds and
-the ankle-brachial index is greater than 0.9.
- the presence of warm hands and feet
-absence of continuous pain in fingers and toes or leg pain when walking.3
Symptoms of inadequate perfusion - answerPain.
Edema (swelling). Patients may report their socks leaving an indentation around their
legs or edema in their feet that is worse at the end of the day.
Dizziness or fainting
orthostatic hypotension - answerdrop in systolic blood pressure when a patient moves
from a lying to a sitting or standing position. Nurses inquire about the duration of the
dizziness. For many patients the dizziness subsides if they sit for a few seconds before
standing.
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