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Jolly Angiography
RCA-PDA, LCA-CIRC, heart views
Question | Answer |
---|---|
What comes off of the Left Main Artery? | LAD-Diagonals, Septals. Circumflex-Obtuse Marginals, PDA IF left dominant |
What comes off of the Right Coronary Artery? | SA Nodal Artery (also AVN if seen), Acute Marginals, Posterior Lateral Branch, PDA (if RIGHT dominant) |
What shape is the RCA? | "C" artery |
What do collateral vessels indicate? | 100% blockage of vessel |
Name the arteries that develop to shunt blood to a point below a total occlusion: | Contra-laterals and Ipsi-laterals |
What is Nature's Own Bypass Surgery | Collateral vessels |
Where do collaterals supply blood to? | The blocked side |
Name the three types of occlusions? | Partial, Sub-totaled, Complete |
What do you look for when viewing a coronary angiogram? | *Entire vessel should fill with contrast in one smooth injection *Lesions *collateral flow *competitive flow (if grafts present) *Myocardial "Bridging"- artery pinches down |
Name vessel projections | AP (straight down), Cranial (head), Caudal (feet), Right Anterior Oblique (RAO), Left Anterior Oblique (LAO), combinations of preceding, Orthagonals |
Two projections of the same anatomy seen at different angles | Orthogonal views |
If spine is on the right, it's what view? | LAO |
If spine is on the left, what view is it? | RAO |
What shadows should you look for to find the spine? | Rib shadows and catheter within the aorta |
What direction do the ribs turn into? | Ribs head towards the spine |
What view to the the circumflex/OMB and grafts | Primarily caudal views |
The primary cranial views show what? | LAD/DIagonals and grafts |
In RAO apex of heart points to where? | Right of screen |
In LAO, the RCA resembles what? | A "C" shape |
In LAO, the LAD lies where? | To the left |
Which artery USUALLY lies closest to the spine? | Circumflex |
In projections of the left coronary system, look for what part of the heart to identify the LAD? | Apex |
In the left coronary system, look for the apex of the heart to identify the what? | Left Anterior Descending artery |
What coronary system do you look to for septal perforators to identify the LAD? | Left coronary system |
What do you look for in the left coronary system? | Septal perforators to identify the LAD |
What is the name of the system of rating quality/quantity of blood flow through vessels during angiography? | TIMI Scale |
No flow, completely occluded vessel | TIMI 0 |
TIMI 0 | No flow, completely occluded vessel |
TIMI 1 | Very limited flow, distal vessel not adequately seen |
Very limited flow, distal vessel not adequately seen | TIMI 1 |
TIMI 2 | Moderate flow, entire lumen seen but still overall slow flow |
Moderate flow, entire lumen seen but still overall slow flow | TIMI 2 |
TIMI 3 | Normal flow, all anatomy seen |
Normal flow, all anatomy seen | TIMI 3 |
RCA and associated branches are seen in what leads? | II, III, aVF |
Inferior myocardium is monitored in what leads? | II, III, aVF |
LAD and associated branches seen in which leads? | All V-leads, I AND aVL LEADS |
All V-leads and I and aVL see what | LAD and associated branches, anterior and lateral myocardium |
Circumflex and associated branches seen in which lead? | V1-V4 |
Posterior myocardium seen where? | Circumflex and associated branches in the posterior myocardium. |