10 exam of cardiovascular organs, blood vessels Flashcards
what is the order of the cariovascular examination
- history
- general condition
- detailed examination of the cardiovascular system
- heart
- blood vessels: arterial, venous, capillary sytem
what is the method for examining arteries
- digital palpation - pulse, pulse pressure
- blood pressure measurement - direct or indirect
- blood flow registration ( doppler US)
- pulse wave velocity (human)
what is pulse pressure
difference between systolic and diastolic blood pressure
how do we calculate systemic arterial blood pressure
cardiac output x total peripheral resistance
what is cardiac output
heart rate ejection volume:
- circuating blood
- heart contraction
- integrity of cardiac structures
what is total periferal resistance
- vessel diameter
- elasticity of vessels
- blood viscosity (PCV)
which artery is available for digital palpation in dog and cat
femoral artery
what is important when we examine arterial pulse
should be palpated on both sides
should be symmetrical
list the physiological findings during arterial pulse examination
- symmetricity
- rate: physiological
- rythm: regular
- size, strength and duration: even, normal
what is irregular and uneven pulse called in latin
- pulsus irregularis
- pulsus inequalis
what can be the abnormal findings of the size of the arterial pulse
- large, hyperkinetic ( pulsus magnus)
- small, hypokinetic (pulsus parvus)
what are the abnormal compressibility findings during arterial pulse examination
- strong or weak -> cardiac function
- hard or soft -> vascular tone (p. durus/mollis)
what er the abnormal duration findings during arterial pulse exam
- sluggish (p. tardus)
- skipping (p. celer)
- size + duration: full (p. plenus) or empty (p. vacuus)
what abnormal findings do we have for pulse quality
- small, brief hard: wiry
- small, prolonged and weak: thready
- skipping and large: bumping
- thrill
- paradox pulse
- pulsus alterans
- pulse deficit
what is latin for wiry and thready pulse type
- wiry = p. contractus
- thready = p. piliformis
what causes thready pulse
heart failiure
hypovolemia
what is latin for bumping pulse and what causes it
- p. celer et magnus
- corrigan pulse:
- PDA
- aortic insufficiency
- anemia
- fever
- bradycardia
what causes the thrill pulse
partly compressed artery
anemia?
what is latin for paradox pulse
and what causes it
- p. paradoxus
- changing with respiration
- cardiac tamponade
what causes pulsus alternans
- arrythmia or cardiomyopathy
what is pulse deficit
no pulse wave after heart beat
what methods do we use to examine the veins
- inspection
- palpation
- measurement of central venous pressure
what veins are available for examination
V. jugularis
what are the two main things we examine in the veins
- degree of fullness
- movement within the veins
degree of fullness
how should the jugular vein normally be
empty
how can we check the degree of fullness of the veins
venous stasis compression test
what results can be abnormal in a venous stasis compression test
- abnormally slow - poor filling
- vein stands out and feels tense
- congestion
- positive venous stasis test
what is a positive venous stasis test
- no emptying below the compression point
- or no disapperance of venous undulation
what causes a positive venous stasis test
- compression
- right sided heart failiure
- pericardial tamponade
list the things we check for when examining movement within veins
- undulation
- negative or atrial venous pulse
- positive or ventricular pulse
- hepatojubular reflux
movement within veins
cause of undulation
- influenced by breathing
- dyspnea
movement within veins
what is negative or atrial venous pulse
- increased right atrial pressure during diastole
- can be normal or due to right sided heart fail
movement within veins
what is positive or ventricular pulse
- increased right ventricular pressure and improper valve closure during systole
- always pathological (right sided heart fail)
what is physiological movements within the veins
- respiratory, diastolic, false (carotis pulse)
- max ventral 1/3 of neck
- disappears with compression test
what is pathological vein pulse
- systolic
- pronounced, over the ventral third of neck
- persists after compression test
is congested jugular vein pathological
always pathological!!
how do we check central venous pressure directly
- catheterization
- accurate, fluid replacement, invasive
how do we check central venous pressure indirectly
- examination of peripheral veins
- v, jugularis, v. saphena, v. cava caud.
- US, x ray
- liver size
what do we use indirect central venous pressure test for
determination of venous congestion
indirect central venous pressure in dogs
- lateral recumbency collapse of v. saphena about 5 cm above zero point
- T7-table + sternum-table / 2
indirect central venous pressure in dogs
- lateral recumbency collapse of v. saphena about 5 cm above zero point
- T7-table + sternum-table / 2
how do we examine the capillaries
examination of the mucous membranes
examination of the capillaries
what mucous membranes should we examine
both cranial and caudal mm should be examined
examination of the capillaries
what are the pathologic colors of the mucous membranes
- cyanotic: poor oxygenation
- pale: anemia, vasoconstriction
examination of the capillaries
what can cause delayed CRT
dehydration, vasoconstriction
examination of the capillaries
how can we differentiate the fullness of the capillaries
- empty - peripheral circulatory insufficiency: livid mm
- increased fulness of the arterioles: light red mm
- overfilling of the venules - congestion: violet mm
examination of the capillaries
list the things we can look for
- color
- CRT
- fullness of capillaries
