10.2 Flashcards
What is Claudication?
Lower extremity swelling, extremity pain with exertion resolving with rest
Order to complete a cardio exam:
(a) Inspection
(b) Palpation
(c) Percussion
(d) Auscultation
Landmarks of the Apical impulse:
5th left intercostal space, midclavicular line.
Positioning of the patient for auscultation
- Sitting
- Supine,
- Left lateral recumbent
BASIC HEART SOUNDS
S1 and S2 “lub-dub”
S1- closure of bicuspid and tricuspid valves. “lub”
S2- closure of aortic and pulmonic valves. “dub”
BASIC HEART SOUNDS
S3 and S4 “Kentucky” and “Tennessee”
S3- early diastole (passive filling) vibration of ventricular walls. “Kentucky”
S4- ventricular filling from atrial kick, loss of compliance or
increase stroke volume secondary to high output. “Tennessee”
FINDINGS ASSOCIATED WITH PATHOLOGY/DISEASE HEART
What indicates a wide apical pulsation?
Left ventricular hypertrophy
FINDINGS ASSOCIATED WITH PATHOLOGY/DISEASE HEART
What indicates loss of palpable apical pulsation?
Fluid, air or displacement.
FINDINGS ASSOCIATED WITH PATHOLOGY/DISEASE HEART
What are thrills associated with?
failure of semilunar valve to close, aortic or pulmonary stenosis, or atrial septal defect.
FINDINGS ASSOCIATED WITH PATHOLOGY/DISEASE HEART
What is associated with loud S1 and S2 heart sounds?
Loud S1: increased blood velocity, mitral stenosis, heart block, hypertension, or calcification of mitral valve.
Loud S2: hypertension, valve disorder, stenosis, or fluid.
FINDINGS ASSOCIATED WITH PATHOLOGY/DISEASE HEART
Murmurs “Wooshing” sound
Disruption of blood flow into, through, or out of the heart.
Their Intensity is graded I-VI
What is a friction rub?
Associated with inflammation of the pericardial sac. Rough parietal and visceral layers make a sound like grating, machine-like rubbing.
What is pulse pressure?
The difference between the systolic and diastolic pressures.
The pulse pressure should range from 30 to 40 mm Hg, even to as much as 50 mm Hg.
The amplitude of the pulse scale:
4 Bounding, aneurysmal
3 Full, increased
2 Expected
1 Diminished, barely palpable
0 Absent, not palpable
Pitting Edema Scale:
1+ Slight pit, disappears rapidly 2-3 mm depth
2+ Somewhat deep pit, disappears in 10 to 15 seconds 4-5 mm
3+ Noticeable deep pit that lasts more than a minute 6-7 mm
4+ Very deep pit that lasts 2 to 5 minutes 8-9 mm in depth
What is the Homan’s sign test?
Physical exam that checks for thrombosis in the lower extremities.
What is the expected Jugular Venous Pressure measurement?
9cm
What is an ultrasound?
A mechanical wave propagated through a medium at a high
frequency to produce images of structures within the human body.
How are ultrasound waves generated?
By the application of electrical
current to PIEZOELECTRIC crystals in the US transducer (probe).
What is the Piezoelectric effect?
Phenomenon where distortion of a crystal causes an electrical change.
Grayscale colors in an ultrasound image:
- BLACK = Fluid
- GRAY = Tissue
- White (brightest) = bone
The denser the tissue, the brighter
ULTRASOUND TERMINOLOGY
Color Flow Doppler
Operating mode two-dimensional image that portrays movement in color.
used to assess blood flow and vessel anatomy
ULTRASOUND TERMINOLOGY
Gain
Regulates the amplification (brightness)
ULTRASOUND TERMINOLOGY
Hyperechoic and Hypoechoic:
Hyperechoic: refers to a lesion or tumor which produces a stronger echo than the surrounding tissues.
Hypoechoic: refers to structures that contain fewer or weaker echoes.
ULTRASOUND TERMINOLOGY
Resolution
Ability to distinguish between two adjacent structures
ULTRASOUND TERMINOLOGY
Transducer
Electromechanical device that contacts the patient and converts electrical energy into mechanical energy and vice versa.
ULTRASOUND TERMINOLOGY
Conducting Gel
US requires the use of a conducting gel to eliminate air between the
probe and skin.
Ultrasonic medium gel is preferred
