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Cardiology > 2.1.2 Normal Heart Exam > Flashcards

2.1.2 Normal Heart Exam Flashcards

1
Q

What is different between arteries and veins upon palpation?

A

Arteries will palpate and veins will not

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2
Q

Where is the mitral area?

A

Left side of patient 5th intercostal space between the mid clavicular line and the anterior axillary line

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3
Q

Following palpation, sustained precordial movements may indicate what?

A

Aortic stenosis, Volume overload, Severe cardiomyopathy, Ventricular aneurysm

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4
Q

What are the characteristics of mitral regurgitation murmur?

A

Holosystolic murmur that is best heard at the apex of the heart. It also radiates to the axilla.

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5
Q

Where is a mitral regurgitation murmur going to be heard best?

A

In the mitral area at the apex

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6
Q

What do you do?

A

This patient has mitral valve stenosis

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7
Q

What is the proper positioning for a cardiac exam?

A

The patient should be 30 degrees from horizontal and the physician should be on the patients right side

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8
Q

Where is an aortic stenosis murmur going to be heard best?

A

In the aortic area - second intercostal area on right side of chest

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9
Q

Where is a venous hum murmur going to be heard best?

A

About the head of the clavicle

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10
Q

What type of murmurs may radiate to the carotid?

A

Aortic Valve murmurs

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11
Q

Where is the tricuspid area?

A

Left side of patient fifth intercostal space between the sternum and mid clavicular line

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12
Q

What are you looking for when you auscultate the carotid arteries?

A

Carotid bruits, which are a sign of turbulent flow due to stenosis

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13
Q

What are the main peripheral pulses in the lower extremities?

A

Femoral - groin area, Dorsalis Pedis, Posterior Tibial - Ankle area

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14
Q

What are some special maneuvers to decrease venous return?

A

Valsalva Squatting to standing Increases outflow tract murmurs

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15
Q

What is occurring at S1?

A

Beginning of systole - closing of the mitral and tricuspid valves

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16
Q

What is a venous hum murmur?

A

It is continuous murmur through systole and diastole. It is associated with high flow states - pregnancy, anemia and pediatric age

17
Q

What are the characteristics of mitral stenosis murmur?

A

Mid - diastolic murmur that is low pitched so use the bell of the stethoscope.

18
Q

What are the 7 categories when characterizing a heart murmur?

A

Timing - systolic/diastolic, early/middle/late

Location of maximum intensity

Shape

Grade - 1 to 6

Radiation

Pitch - high/medium/low

Quality - blowing/harsh/rumbling/musical

19
Q

What is the sound when percussing the heart?

A

It should sound dull (lecturer wasn’t too fond of percussion in a cardiac exam)

20
Q

Where is a mitral stenosis murmur going to be heard best?

A

In the mitral area at the apex

21
Q

What is the location of the pulmonic area?

A

Left side of patient second intercostal space between the sternum and mid clavicular line

22
Q

What are the main peripheral pulses in the upper extremities?

A

Radial and brachial

23
Q

What is an S3 sound?

A

Abnormal early diastolic “filling” sound Ventricular gallop - apex with the bell Heart failure

24
Q

What is edema?

A

Swelling that persists after pressure is released

25
Q

What is an S2 split?

A

Different closing times of the aortic and pulmonic valves. This is normal during inspiration due to extra hangout time

26
Q

What is an S4 sound?

A

Abnormal late diastolic filling sound - heart stiffening

27
Q

What is occurring at S2?

A

Beginning of diastole - closing of the aortic and pulmonic valves

28
Q

Where is the point of maximum impulse?

A

Normal PMI is mid-clavicular line at 5th-6th intercostal space - thought to aid in diagnosis of CHF

29
Q

What are the 4 basic parts of the cardiac exam?

A

Inspection, Palpation, percussion, and auscultation

30
Q

When auscultating, what are you listening for in regards to rhythm and rate?

A

Whether the rhythm is regular vs irregular and whether the patient is bradycardic, normal or tachycardic

31
Q

What is the location of the aortic area?

A

Right side of patient second intercostal space

32
Q

What are the characteristics of a Aortic stenosis murmur?

A

Systolic murmur that presents in a crescendo-decrescendo pattern. It radiates to the carotids and is accompanied with a low and slow upbeat in the carotid

33
Q

Jugular venous pulsations are good estimates of what?

A

Estimate central venous and right atrial pressure as well as RV end diastolic pressure

34
Q

When assessing peripheral pulses what are you comparing?

A

Comparing the pulses laterally The rate and rhythm of the pulses The character of the pulses - bounding vs thready

35
Q

What do you do?

A

Order an EKG and echocardriogram - this patient may have HOCM

36
Q

What are some special maneuvers to increase venous return?

A

Prolonged abdominal palpation Standing to squatting Passive leg elevation Decrease ie HOCM

Cardiology (46 decks)

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