Bates Flashcards
Isolated Systolic Hypertension
Systolic =/> 140
Diastolic < 90
Bladder cuff
- width: AC
- length: AC
- narrow: __
- wide: ___
Heart Level = __
- lower: __
- higher: __
Loose Cuff: __
Width 40% of AC
Length 80% of AC
Narrow: false high
Wide: false low in small arm
Wide: false high in large arm
Heart Level = roughly level with the 4th interspace at its junction with the sternum
Lower: false high
Higher: false low
Loose cuff: false high
Auscultatory Gap
How to Estimate Systolic BP:
a silent interval that may be present between the systolic and the diastolic pressures.
Add 30mmHg to systolic BP measured by palpation
Pressure difference taken both arms of 10-15mmHg
- ___
- ___
- Subclavian Steal Syndrome
2. Aortic Dissection
How to intensify Korotkoff Sounds
Diseases (3)?
- Raise the patient’s arm before and while you inflate the cuff. Then lower the arm and determine the blood pressure.
- Inflate the cuff. Ask the patient to make a fist several times, and then determine the blood pressure.
Occlusive disease:
- Takayasu
- Giant cell arteritis
- Atherosclerosis
Orthostatic Hypertension
Drop in SBP ___
Drop in DBP ___
within ____min of standing
drop in
SBP =/> 20mmHg
DBP =/> 10mmHg
within 3 minutes
Hypertension in UE
Low BP in LE
(>5-10mmHg difference)
COARCTATION OF AORTA
- narrowing of thoracic aorta
usu. proximal
sometimes distal to L subclavian artery
Diminished or delayed femoral pulses
PAOD
Hyperpyrexia
above 41.1C / 106F
Hypothermia
Below 35C / 95F
Periods of deep breathing (hyperpnea) with periods of apnea
Cheyne Stoke’s Breathing
- HF
- Uremia
- Diencephalon Brain Damage
- Drug induced Respiratory Depression
Unpredictable irregular breathing then stops for short periods
Ataxic Breathing/
Biot’s Breathing
- Medullary Brain Damage
- Respiratory depression
Prolonged expiration
Obstructive airway
- narrowed airways increase the resistance to air flow
Violaceous patches over the eyelids?
collagen vascular disease?
Heliotrope
Dermatomyositis
A slightly but uniformly pigmented macule or patch
with irregular border, 0.5-1.5cm in diameter?
6 or more spots measuring >1.5cm suggest?
Cafe Au Lait Spot
Neurofibromatosis
Hypo- or hyper-pigmented, scaly macules
short sleeved shirt distribution
neck, trunk, upper arm
Tinea Versicolor
Depigmented macules that coalesce
Face, hand, feet, extensor surfaces
Vitiligo
Continuous humming/roaring murmur
in both systole and diastole without a silent interval produced by turbulence of blood in JV
Timing?
Location?
Venous Hum
Loudest in diastole
Located above the medial third of the clavicle, right
*common in children
Scratchy/scraping heart sound produced by inflammation of the pericardial sac
Timing - 3 components?
Location?
Intensify when ___ (3)?
Pericardial Friction Rub
- Atrial systole
- Ventricular systole
- Ventricular diastole
Heard best at the 3rd ICS Left Parasternal
Incrase when patient leans forward
exhales
holds breath
Continuous harsh machinery like murmur in both systole and diastole
Timing?
Location?
Loudest in late systole
Obscures S2
Silent interval in late diastole
Heard best at the 2nd ICS, Left Parasternal
Murmur you’ll expect in AV fistula
continuous murmur (meaning both systolic and diastolic component)
Normal pulse pressure
30-40mmHg
Increased arterial pulse with a double systolic peak
Seen in ____
Bisferiens Pulse
Aortic Regurg/Stenosis
~HOCM
Pulse alternates in amplitude from beat to beat even though the rhythm is basically regular
Seen in ____
Pulsus Alterans
LVHF
