cardiac Flashcards
radial artery
wrist in between distal end of radius and lateral to tendon of FCR muscle at the end of brachioradialis
When do you assess rate and rhythm
radial a. rate: no. beats per min. rhythm: regularity of beat (regular vs irregular)
what is brady/tachycardia
less than 60, more than 100
common carotid
medial to SCM and lateral to thyroid cartilage, pt head is straight. Comment on character (strong/weak) and volume
ulnar artery
wrist over distal end of forearm lateral to the tendon of FCU and medial to FDS
brachial a
antecubital fossa, medial side of tendon of biceps brachii when elbow extended. Extend elbow- middle 1/3 of humerus in medial bicipital groove
apex beat
apex of left ventricle, 5th intercostal space, MCL. Once you have found the spot, start more laterally and feel medially to sternum, cardiomegaly have displaced apex, not there if epricardial effusion, obesity, pleural effusion.
heaves
abnormal character of beat. heal of hand will lift with heartbeat due to LV/RV hypertrophy
thrills
palpable murmur due to turbulent flow across a valve,
ausculation: pulmonary valve
left sternal border-2nd ICS
ausculation: aortic valve:
right sternal border, 2nd ICS
ausculation: tricuspid valve
left 5th costosternal border
mitral valve
left 5th intercostal space@ apex beat
upper border of the heart
left 3rd ccto right 2nd ICS.
right border of the heart
right 3rd ICS to 6th CC
lower border of the heart
right 6th cc to 5th ICS at MCL on LHS
left border of the heart
left 5th ICS at MCL to 2nd ICS also on LHS
murmurs
occur due to abnormal blood flow across valve due to
aortic stenosis
ejection systolic murmur. radiates to carotid A, loudest on expiration. lean forward and hold breath and auscultate over carotid a
aortic regurgitation
early diastolic murmur. pt lean forward, expire, auscultate over aortic areas
mitral stenosis
mid diastolic murmur, radiate to left axilla, loudest on expiration. bell
mitral regurgitation
pansystolic murmur during expiration, ascultate into axilla. diaphragm
posterior tibial pulse
posterior to medial malleolus of tibia
dorsalis pedis artery
dorsum of foot, lateral to extensor hallucis longus tendon over 2nd and 3rd cunnifrom bones
femoral pulse
mid- inguinal point. midpoint between ASIS and pubic symphysis.
popliteal pulse
inferior region of poplieal fossa, place thumbs on tibial tiberosity, passively flex knee at 30 degrees and curl fingers into popliteal fossa.
rate
number of r waves in 1 min (in rhythm strip, times 10)
rhythm
regular, irregular
p wave
sinus rhythm. no p wave: atrial fibrillation (oscilating baseline). sinus arrythmia
atrial flutter
saw tooth pattern
axis deviation
lead 1 and AVF: lead 2 and AVL: lead 3 and AVR: leave : LAD, less than minus 30, reach= right axis deviation more than 90. normal: -30 to +90.
1st degree heart block
prolonged PR, but QRS always after p wave
2nd degree heart block, mobitz type 1
prolonging PR interval, till p wave not followed by QRS. regulalry irregular
2nd degree heart block, mobitz type 2
normal PR interval, but not always followed by QRS complex.
3rd degree heart block
p wave does not follow QRS complex
st elevation
ST eleveated myocardial infarction. or st depression. both due to ischaemia of heart tissue due to occlusion (could be due to atherosclerosis of coronary arteries)
lead 1, v5,v6, avl
lateral side of heart, left circumflex artery
II, III, AVF
inferior heart: right coronary artery
V1,V2,V3,V4
left anterior descending artery. V1 and V2: septal. V3 AND 4= anterior
