Cardiac

Question 1

S1
cause
where its loudest

Answer 1

Closure of Tricuspid and Mitral valves (AV valves)
Loudest at apex MCL at 5th ICS

Question 2

S2
cause
where its loudest

Answer 2

Closure of Aortic and Pulmonic vales (Semilunar)
Loudest at RSB at 2nd ICS

Question 3

Source of S3 sound
where is it heard best
State pneumonic

Answer 3

Caused by blood rushing into a dilated ventricle
heard best at apex with bell
‘Kentucky”

Question 4

Medical conditions that can lead to an S3 sound (3)

Answer 4

1. Pulmonary HTN
2. Core Pulmonale
3. Mitral, Aortic or Tricuspid valve insufficiency

Question 5

Source of S4 four sound
best heard where?

Answer 5

blood entering a non-compliant (stiff) ventricle
apex with bell

Question 6

What medical conditions can lead to an S4 sound? (4)

Answer 6

1. MI
2. HTN
3. Vent, hypertrophy
4. Aortic stenosis

Question 7

What causes the S1 and S2 sounds?

Answer 7

valves closing

Question 8

Ratio of time spent in diastole to sytole?

Answer 8

2:1

Question 9

What is occurring with blood flow during diastole?

Answer 9

The ventricles are filling

Question 10

What is occurring with blood flow during systole?

Answer 10

The ventricles are actively contracting and ejecting blood

Question 11

When are the coronary arteries perfusing?

Answer 11

During diastole

Question 12

When during the cardiac cycle does valvular regurgitation (insufficiency) occur?

Answer 12

When valves are closed

Question 13

At what point in the cardiac cycle does valvular stenosis manifest?

Answer 13

When valves are open

Question 14

What two cardiac issues are associated with mitral valve stenosis?

Answer 14

1. Atrial enlargement
2. enlargement leads to afib

Question 15

Systolic murmur timing?

Answer 15

Lub shhh Dubb

Question 16

Diastolic murmur timing?

Answer 16

Lub dub shhhh

Question 17

What valves ae open during systole?

Answer 17

Semilunar (Aortic, Pulmonic)

Question 18

What valves are closed during systole?

Answer 18

AV (Mitral, tricuspid)

Question 19

What murmur may be associated with an acute MI?
What is the cause of this murmur?
Where is it best heard?

Answer 19

1. Mitral regurgitation
2. Mitral valve is attached to the LV wall by papillary muscle and chordae tendineae. MI can effect this function.
3. Sternal border 5th ICS, STAT Pearls says “ systolic murmur at apex w/ radiating to left axialle”.

Question 20

RVMI CVP ranges

Answer 20

CVP > 10mmHg
CVP within 5 mmHg of PAOP
(The Nursing Prof CCRN Review)

Question 21

Bragada Syndrome

Answer 21

1. congenital mutation of NA channel
2. leads to fatal rythm
3. treatment id ICD
4. EKG findings- RBB w/ ST elevation in precordial leads esp. v1-v3
   ‘saddle back ST elevation”
5. S/Sx - palpitations, dizziness, syncope

Question 22

Wellens Syndrome

Answer 22

1. Indicates proximal LAD stenosis
2. Deep inverted or biphasic T waves in V2-V3
   plus recent chest pain w/o st elevation or ^ troponin or q waves(in short)