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Derm-Physical Diagnosis > Cardiac > Flashcards

Cardiac Flashcards

1
Q

S1-lub

A

systolic, closure of mitral and tricuspid valves. Best heard at apex

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2
Q

S2-dub

A

diastolic, closure of aortic and pulmonic valves. Best heard at base

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3
Q

S3

A

diastolic, rapid distension of ventricular walls causing vibration. Best heard at apex

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4
Q

S4

A

systolic, blood rushing past valves, papillary muscles, ventricular wall (atrial kick). Best heard at apex

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5
Q

Physiological splitting

A

S2 - A2 (aortic valve closure)/P2 (pulmonic valve closure). pressure on the right

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6
Q

Physiological splitting

A

S2 - A2 (aortic valve closure)/P2 (pulmonic valve closure). pressure on the right

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7
Q

RA chamber pressure

A
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8
Q

RV chamber pressure

A
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9
Q

LA chamber pressure

A
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10
Q

LV chamber pressure

A
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11
Q

Murmur

A

sound made by blood rushing through narrow/leaky valve

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12
Q

Thrill

A

Buzzing/vibratory sensation-blood flow thru narrow opening (aortic stenosis, VSD)

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13
Q

Lift/heave

A

Vigorous cardiac impulse (ventricular hypertrophy, hyperdynamic ventricular activity)

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14
Q

What do you do if you feel a thrill

A

Auscultate for murmur

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15
Q

PMI

A

pulsation of LV

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16
Q

Bell

A

Low pitched sound (S3, S4). Light pressure

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17
Q

Bell

A

Low pitched sound (S3, S4). Light pressure

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18
Q

S2-dub

A

diastolic, closure of aortic and pulmonic valves

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19
Q

S3

A

diastolic, rapid distension of ventricular walls causing vibration

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20
Q

S4

A

systolic, blood rushing past valves, papillary muscles, ventricular wall (atrial kick)

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21
Q

Pulsus alternans

A

Alternating strong & weak beats - LV systolic impairment

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22
Q

RA chamber pressure

A
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23
Q

RV chamber pressure

A
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24
Q

What murmurs can you hear when a pt leans forward

A

Aortic/pulmonic regurgitation (soft murmurs at the base)

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25
LV chamber pressure
26
Murmur
sound made by blood rushing through narrow/leaky valve
27
Thrill
Buzzing/vibratory sensation-blood flow thru narrow opening (aortic stenosis, VSD)
28
Pathologic S2 split
delayed closure of pulmonic valve (ASD, Pulmonary stenosis, RVHF, RBBB) over age 40
29
What do you do if you feel a thrill
Auscultate for murmur
30
PMI
pulsation of LV
31
Diaphragm
High pitched sounds (S1, S2). Firm pressure
32
Bell
Low pitched sound (S3, S4). Light pressure
33
Normal pulses
115/72
34
Weak pulses
100/82
35
Bounding pulse
120/50
36
Bisferiens pulse
significant aortic valve regurgitation=double pulse; 1st-systole, 2nd-early diastole
37
Pulsus alternans
Alternating strong & weak beats - LV systolic impairment
38
What does JVD indicate
Fluid overload 5cm above RA = norm >4cm above sternum= abnormal
39
Mitral prolapse click
systolic, ballooning of mitral leaflet in LA druing systole, benign usually
40
What murmurs can you hear when a pt leans forward
Aortic/pulmonic regurgitation (soft murmurs at the base)
41
What is heard best in Left lateral decubitus position
Gallops/murmurs -Low pitched filling sounds
42
Systolic ejection "flow" mumur
crescendo-decrescendo (blood flow across semilunar valves) aortic/pulmonic stenosis. Best heard at base. High pressure to high pressure
43
Pansystolic/holosystolic
plateau, regurg. across AV valves/VSD. High pressure to low pressure. no change in intensity
44
Late systolic
mitral prolapse
45
Wide split S2
Delayed pulmonic valve closure (Pulmonic stenosis, RBBB)
46
ASD
Left to right shunt, congenital, systolic ejection murmur, fixed S2 split
47
Paradoxical S2 split
A2 follows P2. delay in contraction of LV due to LBBB
48
Ventricular gallop rhythm
S1+S2+S3
49
Atrial gallop rhythm
S1+S2+S4
50
Maneuvers to identify systolic murmurs
- Standing/strain phase of valsalva | - Squating/release phase of valsalva
51
Bradycardia
52
Rhythmic arrhythmias
Premature atrial/ventricular/nodal contractions
53
Irregularly irregular arrhythmias
A-Fib, Atrial flutter
54
Aortic/pulmonic ejection click
High pitched, valve disease/dilated aorta, pulm. artery, Pulm. HTN
55
Mitral prolapse click
systolic, ballooning of mitral leaflet in LA druing systole
56
Xtics of abnormal heart sounds
- Location - Timing - Grade/intensity - Quality/shape
57
Gradation of murmurs
1/6-barely audible in quiet room 2/6-quiet but clearly audible 3/6-moderately loud 4/6-Loud w/ thrill 5/6-very loud, heard w/ stethoscope partially off chest, obvious thrill 6/6-very loud, heard w/out stethoscope on chest, obvious thrill
58
Systolic ejection "flow" mumur
crescendo-decrescendo (blood flow across semilunar valves) aortic/pulmonic stenosis
59
Pansystolic/holosystolic
plateau, regurg. across AV valves/VSD
60
Late systolic
mitral prolapse
61
Innocent systolic murmur
usually pulmonic, grade 1 or 2 rarely 3. result of turbulent flow, no narrowing
62
ASD
Left to right shunt, congenital, systolic ejection murmur, fixed S2 split
63
VSD
Left to right shunt, Harsh systolic murmur, pansystolic, LLSB thrill
64
Diastolic murmurs
Early-decrescendo, regurgitant flow across aortic/pulmonic Mid-Turbulent flow across AV valves Late-usually continues up to S1
65
Systolic-diastolic murmur
Crescendo-decrescendo, aortic stenosis/regurg.
66
Maneuvers to identify systolic murmurs
- Standing/strain phase of valsalva | - Squating/release phase of valsalva
67
Continuous vs to & fro murmurs
* Patent ductus arteriosus (channel btw aorta & pulm artery doesn't close after birth) * To & fro-systolic/diastolic murmurs * Precardial friction rub

Derm-Physical Diagnosis (6 decks)

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