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Derm-Physical Diagnosis > Cardiac > Flashcards

Cardiac Flashcards

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Dermatology Board Prep 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
Q

LV chamber pressure

A
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26
Q

Murmur

A

sound made by blood rushing through narrow/leaky valve

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27
Q

Thrill

A

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

28
Q

Pathologic S2 split

A

delayed closure of pulmonic valve (ASD, Pulmonary stenosis, RVHF, RBBB) over age 40

29
Q

What do you do if you feel a thrill

A

Auscultate for murmur

30
Q

PMI

A

pulsation of LV

31
Q

Diaphragm

A

High pitched sounds (S1, S2). Firm pressure

32
Q

Bell

A

Low pitched sound (S3, S4). Light pressure

33
Q

Normal pulses

A

115/72

34
Q

Weak pulses

A

100/82

35
Q

Bounding pulse

A

120/50

36
Q

Bisferiens pulse

A

significant aortic valve regurgitation=double pulse; 1st-systole, 2nd-early diastole

37
Q

Pulsus alternans

A

Alternating strong & weak beats - LV systolic impairment

38
Q

What does JVD indicate

A

Fluid overload
5cm above RA = norm
>4cm above sternum= abnormal

39
Q

Mitral prolapse click

A

systolic, ballooning of mitral leaflet in LA druing systole, benign usually

40
Q

What murmurs can you hear when a pt leans forward

A

Aortic/pulmonic regurgitation (soft murmurs at the base)

41
Q

What is heard best in Left lateral decubitus position

A

Gallops/murmurs -Low pitched filling sounds

42
Q

Systolic ejection “flow” mumur

A

crescendo-decrescendo (blood flow across semilunar valves) aortic/pulmonic stenosis. Best heard at base. High pressure to high pressure

43
Q

Pansystolic/holosystolic

A

plateau, regurg. across AV valves/VSD. High pressure to low pressure. no change in intensity

44
Q

Late systolic

A

mitral prolapse

45
Q

Wide split S2

A

Delayed pulmonic valve closure (Pulmonic stenosis, RBBB)

46
Q

ASD

A

Left to right shunt, congenital, systolic ejection murmur, fixed S2 split

47
Q

Paradoxical S2 split

A

A2 follows P2. delay in contraction of LV due to LBBB

48
Q

Ventricular gallop rhythm

A

S1+S2+S3

49
Q

Atrial gallop rhythm

A

S1+S2+S4

50
Q

Maneuvers to identify systolic murmurs

A
  • Standing/strain phase of valsalva

- Squating/release phase of valsalva

51
Q

Bradycardia

A
52
Q

Rhythmic arrhythmias

A

Premature atrial/ventricular/nodal contractions

53
Q

Irregularly irregular arrhythmias

A

A-Fib, Atrial flutter

54
Q

Aortic/pulmonic ejection click

A

High pitched, valve disease/dilated aorta, pulm. artery, Pulm. HTN

55
Q

Mitral prolapse click

A

systolic, ballooning of mitral leaflet in LA druing systole

56
Q

Xtics of abnormal heart sounds

A
  • Location
  • Timing
  • Grade/intensity
  • Quality/shape
57
Q

Gradation of murmurs

A

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
Q

Systolic ejection “flow” mumur

A

crescendo-decrescendo (blood flow across semilunar valves) aortic/pulmonic stenosis

59
Q

Pansystolic/holosystolic

A

plateau, regurg. across AV valves/VSD

60
Q

Late systolic

A

mitral prolapse

61
Q

Innocent systolic murmur

A

usually pulmonic, grade 1 or 2 rarely 3. result of turbulent flow, no narrowing

62
Q

ASD

A

Left to right shunt, congenital, systolic ejection murmur, fixed S2 split

63
Q

VSD

A

Left to right shunt, Harsh systolic murmur, pansystolic, LLSB thrill

64
Q

Diastolic murmurs

A

Early-decrescendo, regurgitant flow across aortic/pulmonic
Mid-Turbulent flow across AV valves
Late-usually continues up to S1

65
Q

Systolic-diastolic murmur

A

Crescendo-decrescendo, aortic stenosis/regurg.

66
Q

Maneuvers to identify systolic murmurs

A
  • Standing/strain phase of valsalva

- Squating/release phase of valsalva

67
Q

Continuous vs to & fro murmurs

A
  • 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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