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PCM III Final > Cardiac Assessment > Flashcards

Cardiac Assessment Flashcards

1
Q

Erb’s point

A

point of transition where S2 or S1 sounds are louder; above the point S2>S1, below S1 >S2

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2
Q

Aortic listening post

A

2nd ICS on R

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3
Q

Pulmonary valve listening post

A

2nd ICS on L

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4
Q

Tricuspid valve listening post

A

5th ICS on R

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5
Q

Mitral valve listening post

A

5th ICS on L

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6
Q

S1 sound

A

AV valve closure

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7
Q

S2 sound

A

semilunar valve closure

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8
Q

Wide physiologic S2 split

A

increase in splitting during inspiration; caused by pulmonic stenosis or RBBB or mitral regurgitation

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9
Q

Fixed S2 splitting

A

wide splitting that does not vary with respiration; caused by ASD and RV failure

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10
Q

Paradoxical splitting S2

A

appears on expiration and disappears on inspiration; aortic valve closure is abnormally delayed, often indicative of LBBB

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11
Q

S3 sound

A

low pitched sound best heard at apex, normally occurs in children but indicative of LV failure or volume overload in people over 40

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12
Q

S4 sound

A

low pitched sound best heard at apex, reflects atrial contraction into a non-compliant ventricle; found in aortic stenosis, hypertension, hypertrophic cardiomyopathy, coronary artery disease

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13
Q

Systolic murmur at RUSB with a reduced carotid pulse

A

aortic stenosis

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14
Q

Systolic murmur at LLSB that does not accentuate with inspiration

A

VSD

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15
Q

Systolic murmur at LLSV that does accentuate with inspiration

A

tricuspid regurgitation

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16
Q

Holosystolic murmur at cardiac apex

A

mitral insufficiency

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17
Q

Systolic click with or without a murmur at cardiac apex

A

mitral valve prolapse

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18
Q

Diastolic murmur at RU or L midsternal border

A

AI

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19
Q

Diastolic murmur at RLSB in left lateral decubitus position

A

mitral stenosis, opening snap!

20
Q

Normal aortic valves become stenotic at what age?

A

> 75 years of age

21
Q

Congenital bicuspid aortic valves become stenotic at what age?

A

40-70 years

22
Q

Classic triad of aortic stenosis

A

heart failure, angina, syncope

23
Q

Heart sounds associated with aortic stenosis

A

S4 gallop, mid-to-late peaking ejection murmur at RUSB or suprasternal notch that radiates to the neck, S2 split

24
Q

Gallavardin effect

A

AS murmur transmitted to apex

25
Q

Systolic ejection murmur becomes …. with squating

A

louder

26
Q

Prognosis of AS pt with angina

A

5 years

27
Q

Prognosis of AS pt with syncope

A

3 years

28
Q

Prognosis of AS pt with HF

A

2 years

29
Q

Native acute AR is caused by..

A

flail leaflet due to endocarditis, type A aortic dissection, trauma

30
Q

Prosthetic valve AR caused by…

A

tissue valve leaflet rupture, mechanical valve closure problem, infection

31
Q

Presentation of pt with acute AR

A

severe pulmonary edema and CO

32
Q

Medical therapy for severe AR

A

vasodilators, ACEis and ARBs used for sx management

33
Q

TR can be caused by…

A

rheumatic heart disease, endocarditis, carcinoid, congenital disease

34
Q

Mitral stenosis is most commonly due to…

A

rheumatic fever

35
Q

Most common congenital defect in children…

A

VSD

36
Q

Clinical presentation MVP

A

thin, younger female; palpitations, dyspnea, exercise intolerance, dizziness

37
Q

Water-hammer or Corrigan pulse

A

rapid rise and fall with elevated systolic and low diastolic pressure

38
Q

Hill sign

A

leg systolic pressure >40mmHg

39
Q

VSD murmur

A

loud, harsh holosystolic murmur in 3rd and 4th ICS

40
Q

Correct way to measure BP

A

avoid caffeine, tobacco, alcohol 30 min prior to measurement, rest quietly for 5 minutes, feet flat on floor, back supported, no talking, arm at level of heart

41
Q

Obtain orthostatic vital signs when concerned about…

A

dehydration, blood loss, syncope/near syncope

42
Q

How long should a pt lay down to take orthostatic VS?

A

at least 5 minutes

43
Q

Positive orthostatics

A

pulse INCREASE of 10 bpm or greater, BP decrease of 20 mmHg or greater

44
Q

Cap refill >2 seconds may indicate…

A

decreased volume, decreased CO, peripheral vascular disease

45
Q

JVD measurement

A

position pt 30-45 degrees, turn head from area being tested and look for pulsating jugular veins near suprasternal notch, measure height and add 5cm

46
Q

6 P’s of limb ischemia

A

paraesthesia, perishing cold, pulselesness, pain, paralysis, pallor

PCM III Final (4 decks)

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