Cardiac Evaluation

Question 1

____ occurs in lung and heart conditions that reduce the amount of oxygen in the blood.

Answer 1

Clubbing

Question 2

What is the severity scale for pitting edema?

Answer 2

0 - No pitting edema
1 - Mild (2mm depression that disappears rapidly)
2 - Moderate (4mm depression that disappears in 10-15 sec)
3 - Moderately severe (6mm depression that lasts more than 1 minute)
4 - Severe (8mm depression that lasts more than 2 minutes)

Question 3

____ is used to detect normal and abnormal heart sounds.

Answer 3

Phonocardiography

Question 4

What is a crescendo?

Answer 4

A sound that is soft to loud

Question 5

What is a decrescendo?

Answer 5

A sound that is loud to soft

Question 6

What does “pansystolic” mean?

Answer 6

Two chambers are widely different in pressure (MR or TR)

Question 7

During ____ there is an increase in TR TS, PI, PS, & venous return.

Answer 7

Inspiration

Question 8

During ____ there is an increase in MR, MS, AS, AI (inversely relates to right side).

Answer 8

Expiration

Question 9

The first heart sound, S1 is produced by the closure of the ____ and ____ valve.

Answer 9

Mitral; Tricuspid

Question 10

The mitral valve closes slightly ____ the tricuspid valve.

Answer 10

Before (because pressures in the left side are higher than the pressures in the right side)

Question 11

S1 marks the beginning of ____ ____.

Answer 11

Isovolumic contraction

Question 12

S1 will become louder if you increase ____ (MR and TR).

Answer 12

Output

Question 13

The second heart sound, S2 is produced by closure of the ____ and ____ valves.

Answer 13

Pulmonic; Aortic

Question 14

S2 marks the beginning of ____ ____.

Answer 14

Isovolumic relaxation.

Question 15

____ is higher pitched and shorter than ____ and tends to sound louder.

Answer 15

S2; S1

Question 16

S2 may intensify with ____ ____.

Answer 16

Systemic hypertension

Question 17

S2 may decrease in intensity with ____.

Answer 17

Hypotension

Question 18

Heart sounds: what is associated with a Loud S1?

Answer 18

Rheumatic MS

Question 19

Heart sounds: what is associated with an opening snap?

Answer 19

Rheumatic MS or TS

Question 20

Heart sounds: what is associated with an ejection sound or click?

Answer 20

Congenital PS or AS

Question 21

Heart sounds: what is associated with MVP?

Answer 21

Midsystolic click

Question 22

Heart sounds: what is associated with a fixed split S2?

Answer 22

ASD

Question 23

Heart sounds: what is associated with a pericardial effusion?

Answer 23

pericardial friction rub

Question 24

Heart sounds: what is associated with a pericardial knock?

Answer 24

Pericarditis

Question 25

Where can you best hear an aortic murmur?

Answer 25

Right upper sternal border

Question 26

Where can you best hear a pulmonic murmur?

Answer 26

Left upper sternal border

Question 27

Where can you best hear a tricuspid murmur?

Answer 27

Left lower sternal border

Question 28

Where can you best hear a mitral murmur?

Answer 28

Apex

Question 29

What are some causes of a systolic murmur?

Answer 29

- Obstruction to the outflow tract (semilunar valves) - Incompetent AV valves - Structural deformities of the aorta or pulmonary artery - Ventricular septal defect (VSD) - holosystolic

Question 30

What are some causes of a diastolic murmur?

Answer 30

- Incompetent semilunar or stenotic AV valves. - Early diastolic murmurs usually result from insufficiency of a semilunar valve or dilation of the valvular ring. - Mid and late diastolic murmurs are generally caused by narrowed, stenotic mitral or tricuspid valves that obstruct blood flow.

Question 31

What sound is caused by the vibration of the ventricular walls during rapid passive filling in early diastole?

Answer 31

S3

Question 32

S3 may also be referred to as ____ ____.

Answer 32

Ventricular gallop

Question 33

An S3 sound may be normal finding in those under age ____.

Answer 33

30 (this is because younger people tend to have more compliant hearts)

Question 34

What heart sound is always abnormal?

Answer 34

S4

Question 35

S3 is the ____ wave.

Answer 35

E

Question 36

S4 is the ____ wave.

Answer 36

A

Question 37

What sound is caused by vibration of the valves, supporting structure, and ventricular walls during the second phase of rapid ventricular filling in late diastole?

Answer 37

S4

Question 38

What are some conditions that cause an S3 sound?

Answer 38

-High cardiac output - Large left to right shunts - Anemia - Valve regurg - Cardiomyopathy

Question 39

S4 may also be referred to as ____ ____.

Answer 39

Atrial gallop

Question 40

What are some conditions that cause an S4 sound?

Answer 40

- HTN - Significant semilunar valve stenosis - CAD - Acute MR

Question 41

Are S3 and S4 low or high pitch?

Answer 41

Low pitch