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ECOS II Final > Cardiac Exam > Flashcards

Cardiac Exam Flashcards

1
Q

What is the proper sequence of a cardiac exam?

A

inspection, palpation, percussion, and auscultation

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2
Q

Where do you look to find the apex of the heart?

A

5th ICS on the left, about 1 cm medial to the MCL

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3
Q

What is a thrill?

A

turbulent blood flow causing murmurs

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4
Q

When do you percuss during a cardiac exam and why?

A

to estimate the cardiac size when PMI is not detectable

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5
Q

How should you percuss during a cardiac exam?

A

you start far left and then move medially to find cardiac dullness

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6
Q

What is the S1 sound representing?

A

the mitral and tricuspid valve closing; beginning of ventricular systole

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7
Q

what is the S2 sound representing?

A

the aortic and pulmonary valve closure; marks the end of systole and beginning of diastole

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8
Q

What do the jugular veins reflect?

A

the activity of the right side of the heart

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9
Q

what is the level of JVP visibility an indication of?

A

the right atrial pressure

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10
Q

when looking at the JVP, which one is better?

A

internal jugular is better than external jugular

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11
Q

How do you look for the JVP?

A

place patient in supine position and then raise to 30-45

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12
Q

what is normal JVP?

A

0-9

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13
Q

What is the most common cause of an elevated JVP?

A

elevated RV diastolic pressure

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14
Q

what is the A wave caused by?

A

right atrial contraction; the tricuspid valve opens

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15
Q

when is a giant a wave seen?

A

when there is increased pressure in the right ventricle, pulmonary hypertension, recurrent pulmonary emboli, or when the right atrium contracts against the closed TV

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16
Q

what is the c wave caused by?

A

backward push by closure of TV during isovolumetric systole and by impact of carotid artery adjacent to the JV

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17
Q

what is the x wave caused by?

A

passive atrial filling and atrial relaxation; blood flows into the RA from the cava and closure of the TV

18
Q

when do you see a steep X descent?

A

in cardiac tamponade and constrictive pericarditis

19
Q

What causes the V wave?

A

atrial filling; increasing the volume and pressure in the RA when the TV is closed

20
Q

when might there be a prominent V wave?

A

in tricuspid regurgitation and pulmonary hypertension

21
Q

What is the Y descent/ slope caused by?

A

opening the TV and rapid RV filling in RV diastole

22
Q

when might there be a deep Y descent/slope?

A

in severe tricuspid regurgitation

23
Q

when might there be a slow Y descent/slope?

A

if there is an obstruction to RV filling

24
Q

What causes an S3 sound?

A

high pressures and abrupt deceleration of inflow across the mitral valve at the end of the rapid filling phase

25
Q

What causes an S4 sound?

A

atrial gallop from forceful contraction of atria against a stiffened ventricle

26
Q

what is the first component of the S1 sound?

A

MV closure

27
Q

what is the second component of the S1 sound?

A

TV closure

28
Q

where is S1 the loudest?

A

at the apex

29
Q

what is the first component of the S2 sound?

A

AV closure

30
Q

what is the second component of the S2 sound?

A

PV closure

31
Q

where is S2 the loudest?

A

at the base of the heart

32
Q

Where do you listen to the aortic valve?

A

right 2nd ICS at the sternal border

33
Q

where do you listen to the pulmonary valve?

A

left 2nd ICS at the sternal border

34
Q

where do you listen to the TV?

A

at the left 4th intercostal space at the sternal border

35
Q

where do you listen to the MV?

A

left 5th ICS at the mid clavicular line

36
Q

What is a grade 1 murmur?

A

barely audible

37
Q

what is a grade 2 murmur?

A

soft but easily heard

38
Q

what is a grade 3 murmur?

A

loud without a thrill

39
Q

what is a grade 4 murmur?

A

loud with a thrill

40
Q

what is a grade 5 murmur?

A

loud with minimal contact between stethoscope and chest- thrill

41
Q

what is a grade 6 murmur?

A

loud can be heard without a stethoscope-thrill

ECOS II Final (5 decks)

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