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PD II > Cardiac Exam > Flashcards

Cardiac Exam Flashcards

1
Q

Preload

A

End diastolic pressure- at the end of diastole. Stretching of the ventricles to their widest prior to contraction

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2
Q

Afterload

A

Tension or stess on the wall of the left ventricle during ejection. Aortic pressure L. ventricle must overcome to eject blood.

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3
Q

Systole

A

Ventricular contaction. Mitral and tricuspid closed, aortic and pulmonic open

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4
Q

Diastole

A

Ventricular relaxation. Mitral and tricuspid open, aortic and pulmonic closed

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5
Q

S1

A

Closure of mitral and tricuspid valves. Beginning of systole. Best heard at Apex

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6
Q

S2

A

Closure of aortic and pulmonic. Beginning of diastole. Best in pulmonic and aortic areas.

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7
Q

S3

A

Rapid ventricular filling. Vibration causing dissension of ventricles early in diastole.

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8
Q

S4

A

Forceful atrial ejection into distended ventricle. Heard with patients with rigid ventricular walls

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9
Q

Murmur

A

Prolonged extra heart sounds. Diseased valves- stenosis, regurgitation- anatomic disorders of valves. Not always pathologic. Grade 1-6. Grade 4+ is palpable thrill.

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10
Q

Bruit

A

Turbulent blood flow caused by abnormality in vessel. Bell

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11
Q

PMI

A

Typically at apex. May be elsewhere if heart is enlarged or hypertrophied

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12
Q

Thrill

A

Palpable murmur. Congenital or valvur abnormalities Turbulent blood flow. Assoc with audible murmur. Ulnar surface of hand- cat purring sensation.

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13
Q

Heave/ Lift

A

Sustained palpable movements localized in precordium. Increased intensity of systolic contraction - Rt ventricular hypertrophy- more force req to squeeze blood out. Palpate 5 areas assoc with heart valves

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14
Q

Situs Inversus/ dextrocardia

A

Heart transplaced to right side of thorax. Congenital

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15
Q

S3 Gallop

A

Occurs in early diastole. Forced dilation of ventricle due to excess blood from atria. Can be normal or pathologic. Mitral regurgitation, mitral stenosis, heart failure, decreased ventricular compliance

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16
Q

S4 Gallop

A

Late stage diastole. Atrial kick- final 20% of output delivered to ventricle. Non compliant ventricle due to hypertrophy, MI, cardiomyopathy. Bell

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17
Q

Rub

A

Dx-Pericarditis. Heart beating against inflamed pericardium. continuous and diffuse. 3 components- 1 systolic, 2 diastolic

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18
Q

Click

A

Mid to late systole. Mitral valve prolapse or late systolic murmur. Diaphragm at apex.

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19
Q

Snap

A

Opening of Mitral and Tricuspid (AV) valves- due to thickening of leaflets. Stenosis, rheumatic heart disease. Diaphragm

20
Q

Ejection Sounds

A

Abnormal dilation or calcification of aortic or pulmonic valves. Pulmonic decrease with respirations

21
Q

Stethoscope

A

Bell and diaphragm to listen at 5 points, bruits,

22
Q

Pen light

A

Tangential lighting for PMI

23
Q

Ruler

A

Measurement from PMI to MSL

24
Q

Inspection

A

Apical pulse, pulsations, heaves/lifts, scarring, cyanosis, PMI

25
Q

Palpation

A

PMI, Heaves/lifts/thrills

26
Q

Auscultation

A

5 pts- bell & diaphragm (S1, S2, rathe, rhythm, regularity, murmur), bruits in abd, carotid, illiac, renal and femoral arteries

27
Q

Percussion

A

Not done

28
Q

Physiologic splitting

A

Splitting of S2 (A2 and P2) during inspiration. Normal

29
Q

Pathologic splitting- Paradoxic

A

Two distinct heart sounds during EXPIRATION. Delay in closure of A2. Left bundle branch block.

30
Q

Pathologic splitting- Fixed

A

Does not vary with respirations. Wide splitting of A2 and P2. Atrial septal defect and right ventricular failure.

31
Q

Dyspnea

A

breathing discomfort that varies in intensity. Issues with gas exchanges in CV- disease with L. heart, pulm. vasc, pericarditis,

32
Q

Diaphoresis

A

Sweating. Due to MI

33
Q

Syncope

A

Transient loss of consciousness. Rapid, short. Arrythmias- tachy and brady, stenosis

34
Q

Cyanosis

A

Blue color on extremities and lips due to insufficient blood supply.

35
Q

Orthopnea

A

SOB when lying flat. Heart failure.

36
Q

Claudication

A

Pain, impairment and discomfort with walking due to insufficient blood supply.

37
Q

xanthelasma

A

waxy yellow deposits on skin around eyes dues to increased levels of cholesterol

38
Q

Paroxysmal nocturnal dyspnea

A

inability to breath while laying down, not relieved by elevating position. Due to CHF

39
Q

Chest pain

A

discomfort in chest, caused by a wide variety of cardiac issues. Often begins during activity, food, stress and cold weather

40
Q

Addl Organ Systems with CV complaints

A

GI (indigestion, cholecystitis), psych. (anxiety, depression), musculoskeletal (trauma, overuse), Resp., peripheral vasculature.

41
Q

hypotension

A

< 90/ 60 mmHg- leads to inadequate blood supply to tissues. Lightheadedness, syncope, dizziness

42
Q

Orthostatic hypotension

A

drop >20mmHg from laying to standing`

43
Q

Normotension

A

SBP: < 90 mmHg

44
Q

Systolic Hypertension

A 
Systolic BP > 140 mm Hg with normal diastolic BP. In the acute setting, due to:
Increased cardiac output
Thyrotoxicosis
Generalized response to stress
Anemia
Pain, anxiety, or both
45
Q

Diastolic Hypertension

A 
Diastolic BP > 90 mm Hg. Isolated diastolic hypertension may be associated with:
Intrinsic renal disease
Endocrine disorders
Renovascular hypertension
Neurologic disorders
46
Q

Murmur

A

Timing, Location, Pitch, Intensity, Pattern, Resp. phase, Radiation

PD II (5 decks)

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