Cardiac EXAM Flashcards
Where is aortic focus?
2nd right ICS
Where is pulmonic focus?
2nd and 3rd left ICS
Erb’s point
3rd left ICS
Tricuspid location
4th left ICS/LLSB
Mitral location
4th or 5th left ICS in MCL
What is Levine’s sign?
Pt holding their hand over their mid chest
What is a lift
Palpable movement of chest due to increased pressure usually from RV hypertrophy
What is a heave?
A more pronounced life
What is a thrill?
A palpable murmur
Having a pt fully exhale while leaning forward accentuates ____________
S2 and aortic murmurs
Having Pt lie on left side while listening over apex accentuates __________
S1 and mitral murmurs
What is the precordium?
The area of the chest overlying the heart
What is preload?
ventricular volume at the end of diastole prior to contraction for systole
What makes S1
closing of tricuspid and mitral valve during systole
What makes S2
Closing of aortic and pulmonic valves during diastole
Explain: “All Physicians Eat Tender Meat”
Aortic --> R 2nd ICS -- S2 Pulmonic --> L 2nd ICS -- S2 Erb's --> L 3rd ICS Tricuspid --> 4th ICS -- S1 Mitral --> 5th ICS mid clavicular -- S1
What causes physiologic splitting of S2?
On inspiration, increased pressure causes more blood to enter from vena cavae and rt. atrium making the pulmonic valve stay open longer.
Xanthelasma is?
waxy fat deposits from hypercholesterolemia
What is the pericardium?
Fibrous sac encasing the heart
Precordium?
Area of the chest overlaying the heart.
Systole
ventricles are contracting
Diastole
Ventricles filling w/ blood
What is pathological splitting?
When there is a split between aortic and pulmonary valves regardless of inspiration of expiration, or when the aortic and pulmonary valves are split wide on expiration and are closer during inspiration
What is preload?
The amount the ventricles stretch out due to blood prior to contraction
What is after load?
What the ventricles have to work against to pump out blood during contraction - forces that oppose ejection of blood
Gallop
either s3 or s4, or both
When does s3 arise?
Mitral regurgitation
When does s4 arise?
During the atrial “kick”
What is a rub?
When the heart rubs against the pericardium, is generally continuous throughout s1 and s2. Sounds like creaking leather.
What is a click?
A adventitious sound due to mitral valve prolapse
What is a snap?
Adventitious sound due to mitral valve stenosis.
What are ejection sounds?
Adventitious sounds due to aortic valve stenosis.
What is the electrical current route in the heart?
SA node, AV node, Bundle of His, Purkinje Fibers, then contraction starts at the apex of the heart and goes north.
Claudication
Cramping pain in the leg induced by exercise, typically caused by obstruction in the arteries
Intensity of a heart murmur goes from 1-6. In which level does a palpable thrill become apparent?
Level 4 out of 6
