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PD Block 2 > Cardiac exam > Flashcards

Cardiac exam Flashcards

1
Q

pericardium

A

tough, double-walled, fibrous sac that encases the heart

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2
Q

aortic valve

A

semi lunar valve, between LV and aorta

  • closes off LV until pressure overcomes the pressure in the aorta
  • prevents blood flowing back into LV during diastole
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3
Q

pulmonic valve

A
  • separates the right ventricle from the pulmonary artery
  • closes off RV, opens to allow blood to be pumped into the lungs to be oxygenated
  • prevents blood flowing back into the RV
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4
Q

great vessels

A 
superior vena cava
inferior vena cava
pulmonary artery
pulmonary vein
aorta
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5
Q

apex

A

summit of the heart, points downward at the base

  • muscles in the apex are primarily responsible for regulating ventricle contraction
  • play a role in transmitting signals from the atrial nodes
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6
Q

base

A

the broader portion of the heart

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7
Q

precordium

A

area on anterior chest overlying the heart

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8
Q

tricuspid valve

A

separate the RA from the RV,

tricuspid allows blood to flow from RA to RV during diastole

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9
Q

mitral valve

A

separates LA from LV

allows blood to flow from LA to LV during diastole

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10
Q

order of cardiac valves

A

try pulling my arm

Tricuspid, Pulmonic, mitral, aortic

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11
Q

systole blood flow

A

increasing ventricular pressure causes tricuspid and mitral valves to close (S1)
-pulmonary artery and aorta open and blood flows from ventricles into the arteries

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12
Q

diastolic blood flow

A
  • ventricular pressure falls below arterial pressure, pulmonary and aortic valves close (S2)
  • ventricular pressure falls below atrial pressure, tricuspid and mitral valves open allowing blood to fill the ventricles (S3)
  • atrial contaction to ensure complete ejection of blood into the ventricles (S4).
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13
Q

What are A2 and P2

A

A2 is the closing of the aortic valve

P2 is the closing of the pulmonic valve

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14
Q

What makes S3?

A

relative passive filling of the ventricles

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15
Q

What makes S4?

A

The atria contraction to ensure the the ejection of any remaining blood.

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16
Q

What is split S2 caused by?

A

the aortic valve usually closes slightly ahead of the pulmonic valve, if that is heart it is called a split S2 sound

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17
Q

where do the electrical impulses in the heart begin?

A

The SA sino atrial node, located in the wall of the right atrium

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18
Q

where do the impulses from the SA node travel?

A

to through both atria to the atrioventricular node (AV node), which is located in the atrial septum

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19
Q

What happens when the impulse arrives at the AV node?

A

the impulse is delayed and then passes down he bundle of His to the Purkinje fibers
- the ventricular contraction is initiated at the apex of the heart and moves toward the base

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20
Q

what is depolarization?

A

spread of stimulus through the heart muscle

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21
Q

what is repolarization?

A

the return of the stimulated heart to a resting state

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22
Q

P wave

A

spread of a stimulus through the atria (atrial depolarization)

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23
Q

PR interval

A

time of the intitial stimulation of the atria to the initial stimulation of the ventricle
-usually .12 to .20 of a second

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24
Q

QRS complex

A

spread of the stimulus through the ventricels,

usually less that 0.1 of a second

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25
ST segment of the T wave
the return of stimulated ventricular muscle to a resting state - ventricular repolarization
26
U wave
a small deflection rarely seen after the T wave | - thought to be the repolarization of the Purkinje fibers
27
QT interval
time elapsed from onset of ventricular depolarization until the completion of the ventricular repolarization
28
when are systole and diastole approximately the same length of time
at about 120 bpm
29
which is usually shorter at resting heart rate?
systole is normally shorter than diastole at a resting heart rate
30
Where is best to listen for aortic focus?
right, 2nd ICS right sternal border | hear S2
31
Where is best for pulmonic focus?
left 2nd and 3rd ICS left sternal border | hear S2
32
Where is best to hear the tricuspid?
left 4th ICS left sternal border
33
Where is best to hear the mitral valve?
left 4-5th ICS in midclavicular line | S1 heard here at apex
34
Where is Erb's point and what is heard here?
left 3rd ICS left sternal border
35
Where is best to hear split S2 sounds?
during deep inspiration | at the pulmonic area: left 2nd and 3rd ICS
36
Where is S1 usually heard louder than S2?
left 4-5th ICS in MCL, apex of heart
37
Where is the best location to hear S2?
Either in the aortic or pulmonic areas: aortic: right 2nd ICS pulmonic: left 2nd ICS
38
Where is S2 louder than S1?
S2 is louder than S1 at the base of the heart
39
When is S2 splitting heard?
During inhalation Causes increased venous return right atrium and slightly reduced pulmonary return to the left A
40
What makes the S1 sound?
Closing of the Mitral and Tricuspid valves | this is the beginning of systole
41
What make the S2 sound?
Closing of the aortic and pulmonic valves | This is the end of systole
42
Hypotension
low blood pressure | systolic lower than 90mmHg
43
orthostatic hypotension
abnormal decrease in BP when going from sitting to standing systolic change > 20mmHg, diastolic change > 10mmHg
44
hypertension
Stage 1: 140-159 / 90-99 | Stage 2: > 160 / 100
45
normotension
46
pericardial friction rub
widely heard, sound clearest toward the apex intense, grating, machine-like may have three components
47
pulmonary valve ejection click
In early systole intensifies on expiration decrease on inspiration best heard: 2nd Left ICS, pt. sitting or supine
48
aortic valve click
In early systole, opening of the AV no affected by respiration best heard apex or right 2nd ICS pt. sitting or supine
49
Mitral valve opening snap
``` early in diastole before S3 sharp snap easily confused with S2 Best heard medial to apex ```
50
Gallops
pre systole intense, easily heard bell at apex, pt. supine or in left lateral recumbent position
51
Thrill
fine, palpable rushing vibration usually felt over the base indicates turbulent blood flow
52
PMI
point of maximal impulse | generated by the apex
53
heave
a more pronounced lift of the RV, | RV hypertrophy
54
Aortic stenosis, murmur
``` systolic ejection murmur crescendo/decrescendo (diamond shaped) can radiate to the carotids can be accompanied by and ejection click heard in the aortic area ```
55
Pulmonic stenosis, murmur
``` systolic ejection murmur crescendo/decrescendo (diamond shaped) doesn't not radiate to the carotid can be accompanied by and ejection click heard in the pulmonic area ```
56
Mitral regurgitation
holo/pan systolic murmur flat murmur, no change radiates to the axila heard best at the apex, mitral location
57
Tricuspid regurgitation
holo/pan systolic murmur flat murmur, no change heard best at tricuspid location
58
Aortic regurgitation
``` along the left sternal border (blood is flowing the other way), not listening at aortic area diastolic murmur (between S2-S1) early diastolic murmur: decrescendo ```
59
Pulmonic regurgitation
``` heard along the upper left sternal border diastolic murmur (between S2-S1) early diastolic murmur: decrescendo ```
60
Mitral stenosis
diastolic murmur (between S2-S1) with an opening snap followed by mid diastolic rumble heard in the mitral area, apex
61
tricuspid stenosis
diastolic murmur (between S2-S1) with an opening snap followed by mid diastolic rumble heard in the tricuspid area
62
what position are S3 and S4 best heard
left lateral decubitus position
63
In which age can S3 normal
In the young
64
preload
end of diastolic pressure, ventricles stretched to greatest dimensions
65
afterload
there stress/tension developed in wall of left ventricle during ejection

PD Block 2 (6 decks)

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