Cardiac Exam Supplement II Flashcards
1
Q
Where is PMI?
A
4th or 5th intercostal space at midclavicular line
2
Q
What is the significance of JVP?
A
Level of JVP visibility gives indication of RAP
3
Q
How do you look at JVP?
A
- Place patient supine allow veins to engorge
- Raise patient 30-45 degrees
- Most peoples hearts are 5 cm below the horizontal plane of the sternal notch
- Measure height of most distended part of vein to the sternal notch
- 0-9 is normal
4
Q
S2?
A
Reflects diastole, closure of ASL and PSL valves
5
Q
What is A wave?
A
- Right atrial contraction
- triscupid open coincides with S1
- Preceeds carotid pulsation
6
Q
What can cause a giant A wave?
A
- obstruction between RA and RV
- Increasaed RV pressure
- Pulm Htn
- Recurrewnt pulmonary emboli
- AV dissociation
7
Q
What is C wave?
A
- Backwards push by closure of the Tricuspid valve during isovolumetric systole and impact of carotid artery adj to JV
8
Q
What is X wave
A
- Passive atrial filling and relaxation, blood flows into RA from vena cava and closure of tricuspid occurs
9
Q
What could cause a steep X wave?
A
- Cardiac tamponade
- Constrictive pericarditis
10
Q
What is V wave?
A
- Atrial filling
- Increasing volme and pressure in RA when tricupsid is closed
11
Q
What causes prominent V wave?
A
- Triscupid regurgiation
- Pulmonary Htn
12
Q
What is Y slope?
A
- Triscupid opens and rapid RV filling occurs
13
Q
What causes steep Y descent?
A
- Severe triscupid regurgitation
14
Q
What does a slow Y descent mean?
A
Obstruction for RV filling
15
Q
what causes increased JVP?
A
- Sup vena cava obstruction
- Severe heart failure
- Constrictive pericarditis
- Cardiac tamponade
- RV infarction
- Restrictive cardiomyopathy
