cardiac lecture part 6

Question 1

_____:no pitting edema

Answer 1

0+

Question 2

_______:mild pitting edema. 2mm depression that disappears rapidly.

Answer 2

1+

Question 3

________:moderate pitting edema. 4mm depression that disappears in 10-15 seconds

Answer 3

2+

Question 4

_______:moderately severe pitting edema. 6mm depression that may last more than 1 minute

Answer 4

3+

Question 5

________:severe pitting edema.8mm depression that can last more than 2 minutes

Answer 5

4+

Question 6

JVP:______________

Answer 6

Jugular venous pressure

Question 7

HJR:_____________

Answer 7

Hepatojugular reflux

Question 8

ABI:_____________

Answer 8

Ankle brachial index

Question 9

Vascular Exam: JVP
Jugular venous pressure if called for

Supine patient, then elevate head of exam table (30-)45° from horizontal (need meniscus visible)

Measure vertical distance of meniscus of internal jugular pulsations from sternal angle

3-4 cm water from sternal angle is ULN (or 8-9 cm from midaxillary line/rt atrium)

Question 10

Vascular Exam: HJR

Hepatojugular reflux if called for
Supine patient, then raise head of exam table
(30-)45° from horizontal
Find meniscus of jugular pulsations w/tangential
light
Tell pt to relax, breathe normally
Press gently but firmly on middle abdomen for
30-60 seconds
Rise of jugular column, then fall is normal
Sustained 3+ cm rise is abnormal

Question 11

Ankle:brachial index (ABI)
Patient supine
Palpate dorsalis pedis or posterior tibial
SBP (ankle cuff) and brachial SBP
Use ultrasound probe
Ankle:arm ratio normally ≥ 1 (at least
>0.9)