Cardiac/ Lymph

Question 1

What are the three layers of the heart wall?

Answer 1

1. Myocardium-pump
2. Endocardium-Chambers and valves
3. Pericardium-double walled sac separated by fluid

Question 2

What are five major risk factors for heart disease?

Answer 2

Obesity (BMI > 30), Smoking history, DM, HTN, HLD

Question 3

What is the area where the heart sits called?

Answer 3

Precordium

Question 4

Where can we see signs of central cyanosis?

Answer 4

Lips, gums, tongue, oral mucosa, conjunctiva

Question 5

What does central cyanosis suggest in terms of circulation?

Answer 5

Poor arterial circulation

Question 6

Where can we look for signs of peripheral cyanosis?

Answer 6

Fingers/toes, earlobes, nails

Question 7

What does peripheral cyanosis suggest is going on with the blood vessels?

Answer 7

Peripheral vasoconstriction

Question 8

With what part of our hand do we palpate for thrills?

Answer 8

MCP joints

Question 9

What are heaves?

Answer 9

Lifting from vigorous pulsation

Question 10

What are thrills on palpitation?

Answer 10

Vibrations

Question 11

What causes the S1 sound?

Answer 11

Closure of tricuspid and mitral valves

Question 12

Is the “lub” sound the start or end of systole?

Answer 12

Start of systole

Question 13

What creates the S2 sound, the end of systole?

Answer 13

Closure of aortic and pulmonic valves (SL valves)

Question 14

What are the precordial areas for auscultation?

Answer 14

Aortic, Pulmonic, tricuspid, and mitral

Question 15

What is a split sound?

Answer 15

When valves are not closing at the same time

Question 16

The S3 ( ventricular gallop) sound occurs right after S2, what creates it?

Answer 16

When ventricles are resistant in early rapid filling phase

Question 17

S4 occurs right before S1, what creates it?

Answer 17

From resistance in the ventricles when filling at the end of diastole

Question 18

With what conditions may we hear an S4( atrial gallop) sound?

Answer 18

Ischemia ( new MI), aortic stenosis, pulmonary HTN

Question 19

What does a 1+ pulse mean?

Answer 19

Weak or thready

Question 20

What does a 3+ pulse mean?

Answer 20

Bounding

Question 21

What is the goal of the lymph system?

Answer 21

To get fluid up and out. Take it from the extremities and excreted in the kidneys

Question 22

What are the three functions of the lymphatic system?

Answer 22

1. Recycle and conserve fluids
2. Absorb lipids
3. Part of the immune system

Question 23

What are lymph node characteristics that we should be worried about?

Answer 23

Immobile/fixed, prolonged swelling over 1.5 cm, widespread adenopathy, lymph nodes on multiple parts of the body

Question 24

What family hx should we be considering with heart problems?

Answer 24

Sudden death before 50, MI, strokes, DM, HTN, and HLD

Question 25

In what cases can S3 be normal?

Answer 25

• young adult, children
• increased heart rate
• late pregnancy

Question 26

Under what conditions can S3 be pathologic? (5)

Answer 26

• older adult
• HTN
• volume overload (CHF)
• mitral regurgitation
• high output states (thyroid,anemia)

Question 27

T/F. An S4 (atrial gallop) is rarely physiologic?

Answer 27

True

Question 28

What 7 things can create murmurs?

Answer 28

• Increased flow through normal structures under conditions like exercise or hyperthyroidism.
• back flow or regurgitation
• flow through narrow or obstructed valves
• flow into dilated chambers
• decrease in blood viscosity
• shunting into abnormal passages
• calcification of the aorta

Question 29

Turbulent blood flow outside of the heart is called what?

Answer 29

Bruit

Question 30

What is claudication?

Answer 30

When muscles are not getting enough oxygen causing pain. Associated with arterial insufficiency.