cardio 1

Question 1

basic characteristics to observe when approaching a cardio patient:

Answer 1

mentation status
posture / ambulation
body condition
respiratory rate and effort

Question 2

normal respiratory rate at rest

Answer 2

18-30 breaths per minute

best monitored in home - no stress

Question 3

what is eupnea?

Answer 3

normal respiratory rate and effort

Question 4

what is dypsnea?

Answer 4

“air hunger” - sensation of difficulty or labored breathing

open mouth breathing, abdominal component to breathing, flared nostrils, extended head and neck

inspiratory, expiratory or mixed efforts

Question 5

what is tachypnea?

Answer 5

rapid respiration rate

Question 6

what is hyperpnea?

Answer 6

increased rate and depth of respiration

Question 7

what is orthopnea?

Answer 7

positional breathing difficulty

Question 8

what is stridor?

Answer 8

high pitched, inspiratory effort

Question 9

what is stertor?

Answer 9

snoring, inspiratory effort

Question 10

what can you assess based on the appearance of the mucous membranes?

Answer 10

hydration status
color
capillary refill time

Question 11

what is the normal capillary refill time (CRT)?

what does CRT indicate?

Question 12

what might pale mucous membranes suggest?

Answer 12

anemia

poor peripheral perfusion

Question 13

what might hyperemic (bright red) mucous membranes suggest?

Answer 13

peripheral vasodilation

• septic shock
• exercise

Question 14

what do cyanotic mucous membranes look like?

what might they suggest?

Answer 14

blue-ish tinge

hypoxemia -> reduced hemoglobin (Hb) oxygenation

indicates over 5g of deoxygenated Hb/dL

Question 15

what vessel is important to note on the neck to evaluate heart function?

what should you evaluate about these vessels?

Answer 15

jugular veins

are they distended without you touching them?

Question 16

to evaluate jugular veins, what position should the patient be in?

Answer 16

standing or sitting w head somewhat extended

may clip or wet hair with alcohol

Question 17

what does jugular venous distension suggest?

describe the anatomy and why this is seen…

Answer 17

increased vena cava pressure - suggestive of right sided heart failure

jugular Vv directly communicate with the vena cava, which communicates with the Right atrium, NO valves separating them so what is happening in the jugular Vv is a direct reflection of what is happening in the right heart

distended jugular Vv means jugular venous pressure is increased so (1) something is obstructing venous return or (2) right sided pressures are too high (suggests right sided heart failure)

Question 18

to what level up the neck is it normal to have jugular pulsation?

Answer 18

up to 1/3 of the way up the neck

Question 19

if jugular pulsation is seen farther than 1/3 of the way up the neck, what does this suggest?

Answer 19

MC thing is leaky tricuspid valve

• abnormal venous pulsation d/t high pressure in Right Atrium, Cr vena cava and then jugular Vv

next MC - AV block - atria contract against a closed valve d/t electrical disconnect btwn atrium and ventricle

Question 20

T / F?

jugular pulsation seen higher up than 1/3 of the neck means heart failure is occurring

Answer 20

FALSE

this may be transient

Question 21

if an animal is thin, what might be seen in the neck and incorrectly identified as jugular pulsation?

Answer 21

carotid pulsation

Question 22

what is important to note when palpating the trachea?

Answer 22

how easy it is to elicit a cough

Question 23

in what species can you readily feel a thyroid slip?

Answer 23

cats

Question 24

on thoracic palpation, where should you feel the apex beat?

over which anatomical structure w/in the heart is this area?

Answer 24

left 5th intercostal space

over mitral valve area

Question 25

what does the apex beat indicate?

Answer 25

the strength of the precordial impulse

Question 26

T/F

it is normal to feel an apex beat

Answer 26

true

apex beat should be present and in its normal location

Question 27

T/F

it is normal to feel a thrill

Answer 27

false

it is NOT ever normal to feel a thrill

Question 28

what is a thrill?

Answer 28

a palpable vibration over the heart

Question 29

if the apex beat can be felt but is not in its normal location, what might that suggest?

Answer 29

• heart enlargement [right sided]

- mass (es) [intra thoracic]

Question 30

what things may affect the intensity of the apex beat?

Answer 30

• patient body condition
• hyper dynamic conditions (anemia, hyperthyroidism)
• underlying cardiac dz (volume overloaded heart dz vs DCM)
• pleural or pericardial effusion

Question 31

on a stethoscope, what type of sound quality does a long tube produce?

Answer 31

lower sound quality

Question 32

which side (big or small) of the stethoscope is the diaphragm?

Answer 32

the big side

Question 33

which side (big or small) of the stethoscope is the bell?

Answer 33

the small side

Question 34

is most auscultation done with the big or small side of the stethoscope?

is this the bell or the diaphragm?

Answer 34

the big side (the diaphragm)

Question 35

which frequency does the diaphragm detect better?

and the bell?

Answer 35

diaphragm -> high frequency

bell -> low frequency

Question 36

what types of heart sounds are considered to be abnormal?

Answer 36

transient sounds: gallops, clicks, splits

murmurs