cardio 1 Flashcards
basic characteristics to observe when approaching a cardio patient:
mentation status
posture / ambulation
body condition
respiratory rate and effort
normal respiratory rate at rest
18-30 breaths per minute
best monitored in home - no stress
what is eupnea?
normal respiratory rate and effort
what is dypsnea?
“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
what is tachypnea?
rapid respiration rate
what is hyperpnea?
increased rate and depth of respiration
what is orthopnea?
positional breathing difficulty
what is stridor?
high pitched, inspiratory effort
what is stertor?
snoring, inspiratory effort
what can you assess based on the appearance of the mucous membranes?
hydration status
color
capillary refill time
what is the normal capillary refill time (CRT)?
what does CRT indicate?
what might pale mucous membranes suggest?
anemia
poor peripheral perfusion
what might hyperemic (bright red) mucous membranes suggest?
peripheral vasodilation
- septic shock
- exercise
what do cyanotic mucous membranes look like?
what might they suggest?
blue-ish tinge
hypoxemia -> reduced hemoglobin (Hb) oxygenation
indicates over 5g of deoxygenated Hb/dL
what vessel is important to note on the neck to evaluate heart function?
what should you evaluate about these vessels?
jugular veins
are they distended without you touching them?
to evaluate jugular veins, what position should the patient be in?
standing or sitting w head somewhat extended
may clip or wet hair with alcohol
what does jugular venous distension suggest?
describe the anatomy and why this is seen…
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)
to what level up the neck is it normal to have jugular pulsation?
up to 1/3 of the way up the neck
if jugular pulsation is seen farther than 1/3 of the way up the neck, what does this suggest?
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
T / F?
jugular pulsation seen higher up than 1/3 of the neck means heart failure is occurring
FALSE
this may be transient
if an animal is thin, what might be seen in the neck and incorrectly identified as jugular pulsation?
carotid pulsation
what is important to note when palpating the trachea?
how easy it is to elicit a cough
in what species can you readily feel a thyroid slip?
cats
on thoracic palpation, where should you feel the apex beat?
over which anatomical structure w/in the heart is this area?
left 5th intercostal space
over mitral valve area
what does the apex beat indicate?
the strength of the precordial impulse
T/F
it is normal to feel an apex beat
true
apex beat should be present and in its normal location
T/F
it is normal to feel a thrill
false
it is NOT ever normal to feel a thrill
what is a thrill?
a palpable vibration over the heart
if the apex beat can be felt but is not in its normal location, what might that suggest?
- heart enlargement [right sided]
- mass (es) [intra thoracic]
what things may affect the intensity of the apex beat?
- patient body condition
- hyper dynamic conditions (anemia, hyperthyroidism)
- underlying cardiac dz (volume overloaded heart dz vs DCM)
- pleural or pericardial effusion
on a stethoscope, what type of sound quality does a long tube produce?
lower sound quality
which side (big or small) of the stethoscope is the diaphragm?
the big side
which side (big or small) of the stethoscope is the bell?
the small side
is most auscultation done with the big or small side of the stethoscope?
is this the bell or the diaphragm?
the big side (the diaphragm)
which frequency does the diaphragm detect better?
and the bell?
diaphragm -> high frequency
bell -> low frequency
what types of heart sounds are considered to be abnormal?
transient sounds: gallops, clicks, splits
murmurs
