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Year 2 Clinical skills > Cardio > Flashcards

Cardio Flashcards

1
Q

pulse rate

A

bpm; right radial pulse

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2
Q

rhythm

A

regular

irregular : atrial fibrillation or ectopic beat

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3
Q

character and volume?

A

carotid artery closest to heart

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4
Q

radial artery where?

A

at wrist - thumb side

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5
Q

ulnar where?

A

wrist pinky finger side

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6
Q

brachial artery

A

cubital fossa

medial side of biceps muscle - when elbow is fully extended

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7
Q

axillary artery

A

medial side of humerus
lateral wall of axilla
posterior to the tendon of the short head of biceps

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8
Q

axilla region

A

anterior border: pectoralis major/minor
lateral border: intertubercular sulcus
medial border: serratus anterior and thoracic wall
posterior border: scapularis , teres major, latissimus dorsi

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9
Q

apex beat?

A

left 5 ICS at MCL

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10
Q

shift in apex beat?

A

enlargement - cardiomegaly

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11
Q

heaves?

A

Since the apex beat is a result of the left ventricle beating, hypertrophy of the left ventricle produces a forceful beat called a ‘heave’ and may extend outwards towards the axilla.

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12
Q

thrills?

A

palpable vibration hyperkinetic
sustained beat
= volume overload HF, Aortic regurg/ mitral regurg

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13
Q

aortic ausculation

A

R 2ICS Diaphragm

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14
Q

Pulmonary ausculation

A

L ICS next to sternum diaphragm

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15
Q

tricuspid asuculation

A

Diaphragm

left 5ICS near sternum

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16
Q

mitral auscultation?

A

bell

left 5th ICS at MCL

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17
Q

aortic stenosis

A

Ejection systolic murmur
Auscultate at the carotid artery
between S1-2

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18
Q

aortic regurgitation

A

early diastolic murmur

auscultate at aortic valve w patient leaning forward

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19
Q

mitral stenosis

A

Mid diastolic murmur
Auscultate at the apex beat with the patient in the left lateral decubitus position (lying on their left side)

s3

20
Q

mitral regurgitation

A

Pansystolic murmur

Auscultate at the apex beat with the patient in the left lateral decubitus position (lying on their left side)

21
Q

Borders of the heart

A

3CC 1 cm from sternal border on the R, to the 6th CC 1cm from sternal border to the 5th ICS at MCL and up to the 2 ICS 2.5cm from sternal border

22
Q

Right border of the heart

A

Lateral to right sternal border at 3CC to 6CC lateral to right sternal border

23
Q

Inferior border

A

Lateral to right sternal border at 6th CC to medial to MCL in 5th ICS

24
Q

Surface mark arch of aorta

A

Begins at 2CC R sternal angle [ascending aorta] end of arch is thoracic arch at level of left 2 CC
Top of arch midway between jugular notch and sternal angle

25
Q

What branches off arch of aorta

A

R > L

Brachiocephalic ,subclavian, common carotid

26
Q

Routine sites for venepuncture

Reasons?

A

Antebrachial vein in cubital fossa
Obtain blood
Monitor blood components
Administer therapeutic treatments like medication

27
Q

main cause of oedema?

A

congestive heart failure

28
Q

cap refill time?

A

normal is 2 seconds

greater than 2= poor peripheral perfusion

29
Q

normal hr

A

60-100
bradycardia >60
tachycardia<100

30
Q

tachycardia causes?

A

anxiety

hypovolaemia

31
Q

bradycardia causes?

A

healthy athletes

AV block

32
Q

Pectus escavatum - chest appearance

A

marfans
EDS
sunken in chest

33
Q

pectus carinatum

A

chest protrudes out

34
Q

surgical scar

mitral valve?

A

lateral thoracotomy

35
Q

midline sternotomy scar?

A

CABG / valve

36
Q

left subclavicular scar?

A

pacemaker/ AED

37
Q

malar flush?

A

mitral stenosis

38
Q

pt has a narrow pulse pressure with a slow rising pulse
what is this?
what murmur would you hear and where?

A

aortic stenosis

ejection systolic murmur which radiates to carotids and accentuates at expiration

39
Q

cardiac causes of clubbing?

A

endocarditis
atrial myxoma
congenital cynotic heart disease

40
Q

palmar erythema?

A

hyperthyroid

polychythaemia

41
Q

thready pulse?

A

shock

42
Q

in aortic regurg why does the the stroke volume _____
diastolic blood pressure ___
which causes pulse pressure to ___

A

stroke volume increases in aortic regurg- as blood leaks out during diastole
so the L ventricle has to pump out more blood- so more pressure is required this in turn means that systolic blood pressure increases

diastolic bp decreases however - as some leaks back

causing pulse pressure to increase

43
Q

what does a large pulse pressure cause?

what sign on the nail bed can be seen?

what condition causes this and what is the mx?

A

hyperdynamic circulation - the character of the pulse is bounding or ‘waterhammer’ as the blood slams against walls of arteries with each heartbeat

head bobbing
capillary beds of fingernails to pulsate - quinckes sign

replacement of valve after left ventricular dysfunction occurs

44
Q

waterhammer pulse

why ?
what is it caused by?

A

aortic regurgitation creates a hyperdynamic circulation

so when arm is raised, increases velocity of return to the heart so accentuates the collapsing nature

45
Q

how to accentuate aortic murmur?

A

listen on expiration on aortic region

leaning forward

Year 2 Clinical skills (6 decks)

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