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cpa > cardio > Flashcards

cardio Flashcards

1
Q

What position should the patient be at for a cardio exam?

A

45 degrees

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2
Q

exposure of the patient

A

exposed from waist upwards

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3
Q

where do you palpate the radial artery

A

between
tendon of flexor carpi radialis
and
tendon of brachioradialis

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4
Q

what rate counts as bradycardia and tachycardia

A

bradycardia = <60 bpm
tachycardia = >100 bpm

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5
Q

what to comment on when assessing pulse

A

rate and rhythm

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6
Q

where do you palpate the ulnar artery

A

between
flexor digitorum superficialis
and
flexor carpi ulnaris

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7
Q

where do you palpate the brachial artery

A

medial to biceps tendon

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8
Q

how to position arm during brachial artery palpation

A

flex arm to find tendon
then fully extend to assess pulse

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9
Q

from which arteries can character and volume be assessed

A

only from central arteries eg common carotid

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10
Q

where do you palpate the common carotid artery

A

between
medial border of sternocleidomastoid muscle
and
lateral border of thyroid cartilage

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11
Q

where do you palpate the apex beat

A

5th intercostal space at left mid clavicular line
(align middle finger here, then other fingers above and below)

  • first identify sternal angle and palpates left 2nd rib down to 5th rib, and then onto the 5th intercostal space at the mid clavicular line
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12
Q

where should you start palpating for the apex beat

A

from lateral side towards midclavicular line

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13
Q

what causes a displaced apex beat

A

cardiomegaly

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14
Q

causes of an absent apex beat

A

obesity
pericardial effusion
pleural effusion
emphysema

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15
Q

what is a precordial impulse

A

Precordial impulses are pulsations originating from the heart or great vessels that are visible or palpable on the anterior chest wall

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16
Q

what is a parasternal heave

A

a precordial impulse that can be palpated

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17
Q

where to place hand for parasternal heave

A

place heel of hand parallel to left sternal edge to palpate for heaves

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18
Q

what causes parasternal heaves

A

right ventricular hypertrophy - would feel heel of hand being lifted with each systole

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19
Q

what is a thrill

A

palpable vibration caused by turbulent blood flow through heart valves

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20
Q

how and where to place hand for thrills

A

horizontally across chest wall, at each of the heart valves

21
Q

which sides of the stethoscope do you use for each of the valves

A

diaphragm
- aortic
- pulmonary
- tricuspid

bell
- mitral

22
Q

location of aortic valve

A

right sternal border, 2nd ICS

23
Q

location of pulmonary valve

A

left sternal border, 2nd ICS

24
Q

location of tricuspid valve

A

left 5th costo-sternal border

25
Q

location of mitral valve

A

left 5th ICS at midclavicular line (at apex beat)

26
Q

causes of ejection systolic murmur

A

aortic stenosis
pulmonary stenosis
aortic sclerosis
hypertrophic obstructive cardiomyopathy (HOCM)
atrial septal defect

27
Q

what murmur is heard with aortic stenosis

A

ejection systolic murmur

28
Q

how to assess for aortic stenosis

A

auscultate the carotid arteries
using diaphragm
WHILST PATIENT HOLDS THEIR BREATH

29
Q

what murmur is heard with aortic regurgitation

A

early diastolic murmur

30
Q

how to assess for aortic regurgitation

A

sit patient forward
and auscultate over aortic area
using diaphragm
in EXPIRATION

31
Q

which examinations require the left lateral decubitus position

A

mitral valve regurgitation
mitral stenosis

32
Q

how to assess for mitral valve regurgitation

A

auscultate the mitral area
in left lateral decubitus position
using diaphragm
during EXPIRATION
auscultate into axilla to identify radiation of the murmur

33
Q

what murmur is heard for mitral valve regurgitation

A

pan systolic murmur

34
Q

what murmur is heard for mitral stenosis

A

mid diastolic murmur

35
Q

how to assess for mitral stenosis

A

auscultate the mitral area
in left lateral decubitus position
using bell
during EXPIRATION

36
Q

where is the femoral pulse palpated

A

at the mid inguinal point (midpoint between ASIS and pubic symphysis)

37
Q

where is popliteal pulse felt

A

inferior region of popliteal fossa

38
Q

how to assess for popliteal pulse

A

place thumbs on tibial tuberosity
passively flex the knee to 30 degrees
curl fingers into popliteal fossa
(this compresses the popliteal artery against the tibia)

39
Q

where is the posterior tibial pulse felt

A

posterior to the medial malleulos of the tibia

40
Q

what to remember when palpating posterior tibial pulse

A

palpate to confirm its presence
then compare pulse between the 2 feet

41
Q

where is the dorsal pedis pulse felt

A

on the dorsum of the foot
- lateral to extensor hallucis longus tendon
- over the 2nd and 3rd cuneiform bones

42
Q

borders of the heart

A

right upper:
3rd CC, 1cm from sternal edge

left upper:
2nd ICS, 2.5cm from sternal edge

right lower:
6th CC, 1 cm from sternal edge

left lower:
5th ICS, mid clavicular line

43
Q

which pulse is the strongest pulse

A

carotid pusle

44
Q

which pulse is used for assessment of character and volume and diagnosis of underlying heart disease

A

carotid artery pulse

45
Q

where is superficial temporal artery assessed

A

in front of tragus of ear

46
Q

what is the terminal branch of external carotid artery

A

superficial temporal artery

47
Q

where is subclavian artery assessed

A

in supraclavicular fossa region
- at the angle between the clavicle and sternocleidomastoid

48
Q

differentiate type A and B aortic dissection

A

type A = severe chest pain, anterior and posterior
type B = back pain, followed by chest and abdominal pain

cpa (6 decks)

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