Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Clinical > Cardio > Flashcards

Cardio Flashcards

1
Q

What are the most common cardiac problems? (5)

A
  • Myocardial infarction
  • Angina
  • HR abnormalities e.g atrial fibrillation
  • Heart failure
  • Heart valve disease e.g stenosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What position should a patient be in for a cardiac exam?

A

Semi supine - 45 degrees

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What needs to be exposed for cardiac exam?

A

Chest

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the end of bed observations that can be made in a cardiac exam? (7)

A
  • Oxygen mass
  • GTN sprays
  • Walking aids
  • Drip stand
  • Nebuliser
  • Urinary catheter
  • Snacks
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What features of a patient can be seen from their general appearance relevant to a cardio exam? (10)

A
  • In pain?
  • Unwell?
  • Breathless?
  • Obvious scars?
  • Drips/inhalers/oxygen?
  • Cyanosis?
  • Pallor?
  • Oedema?
  • Down’s Syndrome?
  • Marfan’s?
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

List the order for body areas to examine (16)

A
  • Hands and nails
  • Radial pulse
  • Respiratory rate
  • Collapsing pulse
  • Radio-radial delay
  • Radio-femoral delay
  • Blood pressure and brachial pulse
  • Neck
  • Face
  • Eyes
  • Mouth
  • Chest
  • Arteries (renal, femoral, aorta)
  • Spine base
  • Lung bases
  • Foot pulses (popliteal/posterior tibilal/dorsalis pedis)
  • Feet and ankles
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is looked for on the hands with palms facing downwards? (4)

A
  • Clubbing
  • Splinter haemorrhages
  • Capillary refill time
  • Temperature
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are splinter haemorrhages a sign of? (2)

A
  • Infective endocarditus

- Trauma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is clubbing?

A

Loss of angle/Schamroth’s window between nail and nail bed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is Schamroth’s window?

A

Diamond shaped window in healthy individual between nails back to back

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How does one observe clubbing?

A

Ask patient to place nails of their index fingers back to back

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the cardiac diseases associated with clubbing? (3)

A
  • Endocarditis
  • Cyanotic congenital heart disease
  • Atrial myxoma - non cancerous tumour in upper L/R heart side
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How do you check for capillary refill time?

A

Press down on patient fingernail for 5 secs and time for when blood returns

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

When does capillary refill time suggest abnormality?

A

Longer than 2 seconds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What can a long capillary refill time suggest?

A

Hypovolaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What can be seen with the palms facing upwards? (7)

A
  • Osler’s nodes
  • Janeway lesions
  • Dupuytren’s contracture
  • Colour/peripheral cyanosis
  • Tar staining
  • Xanthomata
  • Palmar erythema
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is Dupenytren’s contracture?

A

Small hard nodules just over skin of palm (thickening of palmar fascia) - worsens over time until fingers can no longer straightened

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What does Dupenytren’s contracture suggest? (7)

A
  • Increased alcohol usage
  • Liver cirrhosis
  • Diabetes
  • Trauma
  • Increased age
  • Smoking
  • Family history
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are Osler’s nodes?

A

Painful red purple raised lumps with a pale centre at fingers and toes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What do Osler’s nodes suggest?

A

Infective endocarditis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are Janeway lesions?

A

Rare non Painful, erythematous small maculopapular palm/sole lesions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What do Janeway lesions indicate?

A

Bacterial endocarditis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is xanthomata in hands?

A

Raised yellow lesions (mostly on wrist tendons)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What does xanthomata suggest?

A

Hyperlipidaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What is the first pulse felt for in a cardio exam?

A

Radial pulse

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What is assessed in radial pulse? (2)

A
  • Rate

- Rhythm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What are the 3 types of rate rhythm?

A
  • Regular
  • Regularly irregular
  • Irregularly irregular
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What does an irregularly irregular rhythm suggest? (3)

A
  • Atrial fibrillation
  • Wandering atrial pacemaker
  • Multifocal atrial tachycardia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What does regularly irregular rate rhythm suggest?

A

Sinus arrhythmia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

How is collapsing pulse assessed?

A
  • Ensure no shoulder pain
  • Palpate radial pulse
  • Raise arm above head briskly
  • Pulse falls away from wrist after 30 secs
  • Tapping impulse in arm muscle bulk
    = positive sign
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What is collapsing pulse also known was?

A

Water hammer pulse

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What is collapsing pulse caused by?

A

Blood empties quickly from arm in diastole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What can collapsing pulse indicate in normal physiological states?

A
  • Fever

- Pregnancy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What cardiac problems can collapsing pulse indicate? (5)

A
  • Aortic regurgitation
  • Patent ductus arteriosus
  • Anaemia
  • AV fistula
  • Thyrotoxicosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What is assessed in a brachial pulse? (2)

A
  • Volume

- Character

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What is radio-radio delay?

A

Inequality between 2 radial pulses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

What does radio-radio delay suggest? (3)

A
  • Aortic coarctation (congenital narrowing)
  • Aortic aneurysm
  • Thoracic inlet syndrome
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

What does radio-femoral delay suggest? (2)

A
  • Aortic coarctation (congenital narrowing

- Aortic embolism/thrombosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

What is assessed in brachial pulse? (2)

A
  • Volume

- Character

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

How do you measure blood pressure?

A

Make notes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

What is narrow pulse pressure associated with?

A

Aortic stenosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

What is wide pulse pressure associated with?

A

Aortic regurgitation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

What would you ideally carry out with blood pressure that you can’t due to time constraints?

A

Measure in both arms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

What is assessed in the neck in a cardio exam? (2)

A
  • Carotid pulse

- JVP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

What is assessed in carotid pulse? (2)

A
  • Character

- Volume

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

What does a slow rising character carotid pulse indicate?

A

Aortic stenosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

How should someone examine the cartoid?

A
  • Auscultate for a bruit before palpating

- Theoretically palpation = dislodge plaque = stroke

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

What 2 things could a “bruit” on auscultating the carotid indicate?

A
  • Clot

- Radiating murmur

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

How is JVP assessed? (5)

A
  • Position patient reclined semi supine 45 degrees
  • Turn patient head away from you
  • Observe for JVP
  • Measure JVP
  • Hepatojugular reflux
50
Q

Where would the JVP be observed?

A

Internal jugular - pulsation L side of neck behind sternocleidomastoid

51
Q

How is JVP measured?

A

Number of centimetres vertically from sternal angle to upper border of pulsation

52
Q

What should JVP be less than?

A

4cm high

53
Q

What is JVP a proxy measure of?

A

Right atrial pressure

54
Q

What does raised JVP indicate? (3)

A
  • Fluid overload
  • Right ventricular failure
  • Tricuspid regurgitation
55
Q

How is the hepatojugular reflux illicited?

A
  • Apply pressure to liver
  • Observe JVP for rise
  • Sustained longer than 1-2 cardiac cycles + greater than 4cm rise = positive result
56
Q

What is a positive hepatojugular reflux sign suggestive of? (2)

A
  • Right sided heart failure

- Tricuspid regurgitation

57
Q

What abnormal colours can be found in the face? (2)

A
  • Pallor

- Malar (high cheek) flush

58
Q

What is malar flush a sign of?

A

Mitral stenosis

59
Q

What signs can be found in the eyes? (3)

A
  • Conjunctival pallor
  • Corneal arcus
  • Xanthelasma
60
Q

How can conjunctival pallor be assessed?

A

Ask patient to pull down lower eyelid

61
Q

What does conjunctival pallor indicate?

A

Anaemia

62
Q

What does corneal arcus look like?

A

Yellowish/grey ring surrounding iris/peripheral cornea

63
Q

What does corneal arcus indicate?

A

Hypercholesterolaemia

64
Q

What is xanthelasma?

A

Yellow raised lesons/deposits around eyelids

65
Q

What does xanthelasma indicate?

A

Hypercholesterolaemia

66
Q

What can fundoscopy find? (2)

A
  • Diabetic retinopathy

- Hypertensive retinopathy

67
Q

What is retinopathy?

A

Damage to retina

68
Q

What is assessed in the mouth? (3)

A
  • Central cyanosis
  • Angular stomatitis
  • High arched palate
69
Q

What indicates central cyanosis in the mouth?

A
  • Patient sticks out tongue

- Bluish discolouration of lips/tongue

70
Q

What is angular stomatitis?

A

Inflammation of the corners of the mouth

71
Q

What does angular stomatitis indicate?

A

Iron deficiency

72
Q

What does a high arched palate indicate? (2)

A
  • Risk of aortic aneurysm/dissection

- Marfan syndrome

73
Q

How should the patient position themselves to view scars on the chest?

A

Hands on hips

74
Q

What scars should be looked for on inspection of the chest? (4)

A
  • Midline sternotomy
  • Lateral thoractomy
  • Clavicular
  • Left midaxillary line
75
Q

What surgeries leave a midline sternotomy scar? (4)

A
  • Open heart surgery
  • Valve replacement
  • Cardiac transplant
  • Coronary artery bypass graft (CABG)
76
Q

What surgeries leave a lateral thoractomy?

A

Minimally invasive valve surgery

77
Q

Where is the lateral thoractomy scar found?

A

Under axilla

78
Q

What do clavicular scars indicate?

A

Pacemaker

79
Q

What do scars in the left midaxillary line indicate?

A

Subcutaneous implantable cardioverter defibrillator (ICD)

80
Q

What do chest wall deformities indicate? (2)

A
  • Pectus excavatum

- Pectus carinatum

81
Q

What do visible pulsations of the apex beat indicate? (2)

A
  • Ventricular hypertrophy

- Hypertension

82
Q

What is palpated for in a cardio exam? (3)

A
  • Apex beat
  • Thrills
  • Heaves
83
Q

How is an apex beat palpated for? (3)

A
  • Lean patient to left side
  • 5th intercostal space
  • Midclavicular line
84
Q

What does lateral displacement of the apex beat suggest?

A

Cardiomegaly

85
Q

What do heaves indicate?

A

Right ventricular hypertrophy

86
Q

How are heaves palpated for? (3)

A
  • Place heel of hand parallel to the left sternal edge
  • Fingers vertical
  • Feel hand lifted in systole
87
Q

How are thrills palpated for? (3)

A
  • Palpable vibration
  • Across each heart valve
  • Place hand flat horizontally across chest wall
88
Q

What are thrills caused by?

A

Turbulent blood flow through a heart valve

89
Q

What areas of the chest are auscultated for? (5)

A
  • Carotid pulse
  • Mitral area
  • Tricuspid area
  • Pulmonary area
  • Aortic area
90
Q

Where is the mitral area of the chest ausculated for? (2)

A
  • 5th intercostal space

- Mid clavicular line

91
Q

Where is the tricuspid area of the chest ausculated for? (2)

A
  • 4th intercostal space

- Left sternal edge

92
Q

Where is the pulmonary area of the chest ausculated for? (2)

A
  • 2nd intercostal space

- Left sternal edge

93
Q

Where is the aortic area of the chest ausculated for? (2)

A
  • 2nd intercostal space

- Right sternal edge

94
Q

What heart sounds are listened for? (4)

A
  • S1
  • S2
  • Silence between S1 and S2
  • Murmurs
95
Q

What does S1 indicate? (2)

A
  • Tricuspid and mitral valve closing

- Ventricular systole

96
Q

What does S2 indicate? (2)

A
  • Pulmonary valve and aortic valve closure

- Systole end

97
Q

What does the silence between S1 and S2 indicate? (2)

A
  • Diastole

- Ventricular filling

98
Q

List the order of areas auscultated in a cardio exam (6)

A
  • All 4 valves with diaphragm (+palpate carotid)
  • Roll patient over to left: apex with bell (Mitral stenosis)
  • Carotids with held breath (bruits+aortic stenosis)
  • Breathe all way out + hold breath (aortic regurgitatin)
  • Lung bases
99
Q

How/what are the carotids auscultated for? (2)

A
  • Auscultate with patient holding breath

- Aortic stenosis/bruits

100
Q

How/what is the aortic regurgitation auscultated for?

A
  • Full expiration
  • Hold breath
  • Left sternal edge
  • Aortic regurgitation
101
Q

How/what is mitral stenosis further auscultated for? (4)

A
  • With bell
  • Roll patient over onto left lateral side
  • During expiration
  • Radiates to axilla
102
Q

Why is the murmur of aortic regurgitation louder on expiration?

A

Increased venous return

103
Q

What does a murmur heard in the mitral area indicate?

A

Mitral stenosis

104
Q

How is aortic regurgitation listened for? (4)

A
  • Breathe all the way out and hold breath
  • Listen over left sternal edge
  • Blowing diastolic sound
  • Radiates to carotids
105
Q

What are listened for in lung bases in a cardio exam?

A

Crackles on inspiration

106
Q

What do crackles in lung bases indicate in a cardio exam? (2)

A
  • Pulmonary oedema (e.g. secondary to left ventricular failure)
  • If no fluid overload: chronic lung diseases
107
Q

Why is the spine base palpated in a cardio exam?

A

Sacral oedema

108
Q

What does oedema indicate?

A

Right ventricular failure

109
Q

What arteries are auscultated for bruits? (3)

A
  • Renal artery
  • Femoral artery
  • Aorta
110
Q

What is a bruit?

A

Turbulent blood flow

111
Q

Where is the renal artery auscultated for?

A

Inferior to and either side of umbilicus

112
Q

What pathologies are looked for in a patients feet and ankles in a cardio exam? (4)

A
  • Ischaemia
  • Venous disease
  • Peripheral oedema
  • Palpate foot pulses
113
Q

What are the signs of ischaemia in a patient’s feet and ankles in a cardio exam? (3)

A
  • Blue toes and feet
  • Hair loss on leg front
  • Ulcers
114
Q

What are the signs of venous disease in a patient’s feet and ankles in a cardio exam? (3)

A
  • Ulcers
  • Dilated large and small veins
  • Brown pigmentation from haemosidesin deposits
115
Q

What finger is used to palpate peripheral oedema?

A

Index middle finger

116
Q

What foot pulses are palpated for? (2)

A
  • Dorsalis pedis
  • Posterior tibial
  • Popliteal
117
Q

What further exams could be carried out after a cardio exam? (5)

A
  • Full peripheral vascular examination
  • 12-lead ECG
  • Dipstick urine
  • Bedside capillary blood glucose – diabetes
  • Fundoscopy
118
Q

How is the dorsalis pedis palpated for? (3)

A
  • Plantar flexion to find extensor tendon of the great toe
  • Lateral to this
  • At level of navicular bone
119
Q

How is the posterior tibial palpated for?

A

Behind and below medial malleolus

120
Q

How is the popliteal palpated for? (4)

A
  • Flex knee
  • Thumbs on tibial tuberosity
  • Curl your fingers into the popliteal fossa
  • Compress the popliteal artery against the tibia
121
Q

How can a murmur be checked for being a systolic murmur?

A

Palpate carotid at same time, see if starts with pulse

Clinical (21 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions