Cardio exam

Question 1

Are jugular pulsations normal in small animals

Answer 1

No

Question 2

Are jugular pulses more likely to be increased when the animal inhales or exhales?

Answer 2

Inhales- increased thoracic pressure which puts more pressure on the right heart

Question 3

T/F: Jugular pulses indicate congestive heart failure

Answer 3

F

Question 4

What do jugular pulses indicate?

Answer 4

Elevated right heart filling pressures or obstruction to filling of right heart

Question 5

What are some causes of jugular pulsations?

Answer 5

Tricuspid insufficiency
Hypertrophied/stiff right ventricle
Complete heart block

Question 6

What are some causes of jugular distension?

Answer 6

Cranial vena cava occlusion (mass or thrombosis)

Very high right heart filling pressure (severe pericardial effusion)

Question 7

What is hepatojugular reflux?

Answer 7

Positive= jugular pulse increased when liver is pressed on

Question 8

What is “pseudo” jugular pulse?

Answer 8

Carotid artery pulsation near the thoracic inlet (dogs)

• palpable
• jug pulse not palpable

Question 9

What is a precordial thrill?

Answer 9

The buzzing present with severe murmurs

Question 10

What is the precordium?

Answer 10

Palpable heart beat through the thorax- do this on physical exam

Question 11

What are you feeling when you palpate pulses?

Answer 11

The difference between systolic and diastolic arterial pressures

Question 12

Define hyperkinetic pulses:

Answer 12

Feel more prominent than normal- caused by increased difference between systolic and diastolic pressure

Question 13

What are weak pulses caused?

Answer 13

Hypokinetic- reduced stroke volume or narrower pulse pressure

Question 14

Define pulse deficit

Answer 14

Less pulses palpable than heart beats

Question 15

T/F: A thorough cardiac exam can be done with the patient laying down

Answer 15

F

Question 16

What sound is S1

Answer 16

AV valve closure

Question 17

What sound is S2

Answer 17

SL valve closure

Question 18

What sound is S3

Answer 18

Vibrations in the heart wall associated with rapid ventricular filling

Question 19

What sound is S4

Answer 19

Atrial contraction- rapid ventricular filling

Question 20

Systolic clicks?

Answer 20

Delayed closure or prolapse of AV valves in mid-late systole

Question 21

Abnormalities in S1

Answer 21

Split S1- conduction alterations between the two sides, can be normal in very large dogs

Question 22

Abnormalities in S2

Answer 22

Split S2- delayed closure of aortic or pulmonic valve

Question 23

Abnormalities in S3

Answer 23

S3 is only heard in small animals with very dilated ventricles- S3 Gallop

Question 24

Abnormalities in S4

Answer 24

S4 is only heard in small animals with very dilated atria - S4 Gallop

Question 25

Pathology of systolic clicks

Answer 25

Most commonly heard with early endocardiosis of the mitral valve- occasionally affects tricuspid valve

Question 26

Difference between murmurs and sound variations?

Answer 26

Sound abnormalities are short and transient, murmurs are long sounds

Question 27

Three steps to describe a murmur?

Answer 27

1. Timing 2. PMI 3. Pitch and quality

Question 28

If the murmur occurs during a palpable pulse, is it systolic or diastolic?

Answer 28

Systolic

Question 29

PMI for the pulmonic valve?

Answer 29

Basal left- above the costo-chondral junction

Question 30

PMI for the aortic valve?

Answer 30

Basal left- above the costo-chondral junction

Question 31

PMI for the mitral valve?

Answer 31

Apical left- below the costo-chondral junction

Question 32

PMI for the tricuspid valve?

Answer 32

At costochondral junction- right

Question 33

PMI for VSD

Answer 33

Right apex- below the costo-chondral junction

Question 34

PMI for PDA

Answer 34

Prebasilar left- craniodorsal to heart base

Question 35

Regurgitant murmur sounds like:

Answer 35

Systolic consistent

Question 36

Ejection murmur sounds like:

Answer 36

Systolic crescendo then decrescendo

Question 37

Blowing murmur sounds like:

Answer 37

Diastolic decrescendo

Question 38

Continuous murmur sounds like:

Answer 38

Slight systolic crescendo, slight diastolic decrescendo

Question 39

To and fro murmur sounds like:

Answer 39

Systolic crescendo to decrescendo, diastolic decrescendo (ejection and blowing)

Question 40

Causes of regurg murmur?

Answer 40

Mitral or Tricuspid

Question 41

Causes of ejection murmur?

Answer 41

Pulmonic valve stenosis, subaortic stenosis, physiologic

Question 42

Causes of blowing murmur?

Answer 42

aortic regurg, pulmonic regurg

Question 43

Causes of continuous murmor?

Answer 43

PDA

Question 44

Causes of to and fro murmur?

Answer 44

Subaortic stenosis, aortic regurg

Question 45

Grade 1 murmur:

Answer 45

Very soft, localized to one region

Question 46

Grade 2 murmur:

Answer 46

Soft, radiates to 2 heart regions

Question 47

Grade 3 murmur:

Answer 47

Moderate, radiates to 2 heart regions

Question 48

Grade 4 murmur:

Answer 48

Loud, present in all 4 heart regions

Question 49

Grade 5 murmur:

Answer 49

Loud, present in all 4 regions, precordial thrill

Question 50

Grade 6 murmur:

Answer 50

Audible without stethoscope

Question 51

Is a louder or softer VSD murmur more severe

Answer 51

Louder is a smaller hole, more turbulent flow

Question 52

What are some cardiac diseases without murmurs

Answer 52

``` Tetrology of Fallot Cardiomyopathies Pericardial effusion Pulmonary hypertension Systemic hypertension Arrhythmias ```

Question 53

Describe stertor and stridor:

Answer 53

Discontinuous sounds and wheezes present without a stethoscope

Question 54

Describe crackles:

Answer 54

Non-musical, discontinuous sounds, like crumpled paper

Question 55

Describe wheezes:

Answer 55

musical, continuous sounds