Cardio examination 2

Question 1

normal HR

Answer 1

● Adults: 60 to 100 bpm (average is 80 bpm); 40 to 60 bpm in aerobically trained
individuals
● Newborns: 80 to 180 bpm (average is 130 bpm)

Question 2

tachycardia

Answer 2

● Compensatory tachycardia: due to volume loss (surgery, dehydration)
● Postural tachycardia syndrome: sustained HR increase of ≥30 bpm within 10 minutes
of standing

Question 3

bradycardia

Answer 3

<60 bpm

Question 4

pulse abnormalities

Answer 4

weak/thready, irregular, bounding full pulse

Question 5

irregular pulse

Answer 5

variations in force or frequency; can be due to arrhythmias, myocarditis

Question 6

weak/thready

Answer 6

low SV, cardiogenic shock, increased peripheral resistance, severe CHF

Question 7

bounding pulse

Answer 7

increased SV, shortened ventricular systole, decreased peripheral
pressure, aortic insufficiency, anxiety, fever, hypertension (HTN), exercise

Question 8

aortic valve

Answer 8

2nd intercostal space (ICS), right sternal border

Question 9

pulmonic valve

Answer 9

2nd ICS, left sternal border

Question 10

tricuspid

Answer 10

4th ICS, left sternal border

Question 11

mitral valve

Answer 11

5th ICS, left midclavicular line
➤ Where you will hear S3 if present
➤ Also called apical pulse; point of maximal impulse

Question 12

erbs point

Answer 12

auscultation location for heart sounds and heart murmurs located at the
3rd left ICS

Question 13

Normal heart sounds
S1

Answer 13

S1 = “Lub”: mitral and tricuspid valves (AV valves) closing → onset of systole
-Decreased sound in first-degree heart block

Question 14

normal heart sounds S2

Answer 14

S2 = “Dub”: aortic and pulmonic valves (semilunar valves) closing → onset of
diastole
➤ Decreased sound in aortic stenosis

Question 15

● Systole occurs between S1 and S2
● Diastole occurs between S2 and S1

Question 16

Abnormal sounds: Gallops

Answer 16

Occurs at S3 and S4

Question 17

S3 = “kenTUCKy” (S1–S2–S3)

Answer 17

➤ Ventricular gallop
➤ Associated with ventricular filling after mitral and tricuspid valves open
Low-frequency turbulence; heard during early diastole
➤ Hallmark sign of CHF
➤ May be normal in children and young athletes

Question 18

S4 = “TENNessee” (S4–S1–S2)

Answer 18

➤ Atrial gallop
➤ Associated with abnormal ventricular filling and atrial contraction
Low-frequency turbulence; heard during late diastole
➤ Associated with MI, HTN, and LV hypertrophy

Question 19

systolic murmur

Answer 19

turbulence between S1 and S2; valvular disease (mitral valve pro-
lapse), aortic stenosis, or may be normal

➤ Abnormal “swishing” sound is heard instead of “lub”; heard as “lush”

Question 20

diastolic murmur

Answer 20

turbulence between S2 and S1; aortic and pulmonary regurgitation
or mitral stenosis
➤ Fairly uncommon

Question 21

murmur grades

Answer 21

grade 1 (softest) to grade 6 (audible with stethoscope lifted off
chest)

Question 22

thrill

Answer 22

abnormal tremor with vascular or cardiac murmur; felt with palpation

Question 23

stenotic valve

Answer 23

impaired opening

Question 24

regurgitant valve

Answer 24

impaired closing

Question 25

bruit

Answer 25

● Adventitious sound or murmur (blowing sound) of arterial or venous origin ➤ Turbulent blood flow ● Common in carotid or femoral arteries ● Indicates atherosclerosis or partially blocked artery

Question 26

pericardial friction rub

Answer 26

● Due to inflammation of the pericardial sac (with or without excessive fluid) ● Post-MI pericarditis: Dressler syndrome Abnormal sound associated with each heartbeat; high-pitched; leathery, scratchy quality