Cardio PE

Question 1

JVP Mesurement

Answer 1

Should be considered routinely with pts with CHF

Assess volume overload

Question 2

Hepatojugular reflux test

Answer 2

Should be considered routinely with pts with CHF

Assess volume overload

Question 3

Left lateral positional heart sound ascultation

Answer 3

Can be doen to more clearly assess tricuspid and mitral murmurs

Easier to palpate PMI

May be easier to see and hear S3 and S4

Question 4

Leaning forward heart sound auscultation

Answer 4

Can hear aortic and pulmonic murmurs more clearly

Question 5

Standing heart sound auscultation

Answer 5

May accentuate murmurs associated with mitral valve prolapse or hypertrophic cardiomyopathy

Will make aortic stenosis murmur softer

Question 6

Squatting or valsalva auscultation

Answer 6

may accentuate aortic stenosis murmur

will decrease intensity of mitral valve prolapse and hypertrophic cardiomyopathy

Question 7

Allen’s Test

Answer 7

Tests patency of radial and ulnar arteries

Raynaud’s

Question 8

Homan’s test

Answer 8

Assess DVT of the leg

Question 9

Ankle Brachial Index (ABI)

Answer 9

Test to assess for peripheral artery disease

Question 10

Midsystolic murmurs

Answer 10

Most common type

Innocent

Physiologic–from changes in metabolism

Pathologic–from structural abnormality in heart or great vessels

Question 11

Pansystolic (Holosystolic) Murmurs

Answer 11

Pathologic

Caused by blood flowing from one chamber of high pressure to chamber of lower pressure through a valve or structure that should be closed

Mitral regurgitation
Tricuspid regurgitation
Ventricular septal defect

Question 12

Systolic Clicks

Answer 12

Usually due to mitral valve prolapse

Usually mid or late systolic

Heard best b/w lower LSB and PMI with diaphragm

Often followed by murmur from mitral regurgitation

Squatting delays

Standing moves it closer to S1

Question 13

Diastolic murmurs

Answer 13

almost always indicate disease

Two main types:

• **Aortic regurgitation **
  
  • Heard best at base, pt sitting forward
  • If S3/S4 present, suggests more severe disease
• **Mitral stenosis **
  
  • Low pitched and located near PMI
  • L lateral decubitus position

Question 14

Murmurs with systolic and diastolic components

Answer 14

Venous hum

Patent ductus arteriosus

Pericardial friction rub

Question 15

Venous hum

Answer 15

Benign

Usually in young children

From turbulent blood flowing through jugular veins

Disappears with compression of jugular

Question 16

Patent Ductus Arteriosis

Answer 16

Congenital patent opening between pulmonary artery and aorta

Usually not heard until 7-10 days when systemic and pulmonary pressure gradients are established

Question 17

Pericardial friction rub

Answer 17

Best heard over pulmonic area

Crunchy or squeaky

Look for underlying causes:
Trauma
Illness
Tumor