Cardiology

Question 1

what is the R border of the heart?

Answer 1

from 3rd right CC, 1cm lateral to sternal border

to the 6th right CC

Question 2

which is the L border of the heart?

Answer 2

from 2nd left ICS, 2.5 cm from sternal border

to 5th ICS at midclavicular line

Question 3

what is the upper border of the heart?

Answer 3

from 3rd right CC, 1cm lateral to sternum

to 2nd L ICS, 2.5cm from sternal border

Question 4

what is the lower border of the heart?

Answer 4

from 6th R CC

to 5th ICS at MCL

Question 5

where does the apex of the heart sit?

Answer 5

Left 5th ICS at MCL

Question 6

when percussing the heart, what does an expanded area of dullness indicate?

Answer 6

dullness to mid-axillary line

cardiomegaly or pericardial effusion

Question 7

where does the V1 lead go?

Answer 7

right 4th ICS next to sternum

Question 8

where does the V2 lead go?

Answer 8

left 4th ICS next to sternum

Question 9

Where does the V3 lead go?

Answer 9

left 5th ICS b/ V2 and V4

Question 10

where does the V4 lead go?

Answer 10

left 5th ICS at MCL

Question 11

Where does the V5 lead go?

Answer 11

Left 5th ICS at anterior axillary line

Question 12

where does the V6 lead go?

Answer 12

left 5th ICS at MAL

Question 13

where do you auscultate the aortic valve?

Answer 13

RIGHT 2nd ICS at sternal border

Question 14

where do you auscultate the pulmonary valve?

Answer 14

LEFT 2nd ICS at sternal border

Question 15

where do you auscultate the tricuspid valve?

Answer 15

LEFT 5th ICS at sternal border

Question 16

where do auscultate the mitral valve?

Answer 16

LEFT 5th ICS at MCL

at location of apex beat

Question 17

what order do you auscultate the valves in?

Answer 17

aortic, pulmonary, tricuspid, mitral

Question 18

where do you listen for valve sounds?

Answer 18

listen downstream from flow of blood through valves

so site of auscultation of heart valves differs from anatomical location

Question 19

where is the anatomical location of the aortic valve?

Answer 19

obliquely-angles at RIGHT 3rd ICS at sternal border

Question 20

what is the anatomical location of the pulmonary valve?

Answer 20

horizontal

LEFT 3rd CC

Question 21

what is the anatomical location of the tricuspid valve?

Answer 21

vertical

RIGHT 4th ICS at sternal border

Question 22

what is the anatomical location of the mitral valve?

Answer 22

oblique

LEFT 4th ICS at sternal border

Question 23

where do you feel the carotid pulse?

Answer 23

anterior border of SCM at level of superior border of laryngeal border

Question 24

how do you locate the carotid pulse?

Answer 24

ask pt to turn head to side to see SCM

just under jaw line

Question 25

what are the 2 sites where the brachial artery can be felt?

Answer 25

1st one: mid arm - medial side of arm (mid way b/ shoulder and elbow). between biceps brachii and triceps brachii tendon 2nd one: cubital fossa

Question 26

where is the radial artery located?

Answer 26

lateral to the tendon of the FCR muscle

Question 27

where is the ulnar artery located?

Answer 27

proximal to pisiform | under lateral border of FCU tendon

Question 28

where is the apex beat in children?

Answer 28

4th ICS

Question 29

what are the causes of the absence of an apex beat?

Answer 29

``` D - dextrocardia R - ribs P - pericardial effusion O - obesity P - pleural effusion E - emphysema ```

Question 30

what is a much quicker method of finding the apex beat?

Answer 30

male nipple = 4th ICS | work down from here

Question 31

what is the most common site of venepuncture?

Answer 31

cubital fossa

Question 32

what are the borders of the cubital fossa?

Answer 32

medial: brachioradialis muscle lateral: pronator teres superior border: imaginary line b/ 2 epicondyles of humerus

Question 33

what are the contents of the cubital fossa (lateral to medial)?

Answer 33

``` radial nerve biceps brachii tendon median cubital vein brachial artery median nerve ```

Question 34

how do you make veins of arm more prominent for OSPE?

Answer 34

repeatedly make fists | while you put one hand on ant arm and other on post arm

Question 35

what are the branches that lead off aortic arch?

Answer 35

brachiocephalic trunk (R common carotid, subclavian arteries) L common carotid artery L subclavian

Question 36

where is the ascending aorta?

Answer 36

begins at lower border of CC | joins aortic arch at 2nd CC

Question 37

where is the descending aorta?

Answer 37

begins at 2nd CC passes down and medially ends 2.5cm superior to transpyloric plane

Question 38

where does the internal jugular vein run?

Answer 38

lateral to carotid arteries

Question 39

what do the coronary arteries supply?

Answer 39

myocardium

Question 40

What are the 2 main coronary arteries?

Answer 40

left main coronary artery | right coronary artery

Question 41

what does the left main coronary artery supply?

Answer 41

oxygenated blood to left ventricle and atrium | gives rise to circumflex artery and left anterior descending artery

Question 42

what does the circumflex artery supply?

Answer 42

left atrium and posterior-lateral portion of left ventricle

Question 43

what does the left anterior descending artery supply?

Answer 43

anterior part of L ventricle | anterior part of interventricular septum

Question 44

what does the R coronary artery supply?

Answer 44

blood to right atrium, right ventricle, SAN and AVN | gives rise to right marginal artery and posterior descending artery

Question 45

what does the right marginal artery supply?

Answer 45

R ventricle

Question 46

what does the posterior descending artery supply?

Answer 46

posterior 1/3 of intraventricular septum