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RUSVM SAM 1 > Cardiology Review and Physical Exam > Flashcards

Cardiology Review and Physical Exam Flashcards

1
Q

Is the resistance in the pulmonary vessels high or low ?

A

Low resistance => low pressure (P=CO x R)

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2
Q

What enters the right atrium at the craniodorsal aspect, near the sinus node?

A

Cranial vena cava

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3
Q

The right atrioventricular valve is AKA?

A

Tricuspid valve

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4
Q

T/F: The right ventricle is crescent shaped and its valves can only be heard on the left side

A

False

Crescent shaped-> beginning in right hemithorax (tricuspid valve) and terminate in left hemithorax (pulmonary valve)

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5
Q

Where do the pleural veins empty into in dogs and cats?

A

Cranial vena cava

-in cats, also empty into the left atrium

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6
Q

Where do the abdominal veins empty into in dogs and cats?

A

Caudal vena cava

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7
Q

Where does the pericardium drain into in cats and dogs??

A

Crainial vena cava

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8
Q

The left AV valve is AKA?

A

Mitral valve

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9
Q

Basilar refers to???

A

Dorsal 1/3rd of the heart

-atria, auricle, aortic, and pulmonary valves, ascending aorta, main PA

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10
Q

Apical refers to???

A

Ventral 2/3 of the heart

-includes the ventricles and AV valves

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11
Q

Where do the coronary arteries originate?

A

Left coronary artery - L aortic sinus

Right coronary artery - R aortic sinus

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12
Q

When does most coronary flow occur?

A

During diastole

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13
Q

The great coronary vein originates at ____________ and empties into the ________

A

Apex of left ventricle; coronary sinus

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14
Q

What are the components of the conduction system of the heart?

A 
SA node
AV node 
Bundle of His
Bundle branches 
Purkinje fibers
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15
Q

Is the ventricular myocardium primarily controlled by the SNS or PSNS?

A

SNS

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16
Q

T/F: the SA and AV nodes have both parasympathetic (vagal) and sympathetic innervation

A

True

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17
Q

The sympathetic effects of the heart are mediated by what receptors?

A

B1 adrenergic receptors

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18
Q

The parasympathetic effects of the heart are mediated by what receptors ?

A

Muscarinic

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19
Q

_________ is the volume of blood ejected out the heart during each cardiac cycle

A

Stroke volume (EDV-ESV)

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20
Q

Stroke volume is determined by what 3 factors?

A

Preload
Afterload
Contractility

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21
Q

What is the sequel of increased right atrial pressure?

A

Increased hydrostatic pressure in vena cava

Increased hydrostatic pressure in systemic veins

Effusion on body cavities -> peritoneal/pleural/pericardial
Interstitial edema in systemic organs

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22
Q

What is the sequel of increased left atrial pressure

A

Increased hydrostatic pressure in pulmonary viewings —> edema in pulmonary parenchyma

Cats ONLY- increased hydrostatic pressure in pleural veins —> effusion in pleural cavity

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23
Q

If you have decreased ambulation and abdominal distention, what concerns may you have relating to the CV system?

A

Thromboembolism (cat)

Hypotension ascites

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24
Q

What do you examine on the head with regard to a CV exam

A

Mucous membranes

  • normal, pink, CRT<2sec
  • assess for pallor, cyanosis, CRT > 2sec, petechiae, and icterus

Eyes
-evaluate for hyphema, retinal hemorrhage, and retinal detachment (systemic hypertension ))

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25
Q

What nutrient is vital for heart function in cats and when lacking you can see central rental degeneration ?

A

Taurine deficiency cardiomyopathy

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26
Q

What would you suspect if there is distention of the jugular veins?

A

Elevated systemic venous pressure

—> right sided heart disease
—> pericardial disease
—> obstruction of the cranial vena cava

27
Q

T/F: it is normal to see pulsation of the jugular vein above the distal third

A

False

Normal below distal third
Abnormal above distal third —> tricuspid regurgitation/ventricular cardiomyopathy/pericardial disease/3rd degree AV block

28
Q

What is the palpable heart beat on the left chest surface ?

A 
Apex beat (AB) 
-mitral valve
29
Q

AB may be exaggerated in patients with __________

A

Cardiomegaly

30
Q

What should you listen for during cardiac auscultation?

A

Start at apex beat

Determine heart rate

Identify normal heart sounds/respiratory sounds

Listen for any abnormal sounds

Listen for arrhythmias

Repeat at aortic and then pulmonary valve and then tricuspid on the right

31
Q

What is the “lub” heart sound?

A

S1

Ventricular systole

32
Q

What are the valves doing during S1?

A

Ventricular systole

  • AV valves closing (this generates the “lub” sound)
  • Semilunar valves opening
33
Q

What is the “dub” heart sound?

A

S2

End of ventricular systole

34
Q

What are the valves doing during S2?

A

AV valves are opening

Semilunar valves are closing (this generates the “dub” sound)

35
Q

S1 and S2 are higher frequency sounds, and are best heard with what part of the stethoscope ?

A

Diaphragm

36
Q

What is a murmur?

A

Sound generated by abnormal movement of blood in the heart chambers or great vessels

37
Q

T/F: the higher the velocity, the louder the murmur

A

True

38
Q

Grade the murmur..

Very faint
Several seconds or longer to hear
Does not radiate

A

Grade 1

39
Q

Grade the murmur

Readily heard
Radiates on same side as the point of maximal intensity

A

Grade 3

40
Q

Grade the murmur

Loud
Rates to opposite side of PMI

A

Grade 4

41
Q

Grade the murmur

Faint
Doesn’t radiate

A

Grade 2

42
Q

Grade the murmur

Palpable thrill
Audible with stethoscope lifted off chest

A

Grade 6

43
Q

Grade the murmur

Palpable thill
Loud
Radiates to opposite side

A

Grade 5

44
Q

It is most common for murmurs to occur when?

A

During systole

  • pansystolic
  • holosystolic
45
Q

What is a gallop?

A

S3 or S4 sounds

Occurring before or after S1 and S2–> usually indicate a “stiff ventricle”

46
Q

What occurs during S4? When is it most commonly heard?

A

Atrial contraction —> active ventricular filling

Hypertrophic cardiomyopathy

47
Q

What occurs during S3? When is it most commonly heard?

A

Passive ventricular filling

Dilated cardiomyopathy

48
Q

S3 and S4 are low frequency sounds, and are best heard with what part of the stethoscope ?

A

Bell

49
Q

A ___________ occurs between S1 and S2. Usually due to a prolapse of an AV valve

A

Systolic click

High frequency -heard best with diaphragm

50
Q

What are pathologic causes of a split S1?

A

Bundle branch block
Ventricular ectopic beat
Mitral/tricuspid stenosis

51
Q

What are pathologic causes of a split S2?

A 
Pulmonary hypertension 
Bundle branch block 
Ventricular ectopic beats 
Left-right intracardiac shunt 
Pulmonic/aortic/mitral stenosis
52
Q

What heart sound is often audible in a patient with 3rd degree AV block

A

S4

53
Q

What are causes of pauses heard in cardiac auscultation ?

A

Premature beat
Sinus arrhythmia
2nd degree AV block
Sinus arrest

54
Q

What are causes of increased intensity of heart sound?

A

Thin body condition

Hyperdynamic states: fever, anemia, hyperthyroidism

55
Q

What are causes of decreased intensity of heart sounds?

A

Obesity
Pericardial or plural effusion
Intrathoracic mass effect
Poor left ventricular contractility

56
Q

Why do a pulmonary auscultation to assess heart function?

A

Congestive heart failure —> pulmonary edema/plural effusion/pericardial effusion

Can hear these on auscultation

57
Q

What sounds may you be able to hear in peracute pulmonary edema ?

A

Bronchial/bronchovesicular sounds increased

58
Q

What would you be able to hear in severe pulmonary edema?

A

Crackles/ wheezes

59
Q

If you hear muffled lung sounds ventrally what do you suspect?

A

Pleural effusion

60
Q 
In a cat.. 
absent femoral pulses 
Paralysis of both hindlimbs 
Cyanotic paw pads 
Firm musculature 
Painful!

What is this?

A

Feline distal aortic thromboembolism “saddle thrombus”

61
Q

What are you primarily looking for in the abdomen when doing a CV exam?

A

Distention - peritoneal effusion or cranial organomegaly

Fluid wave- peritoneal effusion

Cranial organomegaly - hepatomegaly is the most common

62
Q

T/F: patients with CHF may have weight/muscle loss

A

True

-cardiac cachexia

63
Q

If you have a dyspneic patient, how should you conduct your CV exam?

A

Observe
R-respiratory
A-ambulation and abdominal distention
M-mentation

Auscultation
Palpate femoral pulse
Tentative diagnosis and initiate therapy
History

Perform diagnostics once respiratory status has improved and is stable

RUSVM SAM 1 (26 decks)

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