Cardiovascular

Question 1

Family and personal history with increase risk for cardiovascular disease

Answer 1

-diabetes, hypertension, coronary artery disease, hyperlipidemia

Question 2

Sxs concerning with cardiovascular assessment

Answer 2

dyspnea, cough, edema, numbness or pain in extremities, skin color, chest pain, fatigue, dizziness, syncope, diaphoresis, palpitations

Question 3

possible causes of chest pain

Answer 3

• cardiac
• musculoskeletal
• pleural
• GI
• pulmonary
• psychoneurotic

Question 4

Children and chest pain

Answer 4

chest pain in children is seldom due to cardiac problem

Question 5

In assessment of chest pain in adults assume….

Answer 5

cardiac until proven otherwise

Question 6

Valves b/w atrium and ventricles

Answer 6

Atrioventricular

Question 7

Valve b/w left atrium and ventricle

Answer 7

mitral or bicuspid valve

Question 8

Valve b/w right atrium and ventricle

Answer 8

tricuspid

Question 9

When do atrioventricular valves close?

Answer 9

During systole

Question 10

When do atrioventricular valves open?

Answer 10

during diastole

Question 11

What are the valves between ventricles and rest of body?

Answer 11

Semilunar valves

Question 12

Where is the pulmonic semilunar valve?

Answer 12

B/w right ventricle and pulmonary artery

Question 13

Where is the aortic valve?

Answer 13

B/w the left ventricle and the aorta

Question 14

Heart sound heard doing Systole?

Answer 14

s1, AV valves closing

Question 15

Systole- pumping or filling?

Answer 15

pumping

Question 16

Diastole- pumping or filling?

Answer 16

filling

Question 17

Heart sound heard during diastole?

Answer 17

s2, aortic and pulmonic semilunar valves closing

Question 18

Where is s2 loudest?

Answer 18

at base

Question 19

Where is the base of the heart?

Answer 19

at the top

Question 20

Where is s1 loudest?

Answer 20

at the apex

Question 21

Where is apex of heart?

Answer 21

at the bottom

Question 22

s1 - lub or dub?

Answer 22

LUB

Question 23

s2- lub or dub?

Answer 23

DUB

Question 24

What does s1 mark?

Answer 24

beginning of systole

Question 25

What is an s2 split?

Answer 25

aortic valve closes before pulmonic valve during inspiration

Question 26

Tachycardia =

Answer 26

Heart rate >100

Question 27

brachycardia=

Answer 27

heart rate <60

Question 28

3 general things done in cardiovascular assessment

Answer 28

-inspection, palpation, auscultation

Question 29

Where do you hear aortic valve?

Answer 29

-right side of sternum in second intercostal space

Question 30

Where do you hear pulmonic valve?

Answer 30

-left side of sternum in second intercostal space

Question 31

Where do you hear tricuspid valve?

Answer 31

-left side of sternum, fourth intercostal space

Question 32

Where do you hear mitral valve?

Answer 32

-left side of sternum Mid clavicular , 5th intercostal space

Question 33

Angle of louis

Answer 33

-manubriosternal angle

Question 34

Position for inspecting heart?

Answer 34

semifowlers

Question 35

Point of maximal impulse?

Answer 35

Apex , mid clavicular line, 5th intercostal space

Question 36

Erbs point

Answer 36

where you can hear s1 and s2 about the same, located in 3rd intercostal space on left sternal border

Question 37

Cardiac rub

Answer 37

high pitched, SCRATCHY siund caused by ventricle rubbing against pericardial inflammation

Question 38

Best place to hear a cardiac rub?

Answer 38

-lower left sternal border using diaphragm of stethoscope with patient SITTING UP AND LEANING FORWARD while briefly HOLDING BREATH

Question 39

Murmers

Answer 39

- turbulent blood flow thru the heart | - graded 1-6 (higher = worse)

Question 40

Regurgitation murmer

Answer 40

mitral valve insufficiency

Question 41

ejection murmer

Answer 41

aortic stenosis

Question 42

What do you look for in peripheral vascular assessment?

Answer 42

skin temp, color, pulses, capillary, refill, edema

Question 43

2 great vessels of neck

Answer 43

- carotid arteries | - jugular veins

Question 44

Carotid assessment | special thing you can hear?

Answer 44

- palpate for symmetry one at a time | - auscultate for BRUIT (blowing of swishing sound with bell)

Question 45

Jugular Veins

Answer 45

-look for distention bilaterally

Question 46

most difficult pulse to find?

Answer 46

popliteal

Question 47

where do you find femoral pulse?

Answer 47

on imaginary line between superior illiac crest and pubic symphysis

Question 48

Pulse grading

Answer 48

0-absent 1+ weak or thready 2+normal 3+bounding

Question 49

normal time for capillary refill

Answer 49

2 seconds

Question 50

where are hands when checking capillary refill?

Answer 50

at level with heart (not way up or down at side)

Question 51

Assessing for edema

Answer 51

-depress medial malleolous for 5 seconds

Question 52

nonpitting edema

Answer 52

- no indention | - yes swelling

Question 53

pitting edema

Answer 53

- yes indention | - yes swelling

Question 54

pitting edema grading

Answer 54

1+ - 4+

Question 55

1+ pitting edema

Answer 55

disappears rapidly "slight" 2mm

Question 56

2+ pitting edema

Answer 56

10-15 second to dispapear "increased" 4mm

Question 57

3+ pitting edema

Answer 57

1-2 minute to disappear "obvious edema in extremity" , looks swollen 6mm

Question 58

4+ pitting edema

Answer 58

>2 minute to disappear "severe" , looks swollen 8mm

Question 59

DVT signs

Answer 59

- unilateral edema - pain/aches - redness - warmth

Question 60

Arterial peripheral disorder

Answer 60

1. occurs after exercise and intermittent claudication 2. sharp stabbing 3. worse with activity 4. lowering feet reduces pain

Question 61

Venous peripheral disorder

Answer 61

1. pain with prolonged sitting or standing 2. aching, heavy 3. helped with activity 4. raising feet and legs help

Question 62

Arterial SKIN disorder

Answer 62

1. cool/cold 2. hairless 3. shiny 4. pallor on elevation 5. rubor (redness) on dangling

Question 63

Venous skin disorder

Answer 63

1. warm 2. thickened 3. mottled 4. brown pigmented areas

Question 64

Arterial vs venous pulses in disorders

Answer 64

``` arterial = often absent venous = usually present ```

Question 65

Arterial vs venous edema occurence

Answer 65

``` arterial = infrequent venous = frequent ```

Question 66

Acute Arterial Occlusion

Answer 66

6ps 1. pain 2. poikilothermia (coldness) 3. parasthesia 4. paralysis 5. pallor 6. pulselessness