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PDX > Cardiovascular > Flashcards

Cardiovascular Flashcards

1
Q

Precordium

A

Area of the chest that overlies heart and adjacent great vessels

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2
Q

Surface landmarks of the heart

A

Base of heart, Apex (tip) of heart, Erb’s point

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3
Q

Base of heart

A

Located at the third costal cartilage

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4
Q

Apex (tip) of the heart

A

-Located at mitral valve area (left ventricle)
-Used to assess point of maximum impulse

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5
Q

Erb’s point

A

-Halfway point between base and apex
-Location where all 4 valves can be heard

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6
Q

Aortic Valve location

A

Right 2nd intercostal space next to sternum

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7
Q

Pulmonary Valve location

A

Left 2nd intercostal space next to sternum

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8
Q

Erb’s point Location

A

Left 3rd intercostal space

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9
Q

Location of the Tricuspid Valve

A

Left 4th & 5th intercostal space next to sternum

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10
Q

Location of Mitral Valve

A

Left 5th intercostal space just medial to midclavicular line

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11
Q

Cardiac Pain

A

-Most common with activity
-Often a squeeze or pressure
-Like “someone is standing on my chest”

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12
Q

Levine’s Sign

A

Fist clenched (squeezing) over the precordium

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13
Q

Heart Causes

A

-Coronary artery disease (CAD)
-Pericardial disorders,
-Valve problems compromising coronary blood flow

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14
Q

Palpitation

A

-Subjective sensation that the heart has skipped a beat or added an extra bear (pounding, fluttering, racing)
-May be a normal phenomenon or by cardiac issues
(Isolated-common/harmless/After activity-Concerning)
-Pathological issues: Cardiac conditions, non-cardiac conditions, medication, stress, excessive caffeine or alcohol

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15
Q

Anasarca

A

-Extreme generalized edema
-Due to the heart not pumping effectively (fluid buildup)
-Different from typical edema (affects entire body/severe)

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16
Q

Vasovagal Syncope (Vagal Faint)

A

-Fainting as an overreaction to certain triggers
-Occurs as a result of sudden drop in heart rate and blood pressure

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17
Q

Hypovolemic Shock

A

-State of shock resulting from massive blood loss and inadequate tissue perfusion
-Lose more than 20% of body’s blood
-Makes it impossible for heart to pump sufficient blood to rest of organs and body
-Life threatening

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18
Q

Arteriosclerosis

A

-Hardening and thickening of the arterial walls
-Decreases blood flow
-Atherosclerosis contributes to arteriosclerosis

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19
Q

Artherosclerosis

A

-Plaques forms with arterial walls
-Causes narrowing of the lumen
-End organs supplied by these vessels receive diminished circulation

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20
Q

Bruit

A

-Intermittent auscultatory sound (“whooshing”)
-Caused by turbulent flow through an artery due to stenosis (narrowing)
-May also palpate as a thrill

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21
Q

Bruit in the neck vessel can help screen for __________

A

Artherosclerosis

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22
Q

Ischemia

A

-Diminished blood supply to an organ or body part
-Main cause: Artherosclerosis

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23
Q

Infarction

A

-Necrosis (tissue death) due to inadequate blood supply
-Result of prolonged ischemia

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24
Q

Intermittent Claudication

A

-Localized fatigue of the legs that occur while walking (Can be quickly relieved by rest-2 to 5 minutes)
-Discomfort occurs most often in the calf (also can be foot, thigh, hip or buttock)

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25
Q

Thrombophlebitis/thrombosis

A

Blood clot (thrombus) formed in the vein

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26
Q

Embolus

A

-Particle or mass t moves through blood vessels until it reaches a vessel that is too small to let is pass
(Lodges & causes obstruction of blood flow)
-Can cause ischemia and/or infarction

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27
Q

Pulse Pressure

A

-Represents the force that the heart generates each time it contracts
-Difference between systolic and diastolic pressures

28
Q

Normal Pulse Pressure

A

Usually within the range of 30-40mmhg

29
Q

Abnormal Pulse Pressure Causes

A

-Benign causes include vigorous exercise
-Pathological causes: atherosclerosis, and aortic regurgitation

30
Q

Hypertentive Crisis

A

-Acute, severe rise in blood pressure
-May or may not have organ dysfunction

31
Q

Urgency Hypertension

A

> 180/>120 w/o organ damage
-Need evaluation including medication

32
Q

Emergency hypertension

A

> 180/>120 mmHg with organ damage
-Immediate emergency

33
Q

Normal Pulse Pressure Description

A

-Pressure of the pulse: Normal
-Contour: Smooth and rounded

34
Q

Small/Weak Pulse

A

-Pressure of the pulse: Diminished
-Contour: Upstroke slow, peak prolong

35
Q

Large/Bounding Pulse

A

-Pressure of the pulse: Increased
-Contour: Rapid rise and fall, peak brief

36
Q

Bisferiens pulse

A

Increased rate with double peak

37
Q

Pulsus Alternans

A

Regular rhythm but the beats alternate

38
Q

Paradoxial Pulse

A

-Opposite of what normally happens
-Inspiration: Amplitude decreases
-Expiration: Increases

39
Q

Pulsus bigminus

A

Irregular rhythm with 2 beats close together followed by a pulse

40
Q

Inspection of hands and nails

A

Cyanosis, nail clubbing, splinter hemorrhages, palmar erythema, nicotine staining

41
Q

Cyanosis-Related Disorders

A

Heart failure, COPD, Pulmonary embolism

42
Q

Nail clubbing

A

Associated with cardiopulmonary disease

43
Q

Splinter hemorrhages

A

Thin, red to reddish brown lines of blood under the nails that can occur with endocarditis, vasculitis or nail trauma

44
Q

Endocarditis

A

Infection of heart valves

45
Q

Vasculitis

A

Vessel damage from swelling of blood vessels

46
Q

Palmar erythema

A

Portal hypertension

47
Q

Nicotine Staining

A

Associated with smoking

48
Q

Internal jugular vein

A

Lower neck in triangle formed the two heads of the SCM and clavicle

49
Q

Jugular venous pressure (JVP) Measurement

A

-Patient is supine. Elevate trunk to 45 degrees. Tilt chin up &slightly away.
• Use tangential light to find internal jugular vein pulsations. This is the top of the venous column of blood.
• Extend a card/ tongue depressor horizontally from the pulsation while holding a ruler vertically from the sternal angle.
• The card and ruler should intersect. Measure the vertical
distance.

50
Q

Interpretation of JVP

A

Normal: less than 2-3cm (<1 inch)
Abnormal: Above 3cm (more than 1 inch), absent

51
Q

Elevated JVP means

A

-Classic sign of venous hypertension
-Right sided heart failure
-Tricuspid stenosis

52
Q

Observe the precordial area for:

A

-Asymmetry/deformities
-Difficulty breathing
-Heaves (lifting of chest) or pulsations (location, size, contour, & timing)

53
Q

Apical Pulse (Apex beat)

A

• Look for Located at Point of Maximum Impulse (PMI) at 5th ICP, midclavicular line
• Ask patient to exhale slowly & hold breath at end of expiration
• If unable to visualize, have patient roll 45° toward left lateral decubitus position
• Exhale completely while shining penlight across region.
• Look for size, intensity, location

54
Q

Apex Beat

A

If observed, suggests cardiomegaly, such as left
ventricular hypertrophy

55
Q

Orthopnea

A

Difficulty breathing while supine; Consider pulmonary edema due to left ventricular failure

56
Q

Sternoclavicular pulsation

A

May suggest dissecting aneurysm of ascending aorta.

57
Q

Epigastric & subxiphoid pulsations

A

Usually abnormal; Related to right ventricular hypertrophy or abdominal aortic aneurysm

58
Q

Palpation: Apical Impulse (apex beat)

A

• Used fingertips
• Palpate at Point of Maximal Impulse: Location: 5th intercostal space, midclavicular line
• Normal: 2-3 cm diameter
• Abnormal: >3 cm diameter: left ventricular hypertrophy
(Laterally displaced: indicates cardiomegaly)

59
Q

Palpation: Thrills interpretation

A

-Normal: No vibration
-Abnormal: Individual locations can indicate different conditions; Aortic valve: ascending aortic aneurysm/Tricuspid valve: Left atrial enlargement

60
Q

Percussion Interpretations (Heart)

A

Normal: dullness from sternum to approximately 6cm lateral to the left of the sternum
Abnormal: If large, may suggest hypertrophy

61
Q

Auscultation of Heart: Principles

A

-Diaphragm: High pitched sounds
-Bell: Low pitched sounds

62
Q

Heart Sounds: Types

A

-Normal: S1 (Lub) and S2 (Dub)
-Extra 3rd sounds: S3 and S4 gallop
-Heart murmur
-Split sounds
-Systolic: Interval between S1 and S2
-Diastolic: Interval between S2 and S1

63
Q

S1 Lub

A

-Closure of mitral & tricuspid valves
-Blood flows from atrium to ventricle
-Start of systole
-Best heard with bell
-Ideal to hear sound over mitral

64
Q

S2 Dub

A

-Closure of aortic and pulmonary valves
-Blood flows from ventricles to body & lung
-Best heard with diaphragm
-Ideal listen at pulmonic

65
Q

S2 physiological split

A

Best heard at pulmonic area with inspiration
Use diaphragm (high pitched sound)
Normal (90% have it)

PDX (13 decks)

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