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PD Block 2 > Cardiovascular > Flashcards

Cardiovascular Flashcards

1
Q

Precordium

A

area on anterior chest overlying the heart and lower thorax

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2
Q

Order of heart valves

A

tricuspid, pulmonic, mitral, aortic

Try Pulling My Arm

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3
Q

Systole

A

S1 (tricuspid, mitral valves close) aortic and pulmonic valves open, ventricles contract

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4
Q

Diastole

A

S2 (pulmonic, aortic valves close), tricuspid and mitral valves open, blood fills ventricles, atria contract

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5
Q

Preload

A

end of diastolic pressure, ventricles stretched to greatest dimensions

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6
Q

Afterload

A

the stress /tension developed in wall of left ventricle during ejection

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7
Q

S1

A

tricuspid, mitral valves close; loudest at apex of heart

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8
Q

S2

A

pulmonic, aortic valves close; loudest at base of heart (Erb’s point in particular)

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9
Q

S3

A

blood fills ventricles

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10
Q

S4

A

atria contract

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11
Q

Mumur

A

extra heart sounds, disruption of blood flow

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12
Q

Point of maximal impulse (PMI)

A

generated by the apex maybe produced by enlarged ventricle, dilated aorta/dialted pulmonary artery, or an LV wall motion abnormality. Should be less than 1 cm in diameter

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13
Q

Thrill

A

a fine, plapable, rushing vibration (a palpable murmur usually over the base of the heart, indicates turbulence or disruption of expected blood flow). Signifies that the murmur is grade 4 or higher

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14
Q

Heave

A

a more pronunced lift /lift- RV hypertrophy

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15
Q

Gallop

A

S3, when you hear this third heart sound it mimics a “gallop”

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16
Q

Rub

A

friction rub, inflammation of pericardial sac (pericarditis), heard toward apex

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17
Q

Click

A

high pitched sounds that occur at maximal opening of aortic/pulmonary valves, heard just after S1

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18
Q

Snap

A

opening of mitral valve

19
Q

Aortic surface point

A

Right 2nd ICS; hear S2

20
Q

Pulmonic surface point

A

Left 2nd and 3rd ICS; hear S2

21
Q

Erb’s point

A

Left 3rd ICS; BEST hearing of S2

22
Q

Tricuspid surface point

A

Left 4th ICS/Lower left sternal border

23
Q

Mitral surface point

A

Left 4-5th ICS in midclavicular line; S1 heard here at apex

24
Q

Physiologic splitting

A

i. During expiration, the pulmonic valve closes only 30 ms after the aortic valve, S2 is heard as one sound
ii. During inspiration, the chest expands (vacuum -> inspiration), this decrease in pressure increases venous return to the right atrium and ventricle, the extra blood volume causes a delay in ejection, and the pulmonic valve closes later. The delay can be heard as a split S2 - especially common in young people.

25
Q

Fixed splitting

A

splitting that does not vary with inspiration/expiration, usually due to a septal defect, that is, a shunt between septa, either an ASD (atrial septal defect) or VSD (ventricular septal defect)

26
Q

Paradoxic splitting

A

pulmonic valve closes before aortic valve, determined on exam because splitting increases during expiration, rather than inspiration. Caused by conditions that delay left ventricular emptying (aortic stenosis, etc.)

27
Q

Chest pain

A

Many differential diagnoses for chest pain not just CV!
Angina pectoris- pressure or choking sensation sub- sternal &/or into neck, jaw. Levine’s sign (hand over chest)= ischemic pain.When assoc. w/ breathing= called pleuritic chest pain. Chest pain in children & adolescents seldom due to cardiac problem, also- not usually related to heart when it’s a constant all day achiness, or a sharp jab that only lasts 1-2 seconds

28
Q

Fatigue

A

Worse w/ exertion, unable to keep up w/ peers, persistent, chronic hypoxia, body working hard to compensate

29
Q

Dyspnea

A

Difficult & labored breathing w/ shortness of breath, worse w/ exertion, better w/ rest- propped w pillows,
Increases w/ severity of pulmonary and cardiovascular disease

30
Q

Diaphoresis

A

Often w/ anxiety, sympathetic response to stress, seen in MIs

31
Q

Syncope

A

Fainting-temporary loss of consciousness, brief lack of blood flow to brain- also associated w/ palps, exertion, dysrhythmia, sudden neck turning, or change in posture, common CV symptom in older patients, seen in hypovolemia, low BP, bradycardia, & valve stenosis

32
Q

Cyanosis

A

Due to hypoxia, nails (peripheral cyanosis occurs first) periorbital (in kids esp during eating), also in kids- characteristic of congenital heart defects allowing mixture of arterial & venous blood or prevented oxygenated blood.

33
Q

Cough

A

Dry, wet, nighttime, worse lying down, maybe assoc. w/ valvular disease

34
Q

Orthopnea

A

Shortness of breath that begins or increases w/ lying down, relieved by sitting or standing, ask if pt sleeps w/ pillows propping, associated w/ heart failure

35
Q

Claudication

A

Pain, burning, fatigue in legs/ buttocks, occurs w/ walking, better with rest, symptom of narrowing of artery or blockage, may be able to hear bruit (atherosclerosis is the most common cause of arterial blockage which can cause claudication)

36
Q

Paroxymal nocturnal dyspnea

A

Sudden onset of shortness of breath after a period of sleep, issues with pulmonary function related to CV disease, congestion, better w/ sitting up

37
Q

Xanthelasma

A

Yellow waxy deposits around eyes, occurs with extreme hyper-cholesterolemia, hyper-lipedmia which are related CV health risks

38
Q

Which other systems should you examine when evaluating a CV complaint?

A
  1. GI Evaluation- Could be GERD or heartburn
  2. Respiratory
  3. Peripheral Vascular Exam
  4. Musculoskeletal- could be joint pain around precordium area
  5. Psych- Could be anxiety
39
Q

Hypotension

A

low blood pressure, systolic

40
Q

Postural / orthostatic hypotension

A

abnormal decrease in blood pressure from sitting to standing. Systolic chance > 20 mmHg or diastolic change >10 mmHg noted as significant.

41
Q

Hypertension

A

high blood pressure, 2 stages.
Stage I: systolic 140-159 mmHg, diastolic 90-99 mmHg
Stage II: systolic >160 mmHg, diastolic >100 mmHg

42
Q

Normotension

A

normal blood pressure

systolic: 90-140
diastolic: 60-90

43
Q

Seven dimensions of hear murmur

A
  1. timing and duration
  2. pitch
  3. intensity
  4. pattern
  5. location
  6. radiation
  7. respiratory phase variations

PD Block 2 (6 decks)

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