cardiovascular Flashcards
what should you say about the pulse
rate and rhythm
what does a fine tremour suggest
B2 agonist
name some cardiovascular causes of clubbing
hypoxia
endocarditis
some congenital heart diseases
what extra tests should you offer
abdo blood pressure fundoscopy ecg obs chart urine
what are you looking for in fundoscopy
hypertensive retinopathy
what does hypertensive retinopathy look like
arteriolar narrowing arteriosclerosis haemorrhage cotton wool spots microaneurysms hardened exudate
what parts of an abdo exam would you do as part of a cardiovascular exam
aortic aneurysms
superficial palpation over left and right upper quadrants
enlarged liver
renal and femoral bruits
what would you comment on in the obs chart
pulse
bp
Temperature
urine output (renal perfusion)
how do you assess for mitral stenosis
roll pt to left lateral in expiration. listen with bell at apex
how do you assess for mitral regurgitation
diaphragm in the left axilla
how do you assess for aortic regurge
sit patient forwards listen with diaphragm in expiration at lower left sternal edge
how do you assess aortic stenosis
with diaphragm in held inspiration over both carotids
also carotic bruits
how do you assess for oedema
press for 10 seconds
what is the tricuspid area
4th left intercostal space LSE
what is the pulmonary area
2nd left ICS lateral to the sternum
what is the aortic area
2nd right ICS LSE
where do you feel for thrills
sternal notch, apex and upper part of the praecordium
how do you assess for heaves
place your right outstretched hand to the left of the sternum
a heave will lift the heel of the hand off
ie right ventricular hypertrophy
what does a raised JVP indicate
right heart failure and volume
look between the heads of sternocleidomastoid above the clavicle
what is the maximum normal height of the JVP
3cm
how do you calculate the right atrial pressure of water
add 5cm to the JVP
what pathology would give a collapsing pulse
aortic regurge
what manoever should be done with the bell
mitral stenosis
what manoever should be done with the diaphragm
mitral regurge, aortic stenosis and regurg
what is easy to forget
blood pressure
abdo exam
auscultating the carotids
flapping tremor
what manoevers are done in expiration
mitral stenosis
and aortic regurge
in what condition would you find a narrow pulse pressure
aortic stenosis
in what condition would you find a wide pulse pressure
aortic regurgitation
in what condition would the pulse have a slow rising character
aortic stenosis
what does a raised JVP indicate
fluid overload
right ventricular failure
tricuspid regurgitation
what is the hepatojugular reflex (offer)
apply pressure over the liver
observe JVP rise
