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Clinical diagnostics > cardiovascular > Flashcards

cardiovascular Flashcards

1
Q

Order of cardiovascular examination

A

– History (fatigue, dyspnea, coughing, ascites,
oedema, fainting)
– General condition (impression)
– Detailed examination of the cardiovascular system – Heart
– Blood vessels:
Arterial system
Venous system (Capillary system)

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2
Q

Physical cardiovascular examination:

A
  • Inspection(heart,vessels)
  • Palpation(heart,vessels)
  • Percussion(heart)
  • Auscultation(heart)
– Thoracic radiography
– Electrocardiography (ECG)
– Echocardiography
– Blood pressure measurement
– Phonocardiography (PCG)
– Nonselective angiocardiography
– Cardiac catheterization
• intracardiac pressure measurement • oxymetry
• selective angiocardiography
– Radionuclide imaging
– Serology (Lyme, ANA test, Dirofilaria, Trypanosome, etc.)
– (CT, MRI)
– Blood test (ANP, BNP, troponin, endothelin)
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3
Q

heart palpation

A

• Location of the heartbeat
influenced by the strength of the beat
dislocation of the cardiac beat can be caused by: tumor, abscess, pneumothorax, diaphragmatic hernia

• Strength(intensity)of the heartbeat

increased: exercise, cardiac hypertrophy, dislocation
decreased: cardiac insufficiency (DCM), pericardial/pleural fluid, thickened chest wall

• Fremitus(palpablethrill):
endocardial, pericardial, extrapericardial

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4
Q

Normal place of heart (apex) beat in horse

A

left : 3-6 ics

right: 3-4 ics

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5
Q

Normal place of heart (apex) beat in cow, swine , small ru

A

left : 3-5 ics

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6
Q

Normal place of heart (apex) beat in dog and cat

A

left : 3-6 ics

right: 3-5 ics

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7
Q

Normal place of heart (apex) beat in rabbit

A

left : 2-4 ics

right: 2-4 ics

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8
Q

horse cardiac dullness

A

absolute
left : 3-5 ics
right: 3-4 ics

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9
Q

Ru cardiac dullness

A

Relative

left: 3-4

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10
Q

Swine cardiac dullness

A

Relative

left: 2-3

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11
Q

Dog cardiac dullness

A

Absolute
left : 4-6 ics
right: 4-5 ics

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12
Q

Cat cardiac dullness

A

Relative

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13
Q

Enlargement of cardiac dullness

A

cardiac enlargement (dilation, hypertrophy)
cardiac dislocation
pericardial effusion
• False enlargement:
dullness in other neighboring organs
detection: frictional (rubbing) auscultation

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14
Q

Decreasing of cardiac dullness:

A

lung emphysema
emphysema of the skin
pneumothorax
cardiac dislocation

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15
Q

Normal heart sounds:

A

4

Audibility is different according to species and heart rate

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16
Q

Changes of heart sounds

A

FRIDA

Frequency (heart rate)

  • Usually the same as the pulse (but there can be a pulse deficit!)
  • Different in various species (normal values)
  • Changes; tachycardia, bradycardia (physiological or abnormal)

Rhythm

  • Normally regular (respiratory arrhythmia)
  • Horse: intermission cordis (dropped beat)
  • Arrhythmia: pathological forms

Intensity
- Normally strong and even (uniform strength)
- Pounding beat: increasing of the first and/or second sound (slight variation over
different valve areas)
- Reduce heart sounds: decreased cardiac output
- +/- Pericardial, pleural effusion, obesity

Demarcation

  • Horse: LUB-LUB-DUP-DUP
  • Changes: different species and heart rate
  • Duplication of heart sounds

Adventitious sounds
- Endocardial murmurs:
o Morphological or functional origin
o Stable: location, intensity, relation to cardiac cycle
→ Causes: morphological changes (valve deformities, septal or vessel malformations),
functional changes
- Extracardial murmurs:
o Pericardial or pleuropericardial
o Variable location, intensity, more or less related to cardiac or respiratory cycle → Causes: pericardial splashes, rubbing, pleuropericardial rubbing
Valsalva probe: pleuropericardial rubbing (disappears if breathing stops)

17
Q

Grading of murmurs

A

I
Very soft murmur, heard only after a few seconds in a quiet room
II
Soft murmur but easily heard directly upon auscultation
III
Moderate intensity murmur with good audibility
IV
Loud murmur, very good audibility but without precordial thrill
V
Very loud murmur with precordial thrill
VI
Loudest murmur, even audible with stethoscope lifte

18
Q

Examination of the blood vessels: ARTERIES

Methods:

A
  • Digital palpation
  • Blood pressure measurement (direct, indirect (sphygmomanometer))
  • Blood flow registration (Doppler ultrasound)
19
Q

Examination of the arterial pulses, parameters

A

Should be palpated on both sides → symmetric!

Frequency, rhythm and quality (size, strength and duration of the pulse wave and the degree of fullness of the artery)

Normal findings:

  1. Symmetric
  2. Rate: physiological
  3. Rhythm: regular
  4. Size, duration and strength: even, normal
20
Q

Pulse quality

A

Size: Difference between systolic and diastolic blood pressure = Pulse pressure
Determined by: Heart rate, stroke volume, and peripheral resistance

21
Q

Abnormal findings of pulse quality:

A
  • Irregular pulse (pulsus irregularis) – due to respiratory or true arrhythmia
  • Uneven pulse (pulsus inequalis, pulsus alternans) – every other beat
  • Small, brief and hard: wiry (pulsus contractus)
  • Small, prolonged and weak: thread (pulsus piliformis)
  • Skipping and large: bumping (pulsus celer et magnus) → Corrigan-pulse
  • Paradox pulse (pulsus paradoxus) – weak in inspiration vs. expiration → caused by
    cardiac tamponade
  • Changing with respiration (pericardial tamponade)
Size:
- Large, hyperkinetic (pulsus magnus)
- Small, hypokinetic (pulsus parvus)
Strength:
- Strong/weak → cardiac function
- Hard (pulsus durus)/soft (pulsus mollis) → vascular tone
Duration:
- Sluggish (pulsus tardus)
- Skipping (pulsus celer)
Size and duration:
- Full (pulsus plenus)
- Empty (pulsus vacuus)
22
Q

Examination of the blood vessels – VEINS

Methods:

A

Inspection and palpation,

measurement of central venous pressure

23
Q

Veins available for examinations:

A
  • Jugular vein (v. jugularis)
  • Saphenous vein (v. saphena)
  • Episcleral veins, veins of other mucous membranes
  • Subcutaneous abdominal vein (“milk vein”) in cattle

Clinical diagnostics (7 decks)

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