Cardiovascular and Peripheral Vascular Flashcards
Personal habits related to cardiovascular health
smoking/tobacco
diet
exercise
alcohol and drug use
Personal and family history related to CV health
diabetes, hypertension, coronary artery disease, hyperlipidemia
Symptoms related to CV health
chest pain, fatigue, dizziness, syncope, diaphoresis, palpitations, cough, edema, numbness or pain in the extremities, skin
symptoms related to CV health: syncope
fainting
symptoms related to CV health: diaphoresis
profuse swelling
symptoms related to CV health: dyspnea
difficulty breathing
symptoms related to CV health: paroxysmal nocturnal dyspnea
trouble breathing at night, relieved by orthopnea (sleeping at night)
symptoms related to CV health: edema
swelling, collecting fluid in extremities as a result of fluid volume overload
In children and adolescents, chest pain is [seldom/often] due to a cardiac problem
seldom
[t/f] In adults, assume chest pain is respiratory until proven otherwise
false, assume cardiac
Systems that can cause chest pain
cardiac, musculoskeletal, pleural/pulmonary, GI, psychoneurotic
4 heart valves
Try Performing Better Always:
Tricuspid, Pulmonary, Bicuspid (Mitral), Aortic
APT M
Upper: Aortic (R) Pulmonary (L)
Lower: Tricuspid (R) Mitral (L)
atrioventricular valves
mitral and tricuspid
semilunar valves
pulmonic valve and aortic valve
apex is [top/bottom] of the heart
bottom (the point of the left ventricle) where S1 is loudest – closing of mitral and tricuspid valves
s2
closure of aortic and pulmonic valves
s1
closure of mitral and tricuspid valves
when is s2 split normal
during inspiration
tachycardia
> 100 bpm in an adult
bradycardia
<60 bm in an adult
halfway between axilla and middle of sternum
midclavicular line
intercostal spaces are numbered [above/below] the rib
below
t/f: an aortic pulsation is always abnormal
false, can be easily visualized on some people with little adipose dissue
places to visualize pallor or cyanosis in people with more melanin
conjunctival sacs, fingernails, inside of lips
point of maximal impulse
midclavicular line, 5th intercostal space
2245 APT M
2nd ICS R Aortic
2nd ICS L Pulmonic
4th ICS R Tricuspid
5th ICS L Mitral
Erb’s point
3rd intercostal space, left sternal border: Hear s1 and s2 evenly
a high pitched, scratchy sound caused by pericardial inflammation
rub (auscultate lower left sternal border)
regurg murmer
mitral valve insufficiency
ejection murmer
aortic stenosis
grade [I or VI] is the most significant murmer
VI
5 components of peripheral vascular assessment
- skin temp
- color
- pulses
- capillary refill
- edema
bruit (pronounced BREW-ies)
blowing or swishing sound in carotid
JVD
jugular vein distension
“pedal pulse”: typically refers to
top of the foot (dorsalis pedis) – another pedal pulse would be posterior tibial
1+ pulse
weak, thready
3+ pulse
bounding on 3+ scale
strong on 4+ scale
2+ pulse
normal
0 pulse
no pulse palpable
normal time for capillary refill
within 2 seconds (hand at level of heart)
4+ pulse
bounding on 4+ scale
pitting edema grades: multiply grade by what to get mm?
x2 1+ = 2mm 2+ = 4mm 3+ = 6mm 4+ = 8mm
2+ pitting edema
4 mm disappears 10-15 seconds
3+ pitting edema
6 mm lasts 1 min or more, obvious in extremity
4+ pitting edema
8 mm + 2-3 min or more, potentially deformed extremity
DVT s/s
unilateral edema, pain or achiness, erythema, warmth
[encourage/avoid] ambulation with suspected DVT
avoid – don’t want to dislodge clot and cause pulmonary embolism
arterial or venous disorder: sharp, stabbing pain
arterial
arterial or venous disorder: with prolonged sitting or standing
venous
arterial or venous disorder: worse with activity
arterial
arterial or venous disorder: helped by raising feet and legs
venous
arterial or venous disorder: intermittent claudication
arterial
arterial or venous disorder: cool/cold skin
arterial
arterial or venous disorder: mottled, thickened, brown skin
venous
arterial or venous disorder: hairless, shiny
arterial
arterial or venous disorder:
pallor on elevation, rubor on dangling
arterial
arterial or venous disorder: absent pulses
arterial
arterial or venous disorder: edema
venous
6 P’s of acute arterial occlusion
pain poikilothermia (coldness parasthesia paralysis pallor pulselessness
s3
S1 – S2-S3
Ken – Tuck-Y
S4
S4-S1 – S2
TEN-es – see
