Cardiovascular and Peripheral Vascular Assessment Flashcards

1
Q

precordium

A

area of the chest overlying the heart

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2
Q

inspect, palpate, and ausculate

A

no percussing, chest x-ray is more reliable to identify the borders of the heart

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3
Q

Angle of Louis

A

sternal angle, used to identify 2nd intercostal space

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4
Q

Aortic area

A

2nd intercostal space, right sternal boarder

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5
Q

pulmonic area

A

2nd intercostal space on the left sternal border

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6
Q

Erb’s point

A

3rd intercostal space on the left sternal border

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7
Q

Tricuspid area (right ventricular area)

A

4th or 5th intercostal space to the left sternal border

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8
Q

Mitral area (apical area)

A

5th intercostal space, medial to the midclavicular live

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9
Q

epigastric area

A

area overlying the xiphoid process

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10
Q

lift

A

a slight movement

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11
Q

heave

A

more vigorous movement; may see at the sternal border and a left ventricular heave at the apex

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12
Q

apical pulse

A

a normal pulsation located over the apex of the heart, at the 5th intercostal space medial to the midclavicular line

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13
Q

dependent edema

A

found in dependent areas such as feet and sacrum

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14
Q

peripheral edema

A

feet and hands

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15
Q

generalized edema (anasarca)

A

all over the body; massive edema

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16
Q

pulmonary edema

A

fluid accumulation in the lungs due to imbalanced capillary dynamics

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17
Q

cerebral edema

A

fluid in the brain

18
Q

pitting edema

A

press your finger into edematous area for 2-3 seconds and note the depth of indentation

19
Q

grades of pitting edema

A

1+: slight pit, normal contour
2+: deeper pit, fairly normal contour
3+: puffy, appearance of deeper pit
4+: extremely deep pit, definitely swollen

20
Q

thrills

A

palpable cardiac murmur; feels like the throat of the purring cat and is considered abnormal. signifies turbulent blood flow and accompanies loud murmurs

21
Q

pulses

A
palpate all pulses bilaterally
temporal arteries
carotide arteries
radial, ulnar, brachial arteries
apical impulse
femoral, popliteal, posterior tibialis, dorsalis pedis arteries
22
Q

skin temp

A

use dorsum or back of hand

normal=warm

23
Q

skin turgor

A

indicates hydration status
assessed by pitching the skin and releasing it
best tested on the sternum or forehead
skin goes back within 3 seconds

24
Q

capillary refill

A

normal should be 2 seconds or less
3-4 seconds= sluggish
>4= abnormal

25
auscultation of heart
auscultate all pericardial areas first with diaphragm and then bell diaphragm for loud/high pitched sounds bell for low pitched sounds breath through nose rate and rhythm
26
First heart sound (S1)
closure of mitral and tricuspid valves apex of the heart using diaphragm of the stethoscope
27
Second heart sound (S2)
closure of aortic and pulmonic valves base of the heart using diaphragm of the stethoscope
28
Extra heart sounds (S3)
``` Also known as ventricular gallop Heard in the mitral/apical area with the bell of the stethoscope Immediately after S2 (diastole) Normal in children and young adults Never normal in people over 30 Left lateral (side lying) position Kentucky sound ```
29
Extra Heart sound (S4)
Also known as atrial gallop Heard in the mitral area using the bell of the stethoscope Abnormal in most adults happens before S1 Due to increased resistance to ventricular filling Tennessee ischemia, coronary artery disease, aortic stenosis
30
Split S1
mitral and tricuspid heart valves not closing together high pitched sound heard best in the tricuspid area using the diaphragm assoc with right bundle branch block
31
Split S2
aortic and pulmonic valve not closing together more common in children heard best in the pulmonic area with the diaphragm
32
ejection click
click sound produced by movement of stiffly deformed valve | best heard with diaphragm
33
Midsystolic
indicates mitral valve prolapse. Part of the mitral valve balloons into left atrium
34
Murmurs
harsh, rumbling, blowing sound caused by blood flow across a defective valve, or the shunting of blood through an abnormal passage assessed for timing, location, radiation, pitch, quality, intensity
35
intensity of heart murmur grade
grade i: very faint grade ii: quiet but audible grade iii: moderately loud grade iv: loud, associated with a palpable thrill grade v: very loud grade vi: loudest. may be audible with the stethoscope lifted off the chest wall
36
Bruits
blowing or "purring" sound that indicates a distortion of a blood vessel that could interfere with blood flow auscultated with the bell
37
carotid arteries bruits
begin at base towards chin. ask patient to hold breath
38
thyroid gland bruits
if gland feels enlarged. occurs because of accelerated blood flow through gland
39
assess the non cardiac parameter of cardiac function
``` clouded sensorium suddenly decreased visual acuity suddenly decreasing hearing sudden and progressive difficulty in locomotion diminished reflexes ```
40
signs and symptoms of poor perfusion
oliguria: scanty urine production anorexia/constipation: results from marginal perfusion of the GI tract hepatic engorgement: produced by weakened hearts inability to receive and pump venous blood air hunger: from impaired perfusion of oxygenated blood to the lungs