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Medicine > Cardiovascular Exam 3 > Flashcards

Cardiovascular Exam 3 Flashcards

1
Q

what is the leading cause of death in the US?

A

CAD

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2
Q

what is the window to get pts to cardiac cath lab?

A

90 min

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3
Q

why would you measure JVP?

A

suspect right atrial pressure increase

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4
Q

what is a symptom of LV heart failure?

A

SOB, crackles

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5
Q

what is a symptom of RV heart failure?

A

swelling, pitting edema

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6
Q

why do you have to palpate pulses?

A

make sure they have peripheral perfussion

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7
Q

what causes a bruit?

A

trubulence-stenosis or plaque

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8
Q

what is a murmur?

A

turbulence of blood flow through a valve

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9
Q

where may an aortic valve murmur radiate to?

A

carotid artery

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10
Q

what is a thrill?

A

vibration-associated with a murmur (high intensity)

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11
Q

what is a lift or heave?

A

the heart lifts because it is working so hard to try to get blood out
(mitral prolapse)

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12
Q

if PMI is more lateral or larger in diameter what could that mean?

A

left ventricular hypertrophy

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13
Q

where is the normal location of the PMI?

A

4th-5th interspace MCL (midclavicular line)
diameter <2.5 cm (2-3 finger width)
amplitude should be brisk tapping

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14
Q

what causes LVH?

A

increased total peripheral pressure (HTN)

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15
Q

if PMI is hard to find what would you do?

A

turn the pt to the left decubitus position to put the heart against the chest wall

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16
Q

if amplitude of PMI is bounding that could mean

A

it is hypertrophied

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17
Q

what could cause RVH?

A

pulmonary valvular stenosis

increased pulmonary arterial pressure

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18
Q

describe location and purpose of aortic area

A

Right 2nd ICS at SB

listen to aortic valve

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19
Q

describe locatino and purpose of pulmonic area

A

Left 2nd ICS at SB

listen to pulmonic valve

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20
Q

describe location and purpose of tricuspid area

A

Left lower SB (LLSB) at 3rd, 4th, 5th ICS

listen to tricuspid valve, presence of murmurs and abnormal heart sounds

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21
Q

describe location and purpose of mitral area

A

MCL at 5th ICS

listen to mitral valve and presence of abnormal sounds

22
Q

why would you have pt in left lateral decubitus?

A

accentuate S3, S4 and mitral murmurs

23
Q

why would you have pt in sitting position?

A

accentuate aortic murmurs

24
Q

when might an S3 be normal?

A

pregnancy, athletes (volume overloaded)

25
Q

what ocular finding is related to malignant hypertension and end organ damage?

A

papilledema

26
Q

when does S2 split without pathology?

A

during inspiration

27
Q

what is wide splitting?

A

secondary to pulmonary stenosis (delayed closure of the P. valve)-blood travels slower through the valve
splitting persists throughout the respiratory cycle
-would also hear a systolic murmur at the pulmonic listening area

28
Q

what is fixed splitting?

A

splitting that does not vary with respiration (not as wide as wide splitting)
-right ventricular failure (decrease in pressure)

29
Q

what is reversed (paradoxical) splitting?

A

appears on expiration only

-left bundle branch block (diminished contraction = decreased pressure which causes aortic valve to close later)

30
Q

what is valvular regurg (insufficiency)?

A

valve does not fully close and allow blood to flow backward

-only happens when valve is supposed to be closed

31
Q

mitral valve regurg will happen when?

A

during systole (after S1)

32
Q

what is a stenotic valve murmur?

A

narrowed valvulur orifice that obstructs flow

-blood goes forward through a small opening

33
Q

pulmonic stenotic murmur will happen when?

A

systole when pulmonic valve is supposed to be open

34
Q

AV valve stenotic murmur will happen when?

A

diastole when AV valves are open

35
Q

what do you document when you identify a murmur?

A

systolic or diastolic (palpate the radial artery)
what listening area?
qualities-harsh, radiating, etc

36
Q

when does a midsystolic murmur occur?

A

begins after S1, but before S2

-usually related to semilunar stenosis

37
Q

when does pansystolic (holosystolic) occur?

A

occurs throughout systole

-usually related to AV regurg

38
Q

when does late systolic murmur occur?

A

starts in mid-systole to S2

-usually related to mitral valve prolapse

39
Q

when does early diastolic murmur occur?

A

starts after S2 and ends before S1

-usually related to semilunar regurg

40
Q

when does middiastolic murmur occur?

A

starts after S2 but fades away

-usually related to AV stenosis

41
Q

when does pandiastolic murmur occur?

A

occurs throughout diastole

-usually related to semilunar regurg

42
Q

when does late diastolic murmur occur?

A

starts in late diastole and ends at S1

43
Q

what is the location of maximal intensity?

A

where you hear it best, where it originates

44
Q

what is radiation?

A

where else it radiates

  • common one is aortic stenosis (radiates to carotid)
  • common one is mitral regurg (radiates to axilla)
45
Q

what is intensity?

A

graded on 6 pt scale
documented 1/6 (really concentrate)-3/6 (getting close to the chest you can hear it)-4/6 (assoc with a thrill)-6/6 (anyone could hear it even without auscultation)

46
Q

what is pitch?

A

high, medium, low

47
Q

what are quality attributes of a murmur?

A

blowing, harsh, rumbling, musical

48
Q

what is an innocent murmur?

A

no evidence of cardiac disease

  • common in newborns
  • turbulent flow from LV to aorta
49
Q

what is a physiologic murmur?

A

turbulence due to temporary increase in blood flow (pregnancy and anemia)

50
Q

what is a pathologic murmur?

A

caused by cardiac disease

Medicine (146 decks)

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