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Physical assessment > Cardiovascular exam > Flashcards

Cardiovascular exam Flashcards

1
Q

Components of the vascular exam are?

A
  • size and symmetry of distal extremities
  • color and texture of nail beds
  • edema/erythema
  • varicose veins/homans sign
  • ulcers/brawny discoloration
  • clubbing of nails
  • cyanosis
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2
Q

What is clubbing?

A

widened, flattened and scooped

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3
Q

What is brawny?

A

chronic edema, get hemoglobin deposition into skin, heme that stays there discolors skin

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4
Q

Where do you feel for the posterior tibial pulse?

A

medial side by malleolus

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5
Q

What does a pulse scale of 3 which equals bounding possibly indicate?

A
  1. high blood pressure
  2. Aortic insufficiency or regurgitation of aortic valve
  3. aneurysm
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6
Q

Why would regurgitation of aortic valve cause bounding pulse?

A

blood goes up and rushes back in, so have a high difference between systolic and diastolic

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7
Q

What are you checking with the jugular vein? (generally speaking)

A

distention, pressure

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8
Q

When auscultating carotid pulse, what should you have patient do?

A

hold their breath

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9
Q

What is the jugular vein the best estimate of?

A

right arterial pressure AND right sided function

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10
Q

Internal and External jugular veins
Which is more readily visible?
More reliable?

A

visible: external
reliable: internal

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11
Q

What are thrills?

A

palpable vibrations that represent a palpable murmur

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12
Q

What are heaves/lifts?

A

visible movement of pericardium due to movement of the heart

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13
Q

Feeling PMI can be best done when pt is laying on ?

A

left side

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14
Q

When is systole heard?

A

time between S1 and S2 (working time of the heart, when ventricles contract to move blood into lungs and body across pulmonic and aortic valves)

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15
Q

As systole is complete, the —- valves close and create S1? crea

A

AV valves close

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16
Q

When will you hear systolic murmur?

A

with first heart sound, S1

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17
Q

What sound do the AV valves closing make?

A

lubb

S1

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18
Q

What is the sound of S2?

A

dubb

pulmonic and aortic valves closing

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19
Q

Where is S2 hear the loudest?

A

aortic area

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20
Q

What is also happening when the pulmonic and aortic valves are closing, and you are hearing S2?

A

AV valves are opening

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21
Q

What is S2?

A

actually two sounds that merge during expiration!!!

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22
Q

What sound is louder, s1 or s2?

A

s2

23
Q

What is the resting phase of the heart, when the ventricles are refilling with blood from the vena cavas and pulmonary veins?

A

dyastole

24
Q

What is the time between S2 and S1?

A

diastole

25
Q

What is the time between S1 and S2?

A

systole

26
Q

As diastole is completed, the semilunar valves close and create?

A

s2

27
Q

What contracts at the end of diastole?

A

atria

28
Q

What closes first, the aortic or the pulmonic?

A

the aortic **can here a split as the pulmonic valve closes, heard best over pulmonic area

29
Q

What is S3?

A

a gallop
–quiet, early sound during DIASTOLE that reflects the passive filling stage of the ventricles (second stage is the muscular injection from the atria)

30
Q

How do you intensify the S3 sound?

A

have pt raise leg or squeeze hand which increases venous return

31
Q

When is the S3 sound common?

A

young children and young athletic adults due to rapid refiling of ventricle
-CHF, mitral/tricuspid incompetence

32
Q

S4, what can it be confused with because it occurs so late in diastole?

A

split s1

33
Q

what is S4 best hear with?

A

the bell

34
Q

What cough is associated with being worse in the morning, or only in the am?

A

chronic bronchitis

35
Q

What causes a non-productive cough?

A

viral, interstitial lung disease, tumor, asthma, post nasal drip

36
Q

What cough is worse in recumbent position?

A

sinusitis, CHF, reflux

37
Q

What cough is barking?

A

croupe, laryngeal

38
Q

What cough is nocturnal?

A

asthma, chf

39
Q

What cough is productive?

A

infections, bronchiectasis

40
Q

What cough is bloody?

A

tumor, CHF

41
Q

What produces rust sputum?

A

pneumococcal pneumonia

42
Q

What produces yellow, green sputum?

A

pneumonia, bronchiectasis, bronchitis

43
Q

What produces anchovy paste sputum?

A

amebiasis

44
Q

What produces blood streaked sputum?

A

epistaxis, bronchitis secondary to sever cough, tumor

45
Q

What produces frothy and or pink sputum?

A

CHF, PE

46
Q

What produces bloody sputum? NOT BLOODY STREAKED

A

Tumor, malignancy, bronchiectasis, PE

47
Q

What produces foul smelling sputum?

A

bronchiectasis, anaerobes, lung abscess

48
Q

difference b/w PND and orthopena?

A

orthopnea cannot lie down while PND can sleep and then wake up
orthopnea is further advanced CHF

49
Q

What is platypnea?

A

SOB sitting up and better breathing lying down

50
Q

What is kussmaul?

A

pattern of breathing that is deep and rapid = metabolic acidosis

51
Q

What is cheyne-stokes?

A

crescendo/decrescendo interspersed with apnea = brain damage, drugs induced respiratory compromise

52
Q

What is biot?

A

irregular patter of breathing = increased intracranial pressure, brain damage, poison

53
Q

What is ataxic?

A

irregular breathing, more extreme than biots (usually see in neurology and not common)

Physical assessment (1 decks)

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