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Year 3 > Cardiovascular examination > Flashcards

Cardiovascular examination Flashcards

1
Q

What position should the patient be in for a cardiovascular exam?

A

45 degree angle on couch

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2
Q

What should you look for in general inspection in a cardiovascular exam?

A

Medications on the side, devices, cigarettes, catheters, GTN spray, oxygen, IV fluids, number of pillows

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3
Q

What should you look for when inspecting the patient in a cardiovascular exam?

A

Shortness of breath/resp rate, oedema, cyanosis, pallor, malar flush, syndromic features, scars, ECG stickers/leads

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4
Q

What does a lot of pillows suggest?

A

Heart failure

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5
Q

How will a patient be laid if they have pulmonary oedema?

A

Upright as if they were flat the fluid in their lungs would make it hard to breathe

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6
Q

What syndromes are associated with cardiovascular disease?

A

Marfan’s, Down’s

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7
Q

What is malar flush and what does it indicate?

A

A red flush across the cheeks and face, associated with mitral stenosis, occurs because there is backflow in the heart which causes CO2 retention

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8
Q

What syndrome has a widened neck as a feature?

A

Turner’s syndrome

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9
Q

What cardiovascular problem is common in those with Turner’s syndrome?

A

Coarctation of the aorta and a biscuspid aortic valve (should be tricuspid)

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10
Q

What does clubbing indicate?

A

Low blood oxygen

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11
Q

What does tar staining indicate?

A

Smoking

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12
Q

What does peripheral cyanosis in the hands indicate?

A

Reduced cardiac output (especially in hyperkalemia), Brainiard’s disease

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13
Q

What does xanthoma look like?

A

Yellow skin or tender nodules with lipid deposition on the palmar and extensor surfaces of the hand

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14
Q

What does xanthoma indicate?

A

High cholesterol

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15
Q

What are some visible signs associated with infective endocarditis?

A

Clubbing
Poor dentition
Splinter haemorrhages

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16
Q

What do splinter haemorrhages look like?

A

Small brown lines on the nails

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17
Q

What to janeway lesions look like?

A

Small lesions on the palms

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18
Q

What are janeway lesions associated with?

A

Infective endocarditis

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19
Q

What do osler’s nodes look like and where are they found?

A

Small painful nodes on the ends of fingers and toes

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20
Q

What do osler’s nodes indicate?

A

Infective endocaridits

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21
Q

Why do Osler’s nodes occur?

A

Deposition of immune complexes

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22
Q

In a cardiovascular exam when inspecting the hands what should you look for on the nails?

A

Clubbing
Splinter haemorrhages
Quincke’s sign
Tar staining

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23
Q

What should you inspect for when looking at hands in a cardio exam?

A 
Nails
Cap refil time
Temperature
Peripheral cyanosis
Xanthoma
Osler's nodes
Janeway lesions
Arachnodactyly
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24
Q

What is Quincke’s sign and why does it occur?

A

Pulsation of the nail bed associated with aortic regurgitation

25
Q

How do you test cap refil time? What is the normal response?

A

Squeeze the distal end of a patients fingers for 5 seconds and release the colour should return in less than 2 seconds

26
Q

What may hot and sweaty hands indicate in a cardiological exam?

A

MI, fever

27
Q

What might cold hands suggest in a cardiological exam?

A

Poor perfusion

28
Q

What is arachnodactyly and why is it relevant in a cardiological exam?

A

It is a feature of Marfan’s syndrome where fingers are long, it helps identify marfan’s patients who may be at risk of mitral or atrial regurgitation

29
Q

What are the 3 things you do in a cardiological exam when taking pulse?

A 
Radial pulse (rate and rhythmn)
Radio-radial delay
Radio-femoral delay
30
Q

How many bpm is classified as bradycardic?

A

< 60 bpm

31
Q

What may cause bradycardia?

A

Being on beta blockers
Normal in younger people and athletes
Hypothyroidism

32
Q

How many bpm is classified as tachycardic?

A

> 100 bpm

33
Q

What may cause tachycardia?

A

Fever, pain, stress, hyperthyroidism, exercise, hypovolemia

34
Q

If a heart beat is irregular what are the two ways it can be so?

A

Irregularly irregular ie completely spontaneous

Regularly irregular ie there is a pattern

35
Q

What is an irregularly irregular heart rate associated with?

A

Atrial fibrillation

36
Q

What is a regularly irregular heart rate associated with?

A

Heart block

Ectopic beats

37
Q

What are ectopic beats?

A

When a heart beat is missed

38
Q

How do you test for radial radial delay?

A

Feel the radial pulse on both arms and they should be synchronised

39
Q

What may cause a radial radial delay?

A

Aortic dissection, subclavian artery stenosis or aortic cooptation

40
Q

What do you assess when feeling the brachial pulse?

A

Character and volume

41
Q

What characters may a brachial pulse be?

A

Slow rising or bounding

42
Q

What would a slow rising brachial pulse indicate?

A

Aortic stenosis

43
Q

What would a bounding brachial pulse suggest?

A

Carbon dioxide retention or aortic regurgitation

44
Q

What pulses are felt for in a cardiological exam?

A

Radial, brachial

45
Q

What would thready volume when taking a brachial pulse indicate?

A

Hypovolemia

46
Q

How do you assess for collapsing pulse?

A

Take the radial pulse (and brachial pulse simultaneously) and lift their arm up briskly and you may feel their pulse collapse

47
Q

What is collapsing pulse typical of?

A

Aortic regurgitation

48
Q

What must you ask the patient before assessing for collapsing pulse?

A

If their shoulder is in any pain as you will have to quickly lift their arm

49
Q

What blood pressure constitutes hypertension?

A

Greater than or equal to 140/90

50
Q

What blood pressure constitutes hypotension?

A

Less than or equal to 90/60

51
Q

Why do we check blood pressure in both arms?

A

If there is a difference of more than 20 mmHg between the 2 it could indicate aortic dissection or atherosclerosis

52
Q

What is pulse pressure?

A

The difference between the systolic and diastolic blood pressure

53
Q

What constitutes narrow pulse pressure?

A

<25mmHg difference

54
Q

What constitutes wide pulse pressure?

A

> 100mmHg difference

55
Q

What could narrow pulse pressure indicate?

A

Aortic stenosis or congestive heart failure

56
Q

What could wide pulse pressure indicate?

A

Aortic regurgitation or aortic dissection

57
Q

What is conjunctival pallor and what does it indicate in terms of cardiology?

A

Lack of colour when the eye is pulled down (anterior conjunctiva) indicates anaemia which is a risk factor for heart disease

58
Q

What is coarctation of the aorta?

A

A birth defect where part of the aorta is narrower than it should be

59
Q

What is Quincke’s sign?

A

Systolic pulsations after the nail bed is slightly compressed

Year 3 (104 decks)

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