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Semester 2 > Cardiovascular Examination > Flashcards

Cardiovascular Examination Flashcards

1
Q

When would you hear basal crackles in the heart?

A

In heart failure

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2
Q

When do the atrioventricular valves close?

A

The start of systole

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3
Q

When do the semilunar valves close?

A

At the start of diastole

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4
Q

What is the cause of murmurs?

A

Due to turbulent flow caused by anatomical changes or flow changes. Due to valve disorders - stenosis or regurgitation

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5
Q

When would you hear a systolic murmur?

A

In stenosis of aortic and pulmonary valves or regurgitation of atrioventricular valves causes a murmur in diastole

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6
Q

Types of percussion tone

A

Dull Resonant - normal Hyper-resonant Timpani (hollow)

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7
Q

How do you describe heart sounds?

A

When - systole, diastole What - character of sound Where - what valve Transmission - what other area was the sound transmitted to

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8
Q

How can you identify C7?

A

Vertebra prominens

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9
Q

The sternal notch overlies which structure?

A

Trachea

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10
Q

What does the manubrio-sternal angle help you to identify?

A

T4/5, bifurcation of trachea, 2nd costal cartilage, upper order of atria, aortic arch

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11
Q

When would you hear a diastolic murmur?

A

Stenosis of atrioventricular valves or in regurgitation of pulmonary valves

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12
Q

Causes of bruit

A

Turbulent blood flow within the heart or blood vessels, produced by damaged vessels.

Causes: narrowed arteries, septal defects, av-regurgitation

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13
Q

Name 4 principal symptoms of cardiovascular disease

A

Chest pain
Shortness of breath (dyspnoea)
Oedema (ankles)
Palpitations

Also:
Syncope (fainting)
Claudication (limping, cramping pain)

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14
Q

Clincal presentation of angina

A

Central chest pain - crushing, heavy sensation, tightness, choking

Precipitated by: physical exertion, stress, heavy meal

Caused by myocardial ischemia - narrowing

Relieved by nitrates (GTN) and vasodilators or rest

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15
Q

Clinical presentation of MI

A

Central sharp chest pain, radiating to arm/shoulder/neck/jaw

Can be accompanied by sweaing or vomiting

Not releived by rest or nitrate

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16
Q

Presentation of breathing difficulties

A

Dyspnoea - shortness of breath (gasping for air)
PND - sudden shortness of breath while sleeping
Orthopnoea - shortness of breath when lying down

Commonly associated with left heart failure

17
Q

Physiological cause of PND

A

In the recumbent position, there is a redistribution of fluid from the extremities to the lungs.

The left ventricle is unable to match the output of the right ventricle and a backlog of blood in the left ventricle moves up through the atria and into the lung causing congestion. This inhibits gaseous exchange and there is reduced oxygen levels in the blood.

18
Q

Phyiological cause of oedema in CVD

A

Swelling caused by excessive accumulation of fluid in interstitial tissues. Typically affects ankles, feet and lower legs. When a patient lies down fluid re-distributes - sacral oedema seen.

A sign of right heart failure. Backlog from the right side of the heart flows back into the vena cava towards the extremeties which causes increased venuous hydrostatic pressure. This causes venuoous dilation and therefore oedema.

Oedema in CVD is pitting

19
Q

Palpations

A

Awareness of one’s own heartbeat (pounding or fluttering)

Usually associated with arrythmia

20
Q

Name 9 symptoms associated with CVD

A

Dizzyness and Syncope
Fainting
Fatigue
Fever
Nausea and Vomiting
Shortness of breath
Palpitations
Sweating
Oedema
Intermittent claudication (leg)

21
Q

Systemic signs of CVD

(head - toe)

A

General: Beathless at rest, cyanosis, cahexic/obese

Hands: Clubbing, Splinter heamorrages, tar staining, capillary refill

Eyes: Xanthelasma, anaemia, corneal arcus

Face: malar flush, central cyanosis

Neck: JVP, carotid pulse

Pulse: radial - rate, rhytm, collapsing, brachial waveform

Chest: apex beat, thrills, heaves, heart sounds, murmurs, bruit

22
Q

What is hepato-jugular reflux?

A

Used to assess right ventricular failure.

In the supine position, the JVP of patients can be seen between the clavicular and sternal heads of the sternocleiodomastoid muscle. Height of JVP measured above sternal angle.

When firm pressure placed on RUQ of abdomen (15sec) in patients with cardiac pathology a transitent rise in JVP is seen. In normal patients there would be a decrease becuase venuous return to the heart is reduced.

Sign of: tricuspid regurgitation, constrictive pericarditis

23
Q

Palpable abnormalities

A

Heaves: caused by ventricular hypertrophy (apex-left, parasternal-right)

Displaced apex: caused by dilated left ventricle
 Tapping apex (both heart sounds palpable): mitral stenosis

Thrills: palpable heart murmur

24
Q

Abdominal signs of CVD

A

Hepatomegaly

Ascites

Splenomegaly

Abdonimal aortic aneurym

Renal bruit

25
Q

3 common CV causes of chest pain

A

Angina pectoris

MI

Cadiomyopathy

26
Q

Name 3 cardinal symptoms of heart disease

A

Dyspnoea

Chest pain

Syncope or dizzyness

Palpitations

27
Q

Common presenting complaints of heart disease

A

Dyspnoea

Chest pain

Palpitations

Syncope

Swollen legs

Transient neurological symptoms

28
Q

Cardiac causes of dyspnoea

A

Ischaemia: causing transient poor muscle function e.g. coronary artery disease, angina

Left ventricular impairment: leads to poor muscle function. There is reduced cardiac output and increased end-diastolic pressure in the left ventricle. e.g. MI, hypertensive heart disease, dilated cariomyopathy

Valvular heart disease: causes reduced cardiac output due to obstruction to blood flow or regurgitation, increasing LV end-diastolic pressure or LA pressure.

29
Q

What are the four heart sounds?

A

S1: AV valve closure (end of diastole/beginning of systole)

S2: Aortic and pulmonary valve closure (late systole)

S3: Passive LV filling (early diastole)

S4: Atrial kick (active LV filling in late diastole)

30
Q

Causes of systolic murmurs

A

Aortic stenosis

Mitral regurgitation

VSDs

ASDs

Pulmonary stenosis

31
Q

How can you work out if a murmus is systolic or diastolic?

A

When feeling the pulse, systolic murmurs will be heard at the same as feeling the upstroke

Semester 2 (70 decks)

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