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Cardiology > Cardiovascular Examination > Flashcards

Cardiovascular Examination Flashcards

1
Q

How should the patient be positioned in the cardiac examination?

A

At 45 degrees

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2
Q

List 5 things you would look for on general inspection?

A 
Pain
Obvious distress
Breathing - normal, rapid, laboured
Cachexia
Look well/unwell
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3
Q

What do you look for in the nails in the cardiac examination? (4 things)

A

Clubbing
Splinter haemorrhages
Nicotine staining
Peripheral cyanosis

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4
Q

What do you inspect for in the fingers/palms in a cardiac examination? (3 things)

A

Warmth indicating perfusion
Osler’s nodes
Janeway lesions
Palmar crease pallor

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5
Q

What would you do with the wrist in a cardiac examination?

A

Inspect: tendon xanthomata
Take the radial pulse for rate and rhythm
Radio-radial delay
Offer radio-femoral delay

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6
Q

What are 4 causes of bradycardia with a regular rhythm?

A 
Physiological - e.g. athletes
Drugs - e.g. B-blockers
Hypothyroidism
Hypothermia
Complete heart block
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7
Q

What could cause bradycardia with an irregular rhythm? (2 causes)

A

AF with conduction disease

Second degree heart block

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8
Q

What are 5 causes of tachycardia with a regular rhythm?

A 
Anxiety
Fever
Thyrotoxicosis
Anaemia
Congestive heart failure
Drugs - e.g. salbutamol
Shock
SVT
VT
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9
Q

What is the main cause of tachycardia with an irregular rhythm?

A

Atrial fibrillation

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10
Q

What would you look for in the face during a cardio examination?

A

Face: mitral facies? (rosy cheeks with bluish tinge)
Eyes: conjunctival pallor? jaundice? (severe CHF with hepatic congestion) xanthelasmata? (hyperlipidaemia) fundoscopy? (hypertensive changes)
Mouth: high arched palate? (Marfan’s syndrome), dentition? (IE risk factor), central cyanosis?

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11
Q

What should you do in the neck region during a cardio examination?

A

Take the carotid pulse
Auscultate for carotid bruits
Assess JVP

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12
Q

What would you inspect for in the praecordium during a cardiac examination?

A 
Scars? 
Pacemaker?
Implanted defibrillator?
Visible apex beat?
Pulsations?
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13
Q

Where would you normally find the apex beat?

A

5th intercostal space

Mid-clavicular line

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14
Q

Describe your approach to chest auscultation in the cardiac examination.

A

Auscultate the 4 areas: mitral, tricuspid, pulmonary and aortic. Auscultate all areas with the diaphragm, also auscultate the mitral area with the bell.
Determine if there is a murmur.
Then roll the patient to their left away from you and listen again in the mitral area.
Then have the patient sit up and lean forwards. Ask them to breathe in and then breathe out fully and hold their breath while you auscultate.

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15
Q

What can cause an abnormally loud S1?

A

Mitral stenosis

Tachycardia

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16
Q

What can cause an abnormally soft S1?

A

Mitral regurgitation

17
Q

What can cause an abnormally loud S2?

A

Aortic stenosis

Systemic hypertension

18
Q

What can cause an abnormally soft S2?

A

Aortic regurgitation

19
Q

What does a S3 sound like?

A

A third heart sound is similar in cadence to ‘Kentucky’.

20
Q

What does a S4 sound like?

A

A fourth heart sound is similar in cadence to ‘Tennessee’

21
Q

What causes a pansystolic murmur? (2 causes)

A

A pansystolic murmur extends from S1 to S2 without varying in loudness or pitch. It is caused by blood in the ventricle leaking to a lower pressure chamber/vessel. Causes of this are:
Mitral regurgitation
Tricuspid regurgitation
VSD

22
Q

What is a midsystolic murmur? What causes a midsystolic murmur? (2 causes)

A 
A midsystolic murmur begins after S1 and is of greatest intensity in mid-systole. It then wanes during late systole. It is therefore called a 'crescendo-decrescendo' murmur. 
It is caused by:
Aortic stenosis
Pulmonary stenosis
ASD
23
Q

What is a late systolic murmur? What causes a late systolic murmur? (2 causes)

A

In a late systolic murmur there is a gap between S1 and the beginning of the murmur, but the murmur continues right up to S2 (no crescendo-decrescendo). It is caused by:
Mitral valve prolapse
Papillary muscle dysfunction

24
Q

What causes an early diastolic murmur? (2 causes)

A

Aortic regurgitation

Pulmonary regurgitation

25
Q

What causes a mid-disatolic murmur? (2 causes)

A

Mitral stenosis

Tricuspid stenosis

26
Q

What causes a pre-systolic murmur? (2 causes)

A

Mitral stenosis

Tricuspid stenosis

27
Q

What causes a continuous murmur? (2 causes)

A

Patent ductus arteriosus

AV fistula

28
Q

Give 6 features you would inspect for in the lower limbs during a cardio exam.

A 
Cyanosis
Trophic changes
Ulceration
Tendon xanthomata
Oedema
Erythema
29
Q

What are the names of the two pulses you routinely feel for in the feet?

A

Posterior tibial pulse

Dorsalis pedis pulse

Cardiology (7 decks)

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