Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

PCM I Final > Cardiovascular OSCE > Flashcards

Cardiovascular OSCE Flashcards

1
Q

Differentiate between bell and diaphragm of stethoscope

A

Diaphragm for high pitched sounds: S1, S2, AR, MR, friction rubs

Bell for low pitched sounds: S3, S4, MS, carotid bruit

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

4 primary steps to CV exam

A
  1. Inspection
  2. Palpation
  3. Percussion
  4. Auscultation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

General appearance findings for CV exam

A 
Consciousness
Cyanosis
Flushing
Respiratory patterns
Anxiety/distress
Body habitus
Diaphoresis
Neck veins - JVD

Look at shape, landmarks, scars/signs of trauma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What palpation area is used to estimate the location of the apex/left border of the heart?

A

PMI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Patient position for assessing PMI

A

Upright, supine, or lateral decubitus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Where is PMI usually palpated

A

Near 4-5th intercostal space in midclavicular line

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

T/F: PMI may not be felt in healthy heart/patient

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Describe a normal PMI

A

Impulse should be a small, brisk beat and measure less than 2.5 cm. The impulse should last through the first 2/3 of the systolic period (or less). It should not be felt through the second heart sound

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What palpation technique is used when PMI is not felt? Describe this technique

A

Percussion

Start far left where “resonant” and move medially to find cardiac “dullness”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

4 auscultation listening posts for CV exam

A

Aortic valve - R 2nd ICS at SB

Pulmonic valve - L 2nd ICS at SB

Tricuspid valve - L 4th ICS at SB

Mitral valve - L 5th ICS at midclavicular line

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How do heart sounds correspond with systole and diastole?

A

Diastole –> S1 –> systole –> S2 –> diastole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Heart sound S1

A

Closure of tricuspid and mitral valves

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Heart sound S2

A

Closure of aortic and pulmonic valves

[may split with inspiration]

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Heart sound S3

A

Dull, low pitch, best heart with bell

[due to high pressures and abrupt deceleration of inflow across the mitral valve at the end of rapid filling phase]

Physiologic in children/young adults, pathologic in greater than 40 y/o

KENTUCKY

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Heart sound S4

A

Dull, low pitch, best heart with bell

[atrial gallop from forceful contraction of atria against a stiffened (low compliant) ventricle]

Can be normal in trained athletes

TENNESSEE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Where are systolic murmurs heard in relation to heart sounds

A

Between s1 and s2

17
Q

What are the 4 major causes of systolic murmurs

A

Aortic stenosis
Pulmonic stenosis
Mitral regurg
Tricuspid regurg

18
Q

Where are diastolic murmurs heard in relation to heart sounds

A

Between S2 and S1

19
Q

4 major causes of diastolic murmurs

A

Aortic regurg
Pulmonic regurg
Mitral stenosis
Tricuspid stenosis

20
Q

Murmur grading scale

A

Grade 1 = very faint

Grade 2 = quiet, but heard easily with stethoscope

Grade 3 = moderately loud, no thrill

Grade 4 = loud with palpable thrill

Grade 5 = very loud with thrill, may be heard with steth partly off chest

Grade 6 = heard with steth entirely off chest

21
Q

Assessing the carotid pulse

A

Medial to SCM

Assess for thrills and bruits

Do not assess both carotid pulses simultaneously

22
Q

Possible locations for assessing peripheral pulses

A 
Radial
Brachial
Femoral
Popliteal
Dorsalis pedis
Posterior tibial
23
Q

Pulse grading scale

A

0/4 = absent, not palpable

1/4 = diminished, barely palpable

2/4 = average intensity, expected, normal

3/4 = strong, full, increased

4/4 = bounding

24
Q

Should you be concerned if you are only able to locate and palpate EITHER the dorsalis pedis OR posterior tibial pulse?

A

No, not as long as patient’s lower extremity is otherwise intact

25
Q

An abnormal cap refill might indicate what possible conditions?

A

Arterial occlusion
Hypovolemic shock
Hypothermia

26
Q

What is normal cap refill time?

A

2 seconds or less

27
Q

Pitting edema test

A

Press firmly for 5 seconds over the:

  1. Dorsum of the foot
  2. Anterior tibia
  3. Behind medial malleolus
28
Q

Grading scale for pitting edema

A

0 = absent

1 = barely detectable, slight pitting (2 mm); disappears rapidly

2 = slight indentation (4mm); 10-15 seconds

3 = deeper indentation (6 mm); may be >1min

4 = very marked indentation (8 mm); 2-5 min

PCM I Final (5 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions