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AIM - PD > Cardiovascular PD > Flashcards

Cardiovascular PD Flashcards

1
Q

aortic stenosis

A 
harsh
systolic
crescendo-decrescendo
aortic area (R 2nd intercostal)
radiates to carotid area
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2
Q

aortic regurgitation

A 
blowing 
diastolic
decrescendo
Erb's point
heard best leaning forward
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3
Q

mitral regurgitation

A 
harsh 
systolic
holosystolic (plateau)
heard at apex (mitral)
radiates to left axilla
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4
Q

mitral stenosis

A 
loud S1 w opening snap
rumbling mid diastolic
heard best on expiration
at apex
L lateral decubitus
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5
Q

pericardial friction rub

A

High frequency scratching noise.
Mainly in L precordial area.
Exacerbated by inspiration, leaning forward, left lateral decubitus position.
Inflammation of pericardium causes friction in walls which generates noise

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6
Q

pulse amplitude scale

A

0: no palpable pulse
1+: diminished (weak, thready)
2+: normal, brisk, expected
3+: bounding, hyperdynamic

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7
Q

dicrotic notch forms from

A

aortic valve closing

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8
Q

a wave

A

increase in R atrial pressure produced by R atrial contraction

less robust (unless pathologic)

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9
Q

c wave

A

start of systole.

Tricuspid closes and bulges into atrium.

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10
Q

x descent

A

decrease in R atrial pressure.

Caused by R atrial relaxation

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11
Q

v wave

A

Increase in R atrial pressure.

Due to filling with blood from IVC during ventricular systole (tricuspid closed)

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12
Q

y descent

A

Decrease in R atrial pressure due to opening of tricuspid valve at end of ventricular systole

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13
Q

diaphragm

A

High Pitched.

S1, S2, regurgitant murmurs, friction rubs.

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14
Q

bell

A

Low Pitch.

SD3, S4, AV stenosis murmurs

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15
Q

S1 sound

A

start of ventricular contraction.

Closure of AV valves (T, M)

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16
Q

S2 sound

A

End of ventricular contraction.

Closure of semilunar valves (aortic, pulmonic)

17
Q

S3 sound

A

Low pitched sound in early diastole.
Follows S2.
RAPID FILLING OF DILATED VENTRICLE causing AV apparatus to tense and vibrate.
May be normal in young adults.

VOLUME OVERLOAD

  • regurgitant valvular lesion
  • CHF
18
Q

S4 sound

A

Low pitched sound in late diastole.
Precedes S1.
Aorta contracting forcefully against a NONCOMPLIANT, STIFF VENTRICLE

may be due to PRESSURE OVERLOAD on a ventricle

19
Q

intensity scale of cardiac murmurs

A

1: very faint, may not be heard in all positions
2: quiet but recognizable
3: moderately loud
4: loud murmur with palpable thrill
5: loud with palpable thrill, heard w only rim of stethoscope on chest
6: very loud, heard with stethoscope off chest

20
Q

hepatojugular reflex

A

For volume overload.

Pressure on RUQ –> blood flows up jugular vein

21
Q

resonant percussion sound

A

Air.

Ex: over lung

22
Q

dull percussion sound

A

solid

ex: over heart

23
Q

how can you enhance a murmur?

A

have patient do valsalva maneuver

24
Q

Symptoms of cardiac disease (ask these questions to anyone complaining of chest pain)

A 
Palpitations.
Dyspneas (SOB: resting or exertional).
Syncope.
Fatigue.
Dependent edema.
Cyanosis.
25
Q

Korotkoff Sounds

A 
I: 2 consectutive beats (systolic BP)
II: soft, longer sounds
III: loud, crisp sounds
IV: begins to muffle
V: sounds disappear (diastolic BP)
26
Q

distension of external jugular vein

A

HF
obstruction of SVC
enlarged supraclavicular nodes
increased intrathoracic pressure

27
Q

positive hepatojugular reflux

A

elevated JVP for 10 or more seconds (after pushing on RUQ of abdomen to temporarily increase venous return to the R side of the heart)

28
Q

sternal angle is always ___ above RA

A

sternal angle is always 5 cm above RA

29
Q

estimating CVP

A

add 5 to jugular venous pressure (cm H2O)

30
Q

normal CVP

A

7-8 cm H2O

31
Q

normal BP

A

100-120/60-80

32
Q

Point of maximal impulse

A

Felt at 5th intercostal space along midclavicular line (apex of heart)

(movement of L ventricle against the chest wall)

easiest felt in lateral decubitus position

size: less than 2.5cm

brisk and tapping amplitude

felt immediately after S1, should NOT continue to S2

33
Q

physiological splitting of S2

A

closing of aortic valve usually precedes closing of pulmonic valve

with inspiration, gap is widened

34
Q

Ejection Click

A

early systole due to the opening of a defective semilunar valve

35
Q

Midsystolic Click

A

Heard during mid-systole, commonly due to prolapse of a mitral or tricuspid valve

36
Q

mitral opening snap of mitral stenosis

A

occurs after A2

37
Q

tricuspid opening snap of tricuspid stenosis

A

occurs after P2

AIM - PD (15 decks)

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