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BOARDS: Cardiology > Cardiovascular Physical Exam/ECG > Flashcards

Cardiovascular Physical Exam/ECG Flashcards

1
Q

Where is the best place to check for a pulse on an infant?

A

brachial

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2
Q

If a person has a bounding pulse, what would you grade it?

A

4+

1+ = diminished, barely perceptible
2+ = normal, easily palpable
3+ = more strength
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3
Q

Where would you palpate the pedal pulse?

A

at dorsalis pedis: dorsal medial aspect of foot

- used to measure LE circulation

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4
Q

What are some modifiable risk factors for heart disease?

A 
tobacco use
obesity/physical activity
diet
diabetes
cholesterol
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5
Q

What are the bpm values for bradycardia and tachycardia?

A 
tachy = >100
brady = <60
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6
Q

What could a weak/thready pulse indicate?

A

low SV, cardiogenic shock

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7
Q

What is postural tachycardia syndrome?

A

increase in HR that’s >30bpm within 10 minutes of standing

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8
Q

What is the typical HR range for children?

A

60-140

adults = 60-100

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9
Q

You take the pulse of your patient and it’s bounding. What would you grade this, and what might this indicate?

A

4+

Could indicate shortened ventricular systole and decreased peripheral pressure

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10
Q

What should target BMI and cholesterol be?

A

BMI = 18.5 - 24.9

cholesterol = <200
HDL >40, LDL < 100-160

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11
Q

What are the 4 auscultation locations?

A

ALONG STERNAL BORDER:

1) aortic valve: second R intercostal space
2) pulmonary valve: second L intercostal sp.
3) tricuspid valve: 4th L intercostal space

ALONG MIDCLAVICLE:
4) mitral: 5th L intercostal space

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12
Q

Your patient’s pulse is irregular, what could this indicate?

A

arrythmias

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13
Q

What are the S1 and S2 sounds?

A

S1: lub

  • closing of mitral/tricuspid valves
  • marks beginning of systole

S2: dub

  • closing of pulmonary/aortic valves
  • marks end of systole
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14
Q

What is a heart murmur?

A

extra sounds besides just S1/S2

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15
Q

What are S3/4 sounds?

A

S3 = associated with ventricular filling, may indicate LV heart failure in older adults; occurs right after S2

S4 = associated with ventricular filling and atrial contraction; occurs just before S1
- indicates CAD, MI, aortic stenosis, HTN

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16
Q

What does the P wave demonstrate on an EKG?

A

atrial depolarization (both atria)

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17
Q

What does the QRS wave demonstrate on an EKG?

A

ventricular depolarization

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18
Q

What wave represents ventricular repolarization?

A

t-wave

- relaxation of ventricles here

19
Q

What does the PR interval indicate?

A

length of time it takes the impulse to travel from the atria to the purkinje fibers

20
Q

How long should the PR interval be?

A

.12-.20s (each box is .04s)

21
Q

How do you measure the heart rate in an EKG?

A

count number of Rs in a 6s strip and multiply by 10

22
Q

Your patient’s PR interval is .30s. What could this indicate?

A

higher than >.20 could indicate heart block

23
Q

Your patient’s QRS interval is .25s. What could this indicate?

A

QRS should be between .06-.12, so it’s larger and that could indicate a PVC

24
Q

How do you identify the rhythm on an ECG?

A

measure distance between R’s (peaks), looking for same distance for all

25
Q

A run of 3 or more PVSCs ina row indicates what arhythmia?

A

ventricular tachycardia (looks like wide, bizarre QRS waves with no P waves)

26
Q

What is a PVC?

A

premature ventricular contraction

27
Q

What does v-fib look like on ECG?

A

bizarre, erratic activity with NO qrs complexes

28
Q

What are the 3 ventricular arrhythmias?

A

1) PVC
2) ventricular tachy
3) v-fib

29
Q

What would atrial arrhythmias look like on an ECG?

A

issues with p-wave

- variable in shape or not there

30
Q

You examine a depressed ST segment. What does this indicate?

A

ischemia or injury

31
Q

What ECG changes might you see in an acute MI?

A

acute ST elevations

32
Q

An ECG for a patient exhibits a widened QRS, flattened P wave, and peaked T-wave. What does this indicate?

A

hyperkalemia

33
Q

An inverted t-wave can indicate what?

A

hypokalemia, digitalis use

34
Q

What are the bipolar/unipolar leads in an ECG?

A

unipolar: V1-6
bipolar: avR, avL, avF (R/L arm, L foot)

I,II,III are also there, forget if bi or unipolar

35
Q

What does hypocalcemia do to an ECG?

A

prolong QRS (less quick systole)

36
Q

Discuss the varying levels of hypertension.

A

normal: <120/80
prehypertension: 120-139/80-89
hypertension I: 140-159/90-99
hypertension II: >160/100

37
Q

What values determine a hypertensive crisis?

A

> 180 systolic or 110 diastolic

38
Q

What qualifies a patient as orthostatic?

A

is systolic drops 20mmHg or diastolic drops 10mmHg

39
Q

What are normal MAP values?

A

70-110 mmHg

MAP = mean arterial pressure

40
Q

What are the values for tachypnea/bradypnea?

A 
tachypnic = >22
brady = <10
41
Q

What are normal child RRs?

A

20-30 (while adults are 12-20)

42
Q

What is it called when a patient has the inability to breathe when in areclining or supine position?

A

orthopnea

43
Q

What do rales sound like?

A

aka crackles: rattling, bubbling sounds

- may be due to secretions in lungs

44
Q

T/F: pulse ox measures PaO2 of the body.

A

false, SaO2 (only an estimate of PaO2)

BOARDS: Cardiology (13 decks)

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