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!! > Chap. 9 - Cardio techniques > Flashcards

Chap. 9 - Cardio techniques Flashcards

1
Q

What should be done to a hypovolemic patient to see neck veins

A

have them lie flat

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2
Q

What should you do to a patient that has an increased jugular venous pressure

A

elevate the patient head to 60 or 90 degrees

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3
Q

What is increased JVP correlated with

A

acute and chronic and left side heart failure

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4
Q

What findings do you see with COPD patients

A

venous pressure elevate on expiration

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5
Q

Elevated JVP is specific for

A

increased left ventricular end diastolic

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6
Q

What is the usual cause of unilateral distention of the external jugular vein

A

local kinking or obstruction

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7
Q

Where does a prominent a wave occur

A

tricuspid stenosis

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8
Q

Where does absent a waves occur

A

Atrial Fibrillation

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9
Q

Where does large v waves occur

A

tricuspid regurgitation

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10
Q

What will a tortuous and kinked carotid artery produce

A

unilateral pulsatile bulge

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11
Q

What causes decreased pulsations

A

decreased stroke volume

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12
Q

What can pressure on the carotid sinus cause

A

reflex drop in the pulse rate or blood pressure

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13
Q

Where does small, thready or weak pulse occur

A

cardiogenic shock

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14
Q

Where does a bounding pulse occur

A

aortic insufficiency

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15
Q

Where is the carotid upstroke delayed

A

aortic stenosis

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16
Q

Which two pulses vary beat to beat

A

pulsus alternans

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17
Q

Which pulse varies with respiration

A

paradoxical pulse

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18
Q

What are characteristics of Pulsus alternans

A

alternate loud and soft Korotkoff sounds

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19
Q

what do you call the difference of more than 10mmHg between the highest and lowest systolic pressure

A

paradoxical pulse

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20
Q

What diseases can be associated with paradoxical pulse

A

pericardial tamponade

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21
Q

Where can bruits arise from

A

atherosclerotic narrowing

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22
Q

What sounds are characteristics of mitral stenosis

A

S3

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23
Q

What sounds are characteristic of aortic insufficiency

A

soft decrescendo higher pitched diastolic murmur

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24
Q

Where is the S1 sound diminished

A

1st degree heart block

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25
Q

Where is the S2 sound diminished

A

aortic stenosis

26
Q

Where would successful palpation less likely to work

A

thickened chests

27
Q

What percentage of people have a palpable apex in the supine position

A

25% to 40%

28
Q

What percentage of people have a palpable apex in the left lateral decubitus position

A

50% of people

29
Q

What are two things that can displace the apical impulse upward and to the left

A

pregnancy

30
Q

Where is lateral displacement from the cardiac enlargement seen

A

heart failure

31
Q

What does lateral displacement outside the midclavicular line cause

A

cardiac enlargement 3-4x more likely

32
Q

What does a diffuse PMI greater than 3cm in the lateral decubitus position represent

A

left ventricular enlargement

33
Q

What can an increased amplitude of the pulse reflect

A

hyperthyroidism

34
Q

A normally located amplitude that is now a sustained high amplitude impulse is caused by

A

left ventricular hypertrophy from pressure overload

35
Q

where is a sustained low amplitude impulse seen

A

dilated cardiomyopathy

36
Q

What does a brief middiastolic impulse indicate

A

S3

37
Q

What impulse is indicated just before the systolic apical beat itself.

A

S4

38
Q

When does a marked increase in amplitude with little or no change in duration occur

A

volume overload

39
Q

When does an impulse with increased amplitude and duration occurs

A

pressure overload of right ventricle

40
Q

What does a palpable S2 suggest

A

pulmonary hypertension

41
Q

What does a marked dilated failing heart have for its impulse

A

hypokinetic apical that is displaced far to the left

42
Q

What sounds does the left lateral decubitus accentuate

A

left sided S3 and S4

43
Q

The position of sit up, lean forward, exhale completely and stop breathing in expiration will accentuate what sound

A

aortic murmurs (aortic regurgancy)

44
Q

What do diastolic murmurs indicate

A

valvular disease

45
Q

What do systolic murmurs indicate

A

valvular disease but can be nothing

46
Q

What do midsysolic murmurs typically arise from?

A

bloodflow across the semilunar valves

47
Q

What do Pansystolic murmurs often occur with?

A

regurgitant flow across the av nodes

48
Q

What is a late systolic murmur?

A

murmur of the mitral valve prolapse

49
Q

What do early diastolic murmurs typically accompany

A

regurgitant flow across incompetent semilunar valves

50
Q

What do middiastolic and presystolic murmurs reflect

A

turbulent flow across the Av valves

51
Q

Where does a loud murmur of aortic stenosis often radiate to

A

neck in the direction of the arterial flow

52
Q

Where does the murmur of mitral regurgitation often radiate to

A

axilla suggesting the role of bone conduction

53
Q

What is Grade 1 of a murmur

A

very faint

54
Q

What is Grade 2 of a murmur

A

Quiet

55
Q

What is Grade 3 of a murmur

A

moderately loud

56
Q

What is Grade 4 of a murmur

A

loud with palpable thrill

57
Q

What is Grade 5 of a murmur

A

very loud with thrill

58
Q

What is Grade 6 of a murmur

A

very loud with a thrill

59
Q

What is the most compelling feature of the murmur from the hypertrophic cardiomyopathy

A

only systolic murmur that increases during the strain phase

60
Q

Where are the Korotkoff sounds heard during heart failure

A

during phase 2 strain phase

!! (18 decks)

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