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Cardiology 22010 > Chapter 2 Physical Exam > Flashcards

Chapter 2 Physical Exam Flashcards

1
Q

What part of the stethoscope is used for low frequency sounds?

A

Bell

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2
Q

What part of the stethoscope is used for high frequency sounds?

A

Diaphragm

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3
Q

What is the order of the four components of the heart exam?

A

1) Inspection
2) Palpation
3) Percussion (Omitted)
4) Auscultation

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4
Q

Where is the Apical impulse located?

A

5th Left intercostal space, midclavicular line

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5
Q

What can be used to estimate the size of the heart instead of percussion?

A

Point of maximum impulse (PMI)

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6
Q

Closure of the mitral/tricuspid valves

A

S1

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7
Q

Closure of the aortic/pulmonic valves

A

S2

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8
Q

Early diastole (passive filling) vibration of ventricular walls

A

S3

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9
Q

What age is early diastole (S3) a pathological finding?

A

40+ y/o

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10
Q

Ventricular filling from atrial kick (late diastole) loss of compliance or increase stroke volume secondary to high output

A

S4

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11
Q

Potential causes that would cause S4

A

1) HTN
2) Coronary Artery Disease
3) Aortic stenosis
4) Cardiomyopathy

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12
Q

In what type of person is the heart more vertical and central?

A

Slender person

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13
Q

What type of person will the heart lie more horizontally and to the left?

A

Stocky person

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14
Q

Wide apical pulsation would indicate what?

A

Left ventricular hypertrophy

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15
Q

Loss of palpable apical pulsation may indicate what?

A

Fluid, air, or displacement

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16
Q

Thrills are associated with what pathologies?

A

1) Failure of Semilunar valve to close
2) Aortic/Pulmonary stenosis
3) Atrial septal defect

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17
Q

Loud S1 would suggest?

A

1) Increased blood velocity
2) Mitral stenosis
3) Heart block
4) Hypertension
5) Calcification of the mitral valve

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18
Q

Loud S2 would suggest what?

A

1) Hypertension
2) Valve disorder
3) Stenosis
4) Fluid

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19
Q

Mitral/Tricuspid stenosis is seen when?

A

Diastolic

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20
Q

Aortic/Pulmonic Regurgitation

A

Diastolic

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21
Q

Mitral/Tricuspid Regurgitation

A

Systolic murmur

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22
Q

Aortic/Pulmonic stenosis are most common during what?

A

Systole

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23
Q

Mid systolic click with late high-pitched murmur would suggest?

A

Mitral valve prolapse

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24
Q

Pericardial sac inflammation would cause what?

A

Friction rubs. Parietal and visceral layers would make a sound like grating, machine-like, rubbing.

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25
Q

What equipment do you need for a cardiac exam?

A

1) Pencil
2) 15cm ruler (tape and folding rulers)
3) Stethoscope with bell and diaphragm
4) BP Cuff

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26
Q

Difference between systolic and diastolic pressure

A

Pulse pressure

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27
Q

Which part of the BP is more responsive to stimuli?

A

Systolic

28
Q

What is the expected difference of BP between arms?

A

10mm Hg or less

29
Q

What happens to BP when you stand?

A

Systolic pressure drops and diastolic pressure rises

30
Q

Pulse pressure of 4

A

Bounding, aneurysmal

31
Q

Pulse pressure of 3

A

Full, increased

32
Q

Pulse pressure of 2

A

Expected

33
Q

Pulse pressure of 1

A

Diminished, barely palpable

34
Q

Pulse pressure of 0

A

Absent, not palpable

35
Q

Where do you listen for venous hums?

A

Jugular veins over right clavicle

36
Q

Pitting edema 1+

A

Slight pit, disappears rapidly (2-3mm)

37
Q

Pitting edema 2+

A

Somewhat deep pit, disappears in 10 to 15 seconds (4-5mm)

38
Q

Pitting edema 3+

A

Noticeable deep pit that lasts more than a minute (6-7mm)

39
Q

Pitting edema 4+

A

Very deep pit that lasts 2-5 minutes (8-9mm)

40
Q

Clinical test for thrombosis

A

Homan’s sign

41
Q

Typical adult range for BP

A

S: 100-140
D: 60-90

42
Q

Pulse pressure range

A

30 to 40 mm Hg, even to as much as 50 mm Hg

43
Q

Jugular distention >9 cm suggests what?

A

Ventricular failure

44
Q

What happens to BP in old age?

A

Systolic increases, Diastolic decreases, with an overall increase in blood pressure

45
Q

Mechanical wave propagated through a medium at high frequency to produce images of structures within the human body

A

Ultrasound

46
Q

Sound in the mechanical vibrations that travels along longitudinal waves

A

Ultrasound

47
Q

How are ultrasound waves generated?

A

Application of electric current to piezoelectric crystals in the US transducer (probe)

48
Q

Phenomenon where distortion of a crystal causes an electrical change

A

Piezoelectric effect

49
Q

Where can you find the best images in an ultrasound?

A

Directly below the probe

50
Q

Ultrasound frequency used for deep abdominal imaging

A

Lower frequency

51
Q

Ultrasound frequency used for shallow structures

A

Higher frequency

52
Q

What color is tissue on an ultrasound?

A

Gray

53
Q

What color is fluid on an ultrasound?

A

Black

54
Q

Operating mode in which two-Demensional image is generated that portrays moving reflectors in color simultaneously with images

A

Color Flow Doppler

55
Q

Regulates the amplification (brightness) of returning echoes to compensate for loss of transmitted sound caused by absorption and reflection

A

Gain

56
Q

Refers to a lesion or tumor which produces a stronger echo than the surrounding structures

A

Hyperechoic

57
Q

Refers to structures that contain fewer or weaker echoes than surrounding tissues

A

Hypoechoic

58
Q

Ability to distinguish between two adjacent structures

A

Resolution

59
Q

An electromechanical device that is part of an ultrasound system. The device that contacts the patient and converts electrical energy into mechanical energy and vice versa.

A

Transducer

60
Q

How many colors does a color doppler have?

A

Two

61
Q

What color is used to indicate flow going toward the probe?

A

Red

62
Q

What color is used to indicate flow going away from the probe?

A

Blue

63
Q

US probe used for abdominal and OB imaging

A

Curvilinear probes

64
Q

US probe used for soft tissue and small parts imaging

A

Linear

65
Q

US probe used to “bend” beam from flat, small footprint to a wider pie-shaped wedge distally

A

Phased array probe

66
Q

On an Ultrasound, What will reveal as a hypoechoic rim of fluid around the heart?

A

Pericardial effusion

Cardiology 22010 (5 decks)

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