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Patient Assessment > Chapter 9 Cardiology > Flashcards

Chapter 9 Cardiology Flashcards

1
Q

Left ventricular Hypertrophy will have what PMI?

A

PMI >2.5 cm

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2
Q

Jugular veins

A

reflect arterial pressure

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3
Q

Elevated JVP

A

98% specific for increased left ventricular end systolic and diastolic blood pressures

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4
Q

Carotid pulse- brisk

A

normal

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5
Q

Carotid pulse- delayed

A

suggests aortic stenosis

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6
Q

Carotid pulse- bounding

A

suggest cardiac insufficiency

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7
Q

Bruit mumur

A

Indication of turbulent flow (normally should not hear); could indicate atherosclerosis, CVD

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8
Q

PMI- tapping

A

normal

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9
Q

PMI- sustained

A

suggest LV hypertrophy (thickening of heart)

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10
Q

PMI- diffuse

A

suggests a dilated ventricle from CHF cardiomyopathy

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11
Q

Lateral displacement from cardiac enlargement

A

CHF, cardiomyopathy, ischemic heart disease

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12
Q

Palpation of heaves/lifts

A

abnormal ventricular movement

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13
Q

Palpations of thrills/turbulance

A

may accompany loud, harsh, or rumbling murmurs as in aortic stenoisis, ventricular septal defect, damage heart valve

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14
Q

MR. AS

A

Mitral Regurgitation (MR): Aortic stenosis (AS) found only in systole.

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15
Q

MS. AR

A

Mitral Stenosis (MS): Aortic regurgitation (AR); found only in diastole

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16
Q

Mid-systolic murmur

A

Begins after S1 and stops before S2. Brief gaps are audible between murmur and heart sounds. Typically arise from blood flow across the semilunar valves.

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17
Q

Holosystolic (pansystolic) murmur

A

Starts with S1 and stops at S2, without a gap between murmur and heart sounds. These murmurs often occur with regurgitant (backflow) across the atrioventricular valves.

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18
Q

Late diastolic (presystolic) murmur

A

Starts in late diastole and typically continues up to S1.

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19
Q

Early diastolic murmur

A

Starts after S2, with a discernible gap, and then usua fades into silence before the next S1. These murmurs accompany regurgant flow across incompetent semilunar valves.

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20
Q

Sustained, high amplitude apical impulse

A

Suggest left ventricular hypertrophy from pressure overload as in hypertension. If displaced laterally consider volume overload

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21
Q

Sustained, low amplitude apical impulse

A

May result from dilated cardiomyopathy

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22
Q

2nd Left ICS

A

A palpable S2 suggests increased pressure in the pulmonary artery such as pulmonary hypertension

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23
Q

2nd Right ICS

A

A pulsation here can suggust a dilated of aneurysmal aorta

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24
Q

Left lateral decubitus postion

A

This position brings out a left sided S3 & S4 and mitral murmurs, especially mitral stenosis

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25
Q

Lean forward, exhale completely, and stop breathing in expiration

A

This position brings our aortic mumurs (aortic regurgitation).

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26
Q

Mitral stenosis

A

Late diastolic crescendo, valve cannot open wide enough and leads to decrease blood flow to body; often occurs w/ Rheumatic fever

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27
Q

Aortic regurgitation

A

Early diastolic, Descrescendo; leaflets of aortic valve fail to close completely and blood regurgitates from aorta to left ventricle

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28
Q

Aortic stenosis

A

Midsystolic murmur, crescendo/decrescendo; typically arise from narrowed aortic valve

29
Q

Mitral regurgitation

A

Holosystolic murmur; flat; often occurs with backflow across the atrioventricular valves

30
Q

Mitral Regurgitation- example

A

Harsh 2/6 medium pitched holosystolic murmur best heart at apex

31
Q

Aortic Regurgitation- examples

A

Soft blowing 3/6 decrescendo diastolic murmur heart at lower left sternal border

32
Q

Coarctation of the Aorta

A

A pulse in the femoral area or feet will be weaker than pulse in the arms or cartotid. Sometimes pulse may not be felt at all.

33
Q

Grading of murmurs-1

A

Very faint, heard only after listener has “tuned in”; may not be heard in all positions

34
Q

Grading of murmurs-2

A

Quiet, but heart immediately after placing the stethoscope on the chest

35
Q

Grading of murmurs-3

A

Moderately loud

36
Q

Grading of murmurs-4

A

Verly loud, with thrill

37
Q

Grading of murmurs- 5

A

Very loud with thrill. May be heard when the stethoscope is partly off the chest

38
Q

Grading of murmurs-6

A

Very loud with thrill. May be heard when the stethoscope is entirely off the chest

39
Q

Heart murmurs- Quality

A

Apply terms like harsh, musical, soft, blowing

40
Q

Heart murmurs-Pitch

A

Apply terms like high, medium, or low pitched

41
Q

S3

A

Period of rapid ventricular filling as blood flows in early diastole; children/young adults=rapid deceleration of the column of blood against ventricular wall; water faucet; pathological after the age of 40.

42
Q

S4

A

Atrial contraction; Immediately preceeds S1; diastole

43
Q

Cardic Output

A

SV (stroke volume) X HR (heart rate)

44
Q

SV

A

The difference between end-diastolic volume and end-systolic volume; how much blood is pushed out of heart

45
Q

Ejection fraction

A

Stroke volume divided by end-diastolic volume; % of how much blood pushed out vs. how much started with

46
Q

Preload

A

work imposed on the heart before contraction begins filling

47
Q

Afterload

A

the pressure or tension work of the heart (peripheral resistance)

48
Q

Hypertension s/s

A

Often none, headache, Target organ damage (nocturia, visual changes, CV complications i.e. MI)

49
Q

Atrial Fibrillation

A

Irregularly Irregular

50
Q

Holosystolic plateau murmur heard at the left 5th intercostal space, midclavicular line.

A

Mitral Regurgitation

51
Q

Crescendo-Decrescendo systolic murmur heard at the right second intercostal space, right sternal border

A

Aortic Stenosis

52
Q

Crescendo diastolic murmur heard at the left 5th intercostal space, midclavicular line.

A

Mitral Stenosis

53
Q

Decrescendo diastolic murmur heard at the right second intercostal space, right sternal border

A

Aortic Regurgitation

54
Q

Midsystolic Click

A

Mitral Valve Prolapse

55
Q

Between S1 and S2

A

Systole

56
Q

Between S2 and S1

A

Diastole

57
Q

Systole

A

Ventricles contract

58
Q

Diastole

A

Ventricles relax

59
Q

Harsh murmurs are typically:

A

Mitral

60
Q

Soft, blowing murmurs are typically:

A

Aortic

61
Q

Ventricular Septal Defect mimics:

A

Mitral Regurgitation

62
Q

Opening Snap

A

Opening of a stenotic mitral valve

63
Q

Squatting from a standing position

A

Increased Mitral and Aortic Regurgitation

Decreased Hypertrophic Cardiomyopathy murmur

64
Q

Valsalva/Bearing Down

A

Increased Hypertrophic Cardiomyopathy murmur

65
Q

S1 is the first heart sound and is produced by:

A

Closure of the mitral valve

66
Q

S2 is the second heart sound and is produced by:

A

Closure of the aortic valve

67
Q

What type of splitting is always pathological?

A

Expiratory

68
Q

Sounds best heard with the diaphragm:

A

S1, S2, S4, and most murmurs

69
Q

Sounds best heard with the bell:

A

S3 and the rumble of mitral stenosis

Patient Assessment (18 decks)

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