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CD General subjects > Computer test - Cardiac system > Flashcards

Computer test - Cardiac system Flashcards

1
Q

What are the charasteristics of the pulse pressure ?

A
  • Difference between systolic and diastolic blood pressure

- Determined by HR, stroke volume, and peripheral resistance

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2
Q

What are the indications of an ECG ?

A
  • Irregular heartbeats noted during physical exam
  • Bradycardia
  • Tachycardia
  • …
  • Evaluation of cardiac arrhytmias
  • Detect enlarged cardiac chambers (echocardiography is better)
  • Show cardiac disturbances of electrolytess and systemic diseases
  • Aid cardiac diseases diagnosis
  • Monitor anaesthesia
  • Evaluate effectiveness of cardiac drugs (digitalis glycosides…)
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3
Q

In dogs, right sided heart failure can lead to (F/T) :

  • Ascites
  • Pulmonary oedema
  • Distended jugular
  • Dyspnoaea
A

True : Ascites, pulmonary edema, distended jugular

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4
Q

What is true about pre-cordial thrill (fremitus) ?

A

Pathological, grade 5 murmur

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5
Q

When is fremitus heard ?

A

Dry pleurisy, bronchitis, fibrinous pericarditis, stenotic cardial valves, valve insufficiency

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6
Q

Where can the heart be palpated ?

A

Between the 3rd and 6th ICS, all species on both sides except Ru, Pig (only on the left)

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7
Q

Where is the apical beat located on the dog ?

A

Over the edge of the sternum, left 3-6 ICS, right 3-5 ICS

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8
Q

Where can the pulse be measured on the cow ?

  • A. facialis
  • A. transversa faciei
  • A. coccygea
  • A. auricularis caud
  • A. femoralis
  • A. digitalis lat and med
A
  • A. facialis
  • A. transversa faciei
  • A. coccygea
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9
Q

Where can the pulse be measured on the horse ?

  • A. facialis
  • A. transversa faciei
  • A. coccygea
  • A. auricularis caud
  • A. femoralis
  • A. digitalis lat and med
A
  • A. facialis
  • A. transversa faciei
  • A. digitalis lat and med
    (+ median arteries in the axillary region)
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10
Q

Pericardial tamponade in cows signs ?

A

Pulse changes with respiration

Positive veinous stasis test → no emptying below the compression point

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11
Q

What is grade 5/6 of cardiac murmurs ?

A

Very loud murmur with precordial thrill

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12
Q

Puncta maxima of the dog on the left side ?

A

For heart apex : 3-6 ICS

For murmur : 3P-4A-5M

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13
Q

In which species can you feel the heart on the right side ?

  • Cat
  • Cattle
  • Goat
  • Dog
  • Horse
  • Swine
  • Rabbit
A
  • Cat
  • Dog
  • Horse
  • Rabbit
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14
Q

In which species can’t you feel the heart on the right side ?

  • Cat
  • Cattle
  • Goat
  • Dog
  • Horse
  • Swine
  • Rabbit
A
  • Cattle
  • Goat (+ sheep)
  • Swine
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15
Q

Apical beat location in the dog and cat ?

A

Left 3-6 ICS

Right 3-5 ICS

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16
Q

Arterial palpation standpoints ?

A

Rhythm
Symmetry
Rate
Quality → Size, strenght, duration of pulse wave, fullness of artery

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17
Q

Type of examination commonly carried out together with ECG ?

A

PhonoCardioGraphy PCG

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18
Q

What is true concerning the systolic heart murmur in horses ?

  • Can be physiologic
  • Graded 1-3/6
  • Can be heard on the left side of the thorax
  • Localized and brief
  • Intensity may change with exercise
  • Due to ventricular filling
  • Happens in late systole
  • Crescendo
A
  • Can be physiologic
  • Graded 1-3/6
  • Can be heard on the left side of the thorax
  • Localized and brief
  • Intensity may change with exercise
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19
Q

What could cause a cardiac beat dislocation ?

A

Pneumothorax
Hydrothorax
Abscess
Tumour

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20
Q

In dogs, left-sided heart failure can lead to

  • Ascites
  • Dysponea
  • Coughing
  • Tachypnoe
A
  • Dysponea
  • Coughing
  • Tachypnoe
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21
Q

In what kind of conditions would you hear a stronger heartbeat ?

A

Thin thoracic wall
Exercise
Cardiac hypertrophy
Dislocation

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22
Q

What causes enlarged P-wave ?

A

Atrial enlargement

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23
Q

Examination of heart ?

A

Inspection, palpation, percussion, auscultation
Further exams :
HISTORY (+++ important)
X rays
US +/- Doppler
Blood work (ANP, BNP, troponin, endothelin, cTr-l, AST, CK, LDH1, LDH2
ECG, Holter ECG
Blood pressure measurement
Phonocardiography PCG
Non selective angiography
Cardiac catheterization (intracardiac pressure, oxymetry, selective angiography)
Radionucleide imaging
Serology (Lyme, ANA, Dirofilaria, Trypanosoma…)
CT, MRI

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24
Q

Examination of vessels ?

A

Inspection, palpation

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25
Q

What can you evaluate during inspection of the cardiac area ?

A 
Abnormalities of the thorax
Heart beat (ictus cordis) : apex beat (dog+cat), location, intensity
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26
Q

What can you evaluate during palpation of the cardiac area ?

A

Intensity/location of the heart beat
Pain
Fremitus (endo/peri/extraperi -cardial)

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27
Q

Normal place of the heart apex in horse ?

A

Left 3-6 ICS

Right 3-4

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28
Q

Normal place of the heart apex in cattle ?

A

Under the shoulder line

Left 3-5 ICS

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29
Q

Normal place of the heart apex in sheep/goat/swine ?

A

Left 3-5 ICS

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30
Q

Normal place of the heart apex in dog & cat ?

A

Over the edge of the sternum
Left 3-6 ICS
Right 3-5 ICS

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31
Q

Normal place of the heart apex in rabbit ?

A

Over the edge of the sternum
Left 2-4 ICS
Right 2-4 ICS

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32
Q

What can you evaluate during percussion of the cardiac area ?

A

Pain

Cardiac dullness, Diernhofer triangle

33
Q

Area of cardiac dullness and type of cardiac dullness in horse ?

A

Left 3-5 ICS
Right (ventral third) 3-4 ICS
ABSOLUTE

34
Q

Area of cardiac dullness and type of cardiac dullness in cattle & small ruminants ?

A

Left 3-4 ICS

Relative

35
Q

Area of cardiac dullness and type of cardiac dullness in swine ?

A

Left 2-3 ICS

Relative

36
Q

Area of cardiac dullness and type of cardiac dullness in dog ?

A

Left 4-6 ICS
Right (ventral third) 4-5 ICS
ABSOLUTE

37
Q

Area of cardiac dullness and type of cardiac dullness in cat ?

A

Left not easily detected

Relative

38
Q

How is absolute dullness of the cardiac area ?

A

Dull

Due to direct contact between heart and thorax

39
Q

How is relative dullness in cardiac area ?

A

+/- dull

Due to thin lung tissue between heart and thorax

40
Q

Enlargement of cardiac dullness area possible causes ?

A

Cardiac enlargement
Cardiac dislocation
Pericardial effusion

41
Q

False enlargement of cardiac dullness area possible causes ?

A

Dullness in neighbouring organs

Frictional (rubbing) auscultation

42
Q

Decreasing of cardiac dullness area possible causes ?

A

Lung emphysema
Emphysema of the skin
Pneumothorax
Cardiac dislocation

43
Q

How many normal heart sounds ?

A

4

44
Q

What is the cause for the first heart sound ?

A

Beginning of systole, caused by the initial movement of the ventricle, the abrupt arrest of blood flow as AV valves tense, and the early part of ejection

45
Q

What is the cause for the 2nd heart sound ?

A

End of systole, caused by the change in direction of blood flow, closing the semilunar valves

46
Q

What is the cause for the 3rd heart sound ?

A

Termination of rapid ventricular filling, commonly heard at or caudal and dorsal to the apex beat

47
Q

What is the cause for the 4th heart sound ?

A

Atrial contraction and sudden arrest of the distended ventricle

48
Q

In which species can the 4 heart sounds be audible ?

A

Horse

49
Q

In horses, when heart rate is <35 / min, how many heart sounds can be heard ? Which ones ?

A

4

4-1 2-3 4-1 2-3

50
Q

In horses, when heart rate is [35-80] / min, how many heart sounds can be heard ? Which ones ?

A

2

4+1) (2+3) (4+1) (2+3

51
Q

In horses, when heart rate is >80 / min, how many heart sounds can be heard ? Which ones ?

A 
3
1  2  (3+4)  1  2  (3+4)
52
Q

What are the possible changes of heart sounds (5 keywords) ?

A 
FRIDA
Frequency
Rhythm
Intensity
Demarcation
Adventitious sounds
53
Q

Physiological changes in heart rhythm in horses ?

A 
Intermissio cordis (dropped heart beat)
2nd degree AV block
54
Q

What is respiratory arrhythmia ?

A

Slower heart rare during expiration (vagus effect, cranial nerve X)

55
Q

Changes in frequency (examples) ?

A

Tachycardia, bradycardia

56
Q

What heart sounds can be heard in the case of a cardiomyopathy ?

A

4 - 1 - 2

57
Q

2 types of adventitious sounds ?

A

Endocardial & extracardial murmurs

58
Q

Causes for endocardial murmurs ?

A 
Morphological changes (valve deformities, septal/vessel malformations..)
Functional changes (innocent murmurs, anemia..)
59
Q

Causes for extracardial murmurs ?

A

Pericardial or pleuropericardial murmurs → pericardial splashes, rubbing, pleuropericardial rubbing (tested with Valsalva probe)

60
Q

What is the Valsalva probe ?

A

Pleuropericardial-pleuropleural rubbing (disappears if breathing stops). Pericardial rubbing is increased if breathing stops at the end of inspiration (increased intrathoracic pressure)

61
Q

Normal (functional) heart murmurs in horses ?

A

→ Caused by vibrations (ejection of blood from the heart during early systole → blood flow in aorta and pulmonary artery)
Left side of thorax, Grade 1-3, PMI over aortic or pulmonary valves, early-to-midsystolic, crescendo-decrescendo or decrescendo, localized and brief, intensity may change with exercise
→ OR Rapid filling of the ventricles during early diastole (ventricular filling). Common in young horses and thoroughbreds. Left side of thorax, Grade 1-3, PMI over mitral area, early diastolic (S2-3), or late diastolic (S4-S1). Quality is often musical/squeaking

62
Q

PMI in horses ?

A

Pulmonary : left 3rd ICS below point of shoulder
Aortic : left 4th ICS below point of shoulder
Mitral : left 5th ICS halfway between shoulder and sternum
Triscuspid : right 4th ICS

63
Q

Number of murmurs grades ?

A

6

64
Q

Description of murmurs grades ?

A

I - Very soft murmur, heard only after a few seconds in a quiet room
II - Soft murmur but easily heard directly upon auscultation
III - Moderate intensity murmur with good audibility
IV - Loud murmur, very good audibility but without precordial thrill
V - Very loud murmur with precordial thrill
VI - Loudest murmur, even audible with stethoscope lifted from the chest wall

65
Q

Classification of endocardial murmurs standpoints ?

A 
Localization
Grade/Intensity
Timing (related to the cardiac cycle)
Frequency/Pitch
Character (quality, shape : crescendo, decrescendo, continuous, plateau, diamond-shaped)
Conduction (y/n)
Duration
Effect of changing heart rate
66
Q

Possible endocardial murmurs “frequency/pitch”

A

Low, medium, high,

Blwing, whisthling, crackling, rough, musical

67
Q

Examination of the arteries ?

A

Digital palpation
BP measurement (direct/indirect via sphygmomanometer)
Blood flow registration (Doppler US)

68
Q

Where can the pulse be measured on the swine ?

  • A. facialis
  • A. transversa faciei
  • A. coccygea
  • A. auricularis caud
  • A. femoralis
A
  • A. facialis

- A. femoralis

69
Q

Where can the pulse be measured on dogs and cats ?

  • A. facialis
  • A. transversa faciei
  • A. coccygea
  • A. auricularis caud
  • A. femoralis
A
  • A. femoralis
70
Q 
How to qualify these pulse qualities :
Uneven pulse
Irregular pulse
Small, brief &amp; hard pulse
Small, prolonged and weak pulse
Skipping &amp;large pulse
Paradox pulse
A

Uneven pulse = pulsus irregularis (respiratory or true arrhythmia)
Irregular pulse = p.inequalis / alternans (arrhythmia, cardiomyopathy)
Small, brief & hard pulse = p. contractus
Small, prolonged and weak pulse = p. piliformis
Skipping & large pulse = p. celer et magnus (Corrigan-pulse)
Paradox pulse = p. paradoxus = weak during inspiration, strong in expiration, due to cardiac tamponade

71
Q

How to qualify these pulse sizes ?

  • Large & hyperkinetic
  • Small & hypokinetic
A
  • Large & hyperkinetic = pulsus magnus

- Small & hypokinetic = p. parvus

72
Q

How to qualify these pulse durations ?

  • Sluggish
  • Skipping
A
  • Sluggish = pulsus tardus

- Skipping = p.celer

73
Q

How to qualify these pulse sizes & durations ?

  • Full
  • Empty
A
  • Full = pulsus plenus

- Empty = p. vacuus

74
Q

Examination of the veins ?

A

Inspection palpation

Measurement of central venous pressure

75
Q

Veins available for examination ?

A

Jugular
Sapehnous
Episcleral, Mm veins
Subcutaneous abdominal vein (milk vein) in cattle

76
Q

What parameters can be evaluated in veins ?

A

Degree of fullness (jugular vein is normally empty)
Movement within the veins (normal = undulation; negative/atrial venous pulse, positive/ventricular pulse; hepato-jugular reflux)

77
Q

Define :
Negative/atrial venous pulse
Positive or ventricular pulse
Hepato-jugular reflux

A

→ Negative/atrial venous pulse : increased right atrial pressure during diastole, can be normal or caused by tricuspid stenosis
→ Positive or ventricular pulse : increased right ventricular pressure and improper valve closure during systole. Always pathological (right sided heart failure)
→ Hepato-jugular reflux: increased CVP causes distended jugular vein seen by  pushing liver of small animals

78
Q

Pathological vein pulse description ?

A

Systolic, pronounced (over the ventral 1/3rd of the neck), persistant after compression test, congested jugular vein

CD General subjects (14 decks)

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