contin. carotid pulse Flashcards
What type of info does the carotid pulse supply
detecting stenosis or insufficiency of the aortic valve
A tortuous and kinked carotid artery may produces what?
unilateral pulsatile bulge
What are causes of decreased pulsations
decreased stroke volume
Pressure on the carotid can cause what?
reflex drop in pulse rate or blood pressure
Small, thready, or weak pulse occurs where?
cardiogenic shock
A bounding pulse occurs where
aortic insufficiency
where is the carotid upstroke delayed
aortic stenosis
What happens in pulsus alternans
rhythm of pulse remains regular
what does pulsus altermans usually indicate
left sided heart failure
where is pulsus alternans usually best felt
applying light pressure on the radial or femoral arteries
what is paradoxical pulse
great than normal drop in systolic pressure during inspiration
What is a bruit
murmur like sound arising from a turbulent arterial blood flow
What causes a bruit
atherosclerotic narrowing of the internal carotid artery
If a patient has a carotid obstruction, kinking or thrill what should you access?
brachial artery
What is the position of the patient during the cardiac examination
patient should be supine
how do you assess the PMI
patient should be turned to the left lateral decubitus position
How do you bring the left ventricular outflow tract closer to the chest wall to listen for aortic insufficiency
have the patient sit up, lean forward and exhale
What is the relative intensity of sounds S1 and S2
S1 is usually louder than S2 at the apex
What is an invaluable aide to timing the sound or murmur
palpation of the carotid artery during the auscultation
What can inspection of the anterior chest reveal
location of the PMI
What can palpation of the anterior chest reveal
thrills
What is dextrocardia
heart situated in the right chest cavity
What is situs inversus
heart, tri-lobed lung, stomach and spleen are on the right side
What conditions can cause a more prominent pulsation than the apex beat
dilated pulmonary artery
what conditions may displace the apical pulse upward and to the left
pregnancy or a high left diaphragm
what conditions may cause a lateral displacement of the apical pulse
heart failure
A diffuse PMI > 3 in the lateral decubitus position indicate what?
ventricular enlargement
What can an increased amplitude of the impulse be caused by?
hyperthyroidism
What does a sustained high amplitude impulse that is normally located suggest
left ventricular hypertrophy from pressure overload (hypertension)
What does a sustained low amplitude suggest
dilated cardiomyopathy
A marked increase in amplitude with little or no change in duration occurs where
chronic volume overload of the right ventricle
An impulse with increased amplification and duration occurs where?
pressure overload of the right ventricle
What does a prominent pulsation over the left second interspace represent
increased pressure in the pulmonary artery
What does a prominent pulsation over the right second interspace represent
dilated or aneurysmal aorta
