contin. carotid pulse

Question 1

What type of info does the carotid pulse supply

Answer 1

detecting stenosis or insufficiency of the aortic valve

Question 2

A tortuous and kinked carotid artery may produces what?

Answer 2

unilateral pulsatile bulge

Question 3

What are causes of decreased pulsations

Answer 3

decreased stroke volume

Question 4

Pressure on the carotid can cause what?

Answer 4

reflex drop in pulse rate or blood pressure

Question 5

Small, thready, or weak pulse occurs where?

Answer 5

cardiogenic shock

Question 6

A bounding pulse occurs where

Answer 6

aortic insufficiency

Question 7

where is the carotid upstroke delayed

Answer 7

aortic stenosis

Question 8

What happens in pulsus alternans

Answer 8

rhythm of pulse remains regular

Question 9

what does pulsus altermans usually indicate

Answer 9

left sided heart failure

Question 10

where is pulsus alternans usually best felt

Answer 10

applying light pressure on the radial or femoral arteries

Question 11

what is paradoxical pulse

Answer 11

great than normal drop in systolic pressure during inspiration

Question 12

What is a bruit

Answer 12

murmur like sound arising from a turbulent arterial blood flow

Question 13

What causes a bruit

Answer 13

atherosclerotic narrowing of the internal carotid artery

Question 14

If a patient has a carotid obstruction, kinking or thrill what should you access?

Answer 14

brachial artery

Question 15

What is the position of the patient during the cardiac examination

Answer 15

patient should be supine

Question 16

how do you assess the PMI

Answer 16

patient should be turned to the left lateral decubitus position

Question 17

How do you bring the left ventricular outflow tract closer to the chest wall to listen for aortic insufficiency

Answer 17

have the patient sit up, lean forward and exhale

Question 18

What is the relative intensity of sounds S1 and S2

Answer 18

S1 is usually louder than S2 at the apex

Question 19

What is an invaluable aide to timing the sound or murmur

Answer 19

palpation of the carotid artery during the auscultation

Question 20

What can inspection of the anterior chest reveal

Answer 20

location of the PMI

Question 21

What can palpation of the anterior chest reveal

Answer 21

thrills

Question 22

What is dextrocardia

Answer 22

heart situated in the right chest cavity

Question 23

What is situs inversus

Answer 23

heart, tri-lobed lung, stomach and spleen are on the right side

Question 24

What conditions can cause a more prominent pulsation than the apex beat

Answer 24

dilated pulmonary artery

Question 25

what conditions may displace the apical pulse upward and to the left

Answer 25

pregnancy or a high left diaphragm

Question 26

what conditions may cause a lateral displacement of the apical pulse

Answer 26

heart failure

Question 27

A diffuse PMI > 3 in the lateral decubitus position indicate what?

Answer 27

ventricular enlargement

Question 28

What can an increased amplitude of the impulse be caused by?

Answer 28

hyperthyroidism

Question 29

What does a sustained high amplitude impulse that is normally located suggest

Answer 29

left ventricular hypertrophy from pressure overload (hypertension)

Question 30

What does a sustained low amplitude suggest

Answer 30

dilated cardiomyopathy

Question 31

A marked increase in amplitude with little or no change in duration occurs where

Answer 31

chronic volume overload of the right ventricle

Question 32

An impulse with increased amplification and duration occurs where?

Answer 32

pressure overload of the right ventricle

Question 33

What does a prominent pulsation over the left second interspace represent

Answer 33

increased pressure in the pulmonary artery

Question 34

What does a prominent pulsation over the right second interspace represent

Answer 34

dilated or aneurysmal aorta