CV

Question 1

What is the biggest portion of the heart?

Answer 1

The base - top of the heart

Question 2

What is the apex of the heart known as?

Answer 2

The point of maximal impulse

Question 3

What are of the heart works the hardest?

Answer 3

LV

Question 4

What side of the heart is affected by CHF?

Answer 4

Left-sided heart failure

Question 5

When does CHF occur?

Answer 5

When blood flows back into the lungs - congestive

Question 6

What are signs and symptoms of CHF?

Answer 6

Fluid in lungs (crackles), trouble lying down when they sleep, pink frothy sputum, tachypnic, dropped O2 sats

Question 7

What is corpulmonale?

Answer 7

Right sided heart failure

Question 8

What are corpulmonale causes?

Answer 8

Lung problems

Question 9

What are signs/symptoms of corpulmonale?

Answer 9

Edema (especially in lower extremities because blood returns to the RA), jugular vein distention, hepatomegaly

Question 10

What is left ventricular hypertrophy?

Answer 10

When the muscle gets bigger

The container gets smaller

Question 11

What happens when left ventricular hypertrophy occurs?

Answer 11

CO drops
BP decreases
HR ^
Will change the ventricular positioning in the heart from 5th intercostal space to more towards axillary line

Question 12

___ blood flow in the right coronary artery will ___ blood flow to the sinus node

Answer 12

Decreased/decreased

Question 13

Which section of the vein is prone to plaque build-up?

Answer 13

Intima

Question 14

What parts of the body need to be inspected for the CV assessment?

Answer 14

Fingernails, arms, legs, check for hair distribution, cyanosis, venous patterns, color of skin for redness/pallor/brown, presence of edema or atrophy

Question 15

What can flaky brown skin be a sign of?

Answer 15

PVD

Question 16

What can varicose veins mean?

Answer 16

Incompetent valves in legs

Question 17

What is chronic arterial insufficiency?

Answer 17

Arterial narrowing that reduces blood flow to an extremity

Having legs up is bad because it prevents blood from getting to extremities

Question 18

What is the most common cause of chronic arterial insufficiency?

Answer 18

Atherosclerosis

Question 19

What is chronic venous insufficiency?

Answer 19

Impaired venous return to the heart because of venous HTN, damage and incompetent venous valves
Seen as blue because the blood is deoxygenated

Question 20

What is the most common cause of chronic venous insufficiency?

Answer 20

DVT, trauma, age, obesity

Question 21

How do you characterize chronic arterial insufficiency pulses?

Answer 21

Decreased to absent

Question 22

How do you characterize chronic venous insufficiency pulses?

Answer 22

Normal

Question 23

What is the dependent position and how is it related to chronic venous insufficiency?

Answer 23

When blood is working against gravity. Prevents the blood from returning to the heart

Question 24

Is there pain in chronic arterial insufficiency?

Answer 24

Intermittent claudication (periods of pain and no pain)
Pain upon elevation

Question 25

Is there pain in chronic venous insufficiency?

Answer 25

None to aching pain upon dependent position

Question 26

What does jugular venous distention reflect?

Answer 26

Right arterial pressure

Question 27

What pulses must be palpated?

Answer 27

``` Temporal Carotid Brachial Radial Femoral Popliteal Posterior tibial Dorsalis pedis ```

Question 28

What 3 positions will the pt be in during the CV exam?

Answer 28

Supine with HOB at 30 degrees, left side, learning forward

Question 29

Where is the aortic valve heard?

Answer 29

Right 2nd ICS, sternal border

Question 30

Where is the pulmonic valve heard?

Answer 30

Left 2nd ICS, sternal border

Question 31

Where is the tricuspid valve heard?

Answer 31

Between 3rd and 4th left ICS sternal border

Question 32

Where is the mitral valve heard?

Answer 32

Apex | Left between 5th and 6th ICS/MCL

Question 33

What is a heave?

Answer 33

When the heart is working really hard and it raises the chest wall

Question 34

Where is the most likely place to see a heave?

Answer 34

Mitral region or PMI

Question 35

Where is the PMI?

Answer 35

Normally medial to the MCL at 5th ICS

Question 36

What should you feel for when checking apical pulse?

Answer 36

Pulsations/heaves

Question 37

What is a murmur?

Answer 37

Turbulent blood flow through a valve

Question 38

What is S1/lub?

Answer 38

Ventricular contraction (closing of tricuspid/mitral valve)

Question 39

What is S2/dub?

Answer 39

Ventricular relaxation (closing of aortic/pulmonic valve)

Question 40

What is S3?

Answer 40

Extra sound between lub and dub | Can be related to CHF

Question 41

What is a bruit?

Answer 41

Turbulent blood flow in a vessel | Sounds like "sht"

Question 42

When does S4 occur?

Answer 42

Early in diastole

Question 43

What is S4?

Answer 43

A "presystolic sound"

Question 44

When does S4 occur?

Answer 44

Late in diastole

Question 45

How do you listen to an abnormal heart sound?

Answer 45

Using the bell

Question 46

What is pericardial friction rub?

Answer 46

Inflammation of the pericardial sac

Question 47

Where is pericardial friction rub best heard?

Answer 47

3rd ICS to the left of the sternum

Question 48

What does a pericardial friction rub sound like?

Answer 48

"Scratching sound"

Question 49

How can you tell the difference between pericardial friction rub and a lung issue?

Answer 49

Have the pt hold their breath. It if goes away, it's the lungs. If it stays, it's the heart

Question 50

When is a murmur heard?

Answer 50

When turbulence is created

Question 51

What is stenosis?

Answer 51

Narrowing of the valve opening

Question 52

What is regurgitation?

Answer 52

When there is a faulty valve and blood leaks backwards

Question 53

When does a systolic murmur occur

Answer 53

During S1 and stops before S2

Question 54

When does a diastolic murmur occur?

Answer 54

During S2 and stops before the next S1

Question 55

When does a pansystolic murmur occur?

Answer 55

Through all of S1

Question 56

When does a pandiastolic murmur occur?

Answer 56

Through all of S2

Question 57

What is the acronym for systolic murmurs?

Answer 57

MR PASS Includes the murmurs of Mitral Regurg, Physiologic, Aortic Stenosis - All occur between S1 and S2 Mr Pass won MVP so systolic murmurs also include Mitral Valve Prolapse.

Question 58

What is the acronym for diastolic murmurs?

Answer 58

MS ARD | Mitral Stenosis, and Aortic Regurgitaion