Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

PCM III > CV and PV system > Flashcards

CV and PV system Flashcards

1
Q

What do you monitor when measuring peripheral pulses?

A

How they feel. If you can feel them, are they symmetric?

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Heave

A

amplitude is elevated upon palpation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Thrill

A

Feels like a vibration and is from a valve problem

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What does the left lateral decubitus accentuate?

A

Mitral murmurs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What does valsalva accentuate?

A

Aortic murmurs and pericarditis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what is a bruit

A

Noise from turbulence within an artery outside the heart itself

  • Typically lower pitch and softer
  • Usually best heard with the bell
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

grading murmurs

A

1/6: very faint
2/6: quiet, but can easily be heard if in quiet room
3/6: moderately loud

4/6: loud, with palpable thrill
5/6: very loud, thrill, can be heard with stethoscope partially off chest
6/6: very loud, thrill, can be heard with stethoscope OFF the chest

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Turbulence

A

Any arterial area where bruit or murmur is heard, there is turbulence.

Indicates a vulnerable area for atherosclerosis lesions and potential for clots to form

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Valvular problems that may cause murmurs or bruits

A
  • Papillary muscle tear or rupture
  • Chordae tendonae rupture
  • Congenital malformation fibrosis annulus or leaflet
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Common causes of murmurs or bruits

A

Benign- Still’s

patent ductus
septal defects- ASD, VSD
artery stenosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Less common causes of murmurs or bruits

A
  • Tetraology of Fallot
  • Abdominal Aneurysm
  • Hyperthyroid state
  • Obstructive Hypertrophic cardiomyopathy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

S1

A

Mitra and tricupsid closures. Signals onset of systole

Closely timed with the carotid pulse

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

S2

A

Aortic and pulmonic closures. Signals onset of diastole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Causes of S1

A

May be normal variant ( if heard at LSB) or abnormal from RBB or PVC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Right bundle branch block

A

There is a delay or absence of conduction along the RBBB after it branches from the bundle of His. This delays conduction through the ventricle on that side creating separate timing for left and right ventricular contraction which then changes the valve timing.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Split S2

A

May be normal, increasing with inspiration, decreasing with expiration (2-3rd ICS)

Abnormal in pulmonic stenosis or RBBB (no respiratory variation)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

S3

A

Early diastole, closely follows S2
- Best at apex in left lateral decubitus

Occurs at the transition of rapid to slow ventricular filling, ventricular wall is inadequate to accommodate the inflow of blood.

LV myocardial damage causing systolic dysfunction from dilated cardiomyopathy. Due to sudden limitation of normal ventricular relaxation during filling stage in diastole.

Often present in mitral regurgitation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

S4

A

Just before S1, very late diastole just after atrial contraction

Best heard in left lateral decubitus

Caused by vibration of LV from the atrial kick trying to pump the last of the blood in but instead hitting less compliant ventricular wall.. Due to thickening of ventricular walls form a higher work load, and some stiffening.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Ejection click

A

A sound occuring at the moment of maximal pressure with sudden tensing of a valve root.

If annulus isn’t tight, it will move a little bit due to the pressure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Aortic ejection click

A

Early systolic- at onset of left ventricular ejection, aortic root suddenly stretched

Due to dilated aorta

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Aortic stenosis

A

Systolic crescendo-decrescendo
- Transmits sound to carotid arteries

Pathology: rheumatic disease, congenital bicupsid valve, calcification of valve

Symptoms: Dyspnea on exertion, angina, and syncope . S4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Aortic regurgitation

A
  • Early diastolic, high pitch blowing decrescendo murmur from initial high pressure back flow through a more narrow orifice
  • Dilates the left ventricle (S3) and can cause high pulse pressure and brisk carotid pulse
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Pathology of aortic regurgitation

A

Rheumatic disease
Congenital bicupsid valve
Endocarditis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Pulmonic valve ejection click and pathology

A
  • Sudden root tensioning. Very early systole

Pathology: HTN, aneurysm dilating the root
Pulmonary valve stenosis or regurg can alter stress on root of valve causing click

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Systolic crescendo-decresendo murmur

A

Pulmonary stenosis

Symptoms: exertional dyspnea, chest pain, syncope. Can dilate RV and cause S4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Graham Steell Murmur

A

Pulmonary regurg

Identical to aortic regurg, but not as loud.
Pathology: anything that causes pulmonary HTN

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Tricupside stenosis

A

Diastolic low pitch rumble

28
Q

Tricupside regurgitation

A

Early to holosystolic at left sternal border
Will not radiate to left axilla
Inspiration increases RV filling, accentuating the murmur

Pathology: Ebstein congenital anomaly is a very thin valve structure predisposing to failure. Severe failure can enlarge right atrium increasing risk for arrhythima.

29
Q

Mitral valve opening snap

A

Occurs in diastole

When stenotic mitral leaflets are tethered athte orofice but still mobile, as left ventricular emptying lowers intraventricular pressure below the left atrium, they snap into the LV space momentarily before atrial blood flows in

30
Q

Mitral valve stenosis

A

diastolic murmur, can be with opening snap

can result in pulmonary htn, JVD, and RV hypertrophy

31
Q

What causes mitral snap and stenosis?

A

Rheumatic heart disease

32
Q

Mitral valve proplapse

A

Click and murmur

leaflet prolapse = click
mitral regurge = murmur
33
Q

High pitch, short murmur

A

Mitral insufficiency

34
Q

Valsalva

A

Lowers atrial volume.

Standing has same affects

35
Q

What is mitral valve prolapse associated with?

A

Unexplained association with anxiety or panic attacks, and palpitations are not an uncommon complaint.

Very uncommonly associated with CHF and sudden death

36
Q

Holosystolic murmur

A

mitral valve regurg

can radiate to the left axilla

37
Q

Symptoms of hypertrophic obstructive cardiomyopathy

A
  • Exercise induced dyspnea
  • Angina
  • Syncope

Responsible for sudden cardiac death in young athletes

38
Q

When is murmur intensified in hypertrophic obstructive cardiomyopathy?

A

By standing from a squat of valsalva maneuver

39
Q

Study of choice for hypertrophic obstructive cardiomyopathy?

A

Resting echocardiography

40
Q

What is important to look for in sports physicals

A

hypertrophic obstructive cardiomyopathy- even without hearing initial murmur due to sudden death potential with exertion

41
Q

What is the only systolic ejection murmur that increases in intensity during valsalva?

A

hypertrophic obstructive cardiomyopathy

LV volume falls, stroke volume falls, walls collapse in, narrows the exit passageway –> intensified murmur

42
Q

What is accentuated by squatting

A

Increases the murmur of mitral regurg and lessens hypertrophic obstructive cardiomyopathy murmur

Squatting momentarily increases volume from more venous return and increases arterial blood pressure (afterload)

43
Q

What is accentuated by standing

A

Mitral valve prolapse

Standing momentarily decreases volume and therefore right ventricular filling. Not so much volume in LA to prevent back flow

44
Q

Patent ductus arteriosis

A

Results from a remaining fistula between aorta and pulmonary artery.
Causes a continuous murmur through all of systole and most of diastole.

Machine like

45
Q

Pathology of pericarditis

A

Fluid in the sac

  • Infection of pericardium, MI, metastasis to pericardium, post cardiac surgery
  • Often associated with recent respiratory viral infection
46
Q

Pericardial knock

A

Diastolic knock heard widely over precordium in constrictive pericarditis.

Blood coming in to fill RV, LV chambers finds smaller chambers, stops abruptly and vibrates the walls

47
Q

Third spacing

A

The body’s effort to lower work load on the heart by pushing fluid out of the artery and vein, the first and second space, and into whatever other space will take it. We see and hear this the most in the lower legs and lung.

48
Q

Atherosclerosis

A

Occurs in the endothelium, the vessel wall itself.

Is the cause of vascular issues that result in stenosis, plaque, and aneurysm

49
Q

Intermittent claudication

A

A (not fully) occlusive arterial disease of the limbs

  • Symptoms characterized by pain, tension, and weakness of a limb when walking which intensifies with continued walking, resolving only when activity stops
  • Most commonly seen in the legs b/l

Also seen in compression of the cauda equina

50
Q

Symptoms of intermittent claudication

A

Symptoms occur distal to the site of stenosis or occlusion-

Activity induced pain, positional pain, rest pain, poorly healing wounds

51
Q

Physical exam of intermittent claudication

A

Poor pedal pulses, ulcerations, palor, cool, shiny and hairless skin, bruit may be heard

52
Q

Predisposing factors of intermittent claudication

A

Diabetes
Smoking
HTN
hyperlipidemia

53
Q

How to calculate ankle-brachial index (ABI)

A

ankle pressure/arm pressure

54
Q

Interpretation of ABI

A

> 1.3: noncompressible
0.91-1.30: normal
0.41-0.91: mild to moderate peripheral arterial disease
0-0.40 severe peripheral arterial disease

ABI

55
Q

Treatment of intermittent claudication

A
  • Meticulous foot care
  • Smoking cessation
  • Lower lipids
  • Walk, but not through pain
  • Cilostazol, pentoxifylline
  • Revascularization procedures
56
Q

What is the gold standard for targeting surgical intervention in intermittent claudication?

A

Contrast angiography

57
Q

True aneurysm

A

Involves all 3 layers of vessel wall and can dissect

58
Q

Aneurysm

A

Dilation of a segment of a blood vessel.
Due to weakening of the wall from atherosclerosis, HTN, vasculitis, and infection.

Painful only when expanding or leaking

59
Q

Pseduoaneurysm

A

Dilation or hematoma that may or may not involve layers of the vessel wall which is contained and does not dissect

60
Q

Thoracic aneurysm

A

Involves ascending arch and distal aorta

  • Pain from sudden dilation, compression of adjacent organs or dissection
  • Ascending aneurysm can cause aortic regurg by distorting the ring
  • Descending aneurysms are frequently silent, discovered incidentally on CXR
61
Q

Abdominal aortic aneurysm

A
  • 75% are distal to renal arteries

- Uncommon

62
Q

Aneurysm treatment

A

Elective graft - Mortality > 50% if rupture occurs

- Use beta blockers to reduce shear stress unless hypotensive already

63
Q

Raynaud

A

Paroxysmal constriction/dilation of small arteries/arterioles

  • Constriction producing palor, followed by dilation and initial filling of deoxygenated blood in capillaries producing cyanotic color.
  • Disease not associated with other problems
  • Phenomenon associated with scleroderma
  • 80% are women
64
Q

Raynaud treatment

A
  • Avoid or stop smoking
  • Avoid cold temps
  • Avoid beta blockers: block vasodilation receptors leaving vasospastic receptors in sympathetic system unchecked
  • Mange stressors
  • CCBs
65
Q

vasculitis

A

inflammation and damage to vessels, often the lumen, causing stenosis and ischemia to the involved tissue

66
Q

polyarteritis nodosa

A

multisystem necrotizing vasculitis of primarily medium arteries

Inflammation thickens vessel wall causing stenosis, ischemia, and possibly infarct to
distal tissues

Characterized by: fatigue, weakness, fever, wt loss, headache, abdominal or other tissue pain

PCM III (13 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions