CV exam 1/18

Question 1

skin observations linked to

less cardio output and low O2 sat

Answer 1

cyanosis - blue skin, nail beds, lips, tongue
pallor - washed out, absence of pink
diaphoresis - excess sweating, cool, clammy skin

Question 2

how long to palpate pulse?

• regular rhythm
• irregular rhythm

Answer 2

regular - 30 seconds

irregular - 1 min

Question 3

what sitations/diagnoses displace apex of heart upward?

Answer 3

pregnancy

high diaphragm

Question 4

what sitations/diagnoses displace apex of heart laterally?

Answer 4

congestive heart failure
cardiomyopathy
ischemic heart disease

Question 5

where to palpate carotid pulse?

why only one side at a time?

Answer 5

between SCM and trachea

reduce risk of stimulate carotid sinus baroreceptor > cause decrease in HR and BP

Question 6

best place to palpate pulse in infants?

Answer 6

brachial

- medial aspect antecubital fossa

Question 7

pulse palpation sites?

Answer 7

apical
radial
carotid
brachial
femoral
poplital
pedal

Question 8

where to palpate apical pulse, mitral auscultation?

Answer 8

aka PMI point of maximal impulse
patient supine
palpate 5th interspace, midclavicular vertical line = apex of heart
(location may change based on conditions)

Question 9

grade for pulse

• normal
• absent
• bounding

Answer 9

normal 2+
absent 0
bounding 4+

Question 10

normal HR for

• adults
• teens

Answer 10

60-100bpm

Question 11

normal HR for

- children

Answer 11

60-140bpm

Question 12

normal HR and average for

- newborn

Answer 12

90-164bpm

average 127bpm

Question 13

normal HR for

- aerobic athletes

Answer 13

40-60bpm

Question 14

what is tachycardia?

when would you see compensatory tachycardia?

Answer 14

HR >100bpm

volume loss - surgery, dehydration

Question 15

postural tachycardia syndrome-
HR increases #? within 10min standing
- adults
- teenagers

Answer 15

adults >=30bpm

teenagers >=40bpm

Question 16

what is irregular pulse?

possible causes?

Answer 16

varied force and frequency

possibly arrhythmia, myocarditis

Question 17

possible causes weak pulse?

grading scale?

Answer 17

1+ pulse diminished

low stroke volume, cardiogenic shock

Question 18

possible cause bounding pulse?

grading scale?

Answer 18

4+ bounding pulse

shortened ventricular systole, decreased peripheral pressure, aortic insufficiency/aortic regurgitation

Question 19

what is aortic insufficiency, aortic regurgitation

Answer 19

leaking of the aortic valve

• causes blood to flow in the reverse direction during ventricular diastole (aorta > left ventricle)
• cardiac muscle is forced to work harder than normal.

Question 20

auscultation landmarks

• aortic
• pulmonic
• tricuspid
• mitral

Answer 20

aortic - 2nd R intercostal, sternal

• pulmonic - 2nd L intercostal, sternal
• tricuspid - 4th L intercostal, sternal
• mitral - 5th L intercostal, midclavicular

Question 21

what auscultation landmark?

2nd R intercostal, sternal

Answer 21

• aortic

Question 22

what auscultation landmark?

2nd L intercostal, sternal

Answer 22

pulmonic

Question 23

what auscultation landmark?

4th L intercostal, sternal

Answer 23

tricuspid

Question 24

what auscultation landmark?

5th L intercostal, midclavicular

Answer 24

mitral

Question 25

what heart sound?
normal closure mitral and tricuspid valves
beginning of systole

Answer 25

S1 lub

Question 26

what heart sound?

decreased in 1st degree heart block

Answer 26

S1 lub

Question 27

what heart sound?
normal closure aortic and pulmonary valves
end of systole

Answer 27

S2 dub

Question 28

what heart sound?

decreased in aortic stenosis

Answer 28

S2 dub

Question 29

what heart sound?
extra heart sound, between S1 and S2
may indicate valvular disease (eg. mitral valve prolapse) or normal

Answer 29

systolic murmur

Question 30

what heart sound?
extra heart sound, between S2 and S1
usually indicates valvular disease

Answer 30

diastolic murmur

Question 31

how are heart murmurs graded?

• softest audible mumur
• loudest, audible without stethoscope on chest

Answer 31

• softest grade 1

- loudest grade 6

Question 32

what term?

• abnormal tremor/vibratory sensation felt on the skin overlying an area of turbulence
• accompanies vascular or cardiac murmur
• felt on palpation
• caused by an incompetent heart valve

Answer 32

thrill

Question 33

what term?

• vascular murmur
• abnormal sound generated by turbulent flow of blood in an artery due to either an area of partial obstruction or a localized high rate of blood flow through an unobstructed artery.
• blowing sound

Answer 33

bruit

Question 34

where are bruits common?

indicative of what pathology?

Answer 34

femoral arteries, carotid arteries

atherosclerosis

Question 35

what heart sound?
- abnormal 3 sound in each cycle
- Low frequency sound in early diastole, ventricular filling after S2
- increased atrial pressure leading to increased flow rate
indicative of what pathology?

Answer 35

S3 gallop, “Kentucky” gallop
congestive LV heart failure
athletes

Question 36

what heart sound?
- abnormal 3 sound in each cycle
- Low frequency sound in presystolic portion of diastole, during ventricular filling and atrial contraction
- just before S1
- left ventricle is noncompliant, atrial contraction forces blood through AV valves, blood strikes the left ventricle
indicative of what pathology?

Answer 36

S4 gallop, “Tennessee”, after load is high blood slams L ventricle

atrial coronary artery disease, 
MI myocardial infarction, 
chronic hypertension, 
aortic stenosis
ischemic or hypertrophic cardiomyopathy.

Question 37

what term?
disease of the heart muscle that makes it harder for your heart to pump blood to the rest of your body.
- can lead to what?
- main types?

Answer 37

Cardiomyopathy
lead to heart failure.
dilated, hypertrophic and
restrictive cardiomyopathy.