CV Examination Flashcards
Risk factors for CV disease: non modifiable risk factors include: 4 things
Age
Fam hx
Race
Gender
Risk factors:
Men?
Women?
Men > 45
Women > 55
Risk factors:
Fam Hx
Cardiac event in first degree male relative <55 or first degree female relative < 65 — 1.5-2x your risk
Risk factors:
Race
African American
Risk factors:
Gender
M>F (pre-menopause)
M=F (post-menopause)
Reheat are the 7 modifiable risk factors
Cholesterol Diabetes Diet Htn Obesity Physical inactivity Tobacco
Risk factors: Goal for cholesterol? Total? LDL? HDL? Triglycerides
Total: <200
LDL: if low risk: <160, if intermediate risk: <130, If high risk, or have CD, or have DM: <100
HDL: >40 men, >50 women
Triglycerides: <150
Risk factors:
Goal for DM
HgA1C: <7%
Risk factors:
Goal for diet?
Low fat
Low salt
Balance of veggies, fruits, grains, and meats
Risk factors:
Goal for Htn?
<120/<80
Risk factors:
Goal for obesity
BMI?
Waist circumference?
BMI: 18.5-24.9 kg/m2
<40 in (men)
<35 in (female)
Risk factors:
Goal for physical inactivity
At least 30 min exercise, 5-7 days per week
Risk factors:
Goals for tobacco
Quit smoking
Pulse is influenced by what 6 things?
Force of contraction Volume and viscosity of blood Diameter and elasticity of vessels Emotions Exercise Blood temp Hormones
Palpate ___ seconds for regular pulse and ____ for irregular rhythm
30
1-2 minutes
Apical pulse can be palpated where?
SUPINE
5th interspace, midclavicular vertical line
What is the most common pulse monitoring site?
Radial pulse
Carotid pulse is palpated where?
What do you want to watch out for?
Anterior neck btw SCM and trachea
HOB should be elevated
Assess one time at a time to reduce the risk of bradycardia through stimulation of baroreceptor (found in the aortic arch and carotid sinus) - this will produce a reflex drop in pulse rate or BP
Brachial pulse is palpated where?
It is the best for what population?
Over brachial artery - medial aspect of antecubital fossa
Infants
Femoral artery palpated where?
Femoral artery in inguinal region
Popliteal Artery palpated where?
Popliteal artery behind the knee with knee SLIGHTLY FLEXED
What is the grading scale for peripheral pulses?
0 = absent pulse, not palpable 1+ = diminished, barely perceptible 2+ = normal, easily palpable 3+ = full pulse, increased strength 4+ = bounding
Pedal pulse: palpated where?
Over dorsalis pedis, dorsal medial aspect of foot
Normal HR for adults and teens?
60-100 bpm
40-60 in aerobically trained
Normal HR in children?
60-140 bpm
Normal HR in newborn? What is the average?
90-164
Average 127
When is compensatory tachycardia seen?
Volume loss (surgery, dehydration)
What is postural tachycardia syndrome?
Sustained HR greater than or equal to 30bpm within the first 10 min of standing
> or = 40 bpm in teens
Why might one have a weak thready pulse?
Low SV
Cardiogenic shock
Why might one have a bounding full pulse?
Shortened ventricular systole
Decreased peripheral pressure
Aortic insufficiency
Where can you locate the aortic valve for auscultation?
2nd right intercostal space at the sternal border
Where can you locate the pulmonic valve for auscultation?
2nd left intercostal space at the sternal border
Where can you locate the tricuspid valve for auscultation?
4th left intercostal space at the sternal border
Where can you locate the mitral valve for auscultation?
5th left intercostal space at midclavicular area
The S1 (lub) sound is normal closure of \_\_\_\_\_ and \_\_\_\_\_ valve This marks the beginning of \_\_\_\_\_\_\_\_
It would be decreased in _____________
Tricuspid and bicuspid
Systole
First degree heart block
The S2 (dub) sound is the normal closure of the \_\_\_\_\_\_ and \_\_\_\_\_\_ valves. This marks the end of \_\_\_\_\_\_\_\_
Decreased in _________
Pulmonary and aortic
Systole
Aortic stenosis
Systolic murmurs falls between ____ and _____. May indicate _____ _____ (_________) or may be normal
S1 and S2
Valvular disease (mitral valve prolapse)
Diastolic murmurs occur between ____ and _____
Usually indicates ________
S2 and S1
Valvular disease
Grades of heart murmurs range from grade 1 (_____) to grade 6 (_____)
Grade 1: softest audible murmur
Grade 6: audible with stethoscope OFF the chest
Thrill: an abnormal _______ accompanying a _______ or _______ murmur
Felt on palpation
Tremor
Vascular or cardiac
Bruit: an ___________ sound or murmur
________ sound of arterial or venous origin
Common in what two arteries?
Indicative of what?
Adventitious
Blowing
Femoral and carotid
Atherosclerosis
A gallop rhythm is an abnormal heart rhythm with how many sound in each cycle?
Includes ___ and ____
3
S3 and S4
S3 is associated with _________ ________
Occurs soon after ____
In older individuals, may be indicative of ______ ______ ______ (__)
Ventricular filling
S2
CHF (left ventricle)
S4 is associated with ______ ____ and _____ _____
Occurs just before ____
This is indicative of pathology including what 4 things?
Ventricular filling and Atrial contraction
S1
Coronary heart disease, MI, aortic stenosis, chronic htn
