CV Phys. Exam Flashcards
noise produced by turbulent flow of blood
bruits
palpable, turbulent blood flow; palpable murmur
Thrills
Sustained impulses usually produced by an enlarged heart; generally associated w/ HF, either left sided or right sided
Heaves and lifts
sounds you hear when taking a BP
Korotkoff sounds
maximum arterila pressure during contraction of left ventricle
systolic
minimum arterial pressure during relaxation
diastolic
S1 heart sounds
closing of mitral and tricuspid valves; “lub”; beginning of systole
S2 heart sounds
closing of aortic and pulmonic valves; “dub”; beginning diastole
S3 heart sounds
occurs just after S2 as mitral vavle opens; considered normal in young athletes; in elderly generally diagnositic of CHF; “Kentucky”
S4 heart sounds
Occurs just before S1; “Tennessee”; always pathological; RT sided diastolic heart failure; active ischemia
an exaggerated fall in systolic BP and rate on inspiration; found w/ cardiac tamponade, acute asthma, COPD, pericarditis
Pulsus paradoxus
Large volume, anemia, hepatic failure, Resp. failure (high CO2)
Bounding pulses
best for higher pitched sounds like breath sounds and normal heart sounds; S1 & S2; Mitral regurgitation
stethoscope diaphragm (firm pressure)
best for detecting lower pitched sounds like some heart murmurs and bowel sounds; S3 & S4; mitral stenosis
stethoscope bell (light pressure)
incompetent valve leaflets; blood goes wrong way in a one way valve
regurgitation
incompetent sclerotic valves; scar tissue/stiff; only allows blood to go one way, berudgingly
stenosis
general physical wasting w/ loss of weight and muscle mass due to a disease
cachexia
Beck’s Triad
- distended neck veins
- decreased or muffled heart sounds
- decreased blood pressure or hypotension due to cardiac tamponade or pericarditis
Corneal Arcus, aka “arcus senilis”
white, grey, or blue opaque ring around the iris; if present in elderly, assoc w/ hyperlipidemia; have an underlying cardiac issue
clubbing
bulbous swelling of the ends of the fingers and toes; associated w/ cardio, pulmonary, and endocrine issues
Causes of peripheral cyanosis
- cold
- obstruction (DVT, peripheral vascular disease)
- LVF & shock (decreased cardiac output)
Causes of central cyanosis
- arterial blood desaturation/abnormal hemoglobin (polycythemia, altitude, lung disease, methemoglobinemia, sulfhemoglobinemia, shunt)
murmur
a noise produced by turbulent flow of blood in the HEART
What is the “timing” of heart sounds?
S4, S1, S2, S3 heart sounds
cardiac tamponade
accumulation of fluid in the pericardial space, resulting in reduced ventricular filling b/c of decreased space;
tamponade
tourniquet
splinter hermorrhages
tiny blood clots running vertical under nail beds; commonly causes by sub-acute bacterial endocarditis (SBE)
What are some causes of spinter hemorrhages
- sub-acute bacterial endocarditis
- trichinosis (round worms)
- systemic lupus erythermatosus
- Rheumatoid arthritis
- Trauma
pain caused by insufficient blood flow, usually during exercise
Claudication
Janeway Lesions
miniature abscesses; flat, painless, NON-TENDER macules found distally on the palms of hands and soles of feet; tips of fingers and plantar surfaces of toes; associated w/ Sub-acute Bacterial Endocarditis (SBE)
Osler Nodes
Red-purple lumps, slightly raised, TENDER, typically found on fingers and/or toes; common cause: gonococcal infection
Prinzmetal angina
aka: variant angina, typically happens at rest, but in cycles.
common signs/symptoms of SBE
splinter hemorrhage, Janeway lesions,
orthostatic hypotension #’s (take measurements in 3 min increments)
drop in systolic BP of 20 mmHg
drop in diastolic pressure of 10 mmHg
Pulse increase by 20 beats/minute
orthopnea
SOB that occurs when lying flat
Paroxysmal Nocturnal Dyspnea
severe SOB, esp. at night
Ascites
Abnormal build-up of fluid in the abdomen
If you are checking pulses and get a “regularly irregular” pulse, what underlying conditions could this be indicative of?
- 2nd degree heart block
- ventricular bigeminy
- trigeminy
- quardrigeminy
If you are checking pulses and get a “irregularly irregular” pulse, what underlying condition could this be indicative of?
- a-fib
2. frequent ventricular ectopics
When ascultating the apex, what valve are you listening to?
Mitral
When asculatating the LSB, what valve are you listening to?
Tricuspid
When ascultating the Pulmonic area, what valve are you listening to?
Pulmonic
When ascultating the aortic area, what valve are you listening to?
Aortic
FAT CLAM
conditions associated with an S3
What does FAT CLAM stand for?
Fever, fetus Anemia Thyrotoxicosis Constrictive pericarditis Left ventricular failure Acute mocardial infarction Mitral or tricuspid regurgitation
my “4-H CAPE”
conditions associated with an S4
What does “4-H CAPE” stand for?
Hypertrophic cardiomyopathy Hypertensions Hyperthyroidism Heart blocks Certain anemias Acute myocardial infarction Pulmonic & aortic stenosis Elderly7877777m
regurgitations
aortic insufficiency
