CV Phys. Exam

Question 1

noise produced by turbulent flow of blood

Answer 1

bruits

Question 2

palpable, turbulent blood flow; palpable murmur

Answer 2

Thrills

Question 3

Sustained impulses usually produced by an enlarged heart; generally associated w/ HF, either left sided or right sided

Answer 3

Heaves and lifts

Question 4

sounds you hear when taking a BP

Answer 4

Korotkoff sounds

Question 5

maximum arterila pressure during contraction of left ventricle

Answer 5

systolic

Question 6

minimum arterial pressure during relaxation

Answer 6

diastolic

Question 7

S1 heart sounds

Answer 7

closing of mitral and tricuspid valves; “lub”; beginning of systole

Question 8

S2 heart sounds

Answer 8

closing of aortic and pulmonic valves; “dub”; beginning diastole

Question 9

S3 heart sounds

Answer 9

occurs just after S2 as mitral vavle opens; considered normal in young athletes; in elderly generally diagnositic of CHF; “Kentucky”

Question 10

S4 heart sounds

Answer 10

Occurs just before S1; “Tennessee”; always pathological; RT sided diastolic heart failure; active ischemia

Question 11

an exaggerated fall in systolic BP and rate on inspiration; found w/ cardiac tamponade, acute asthma, COPD, pericarditis

Answer 11

Pulsus paradoxus

Question 12

Large volume, anemia, hepatic failure, Resp. failure (high CO2)

Answer 12

Bounding pulses

Question 13

best for higher pitched sounds like breath sounds and normal heart sounds; S1 & S2; Mitral regurgitation

Answer 13

stethoscope diaphragm (firm pressure)

Question 14

best for detecting lower pitched sounds like some heart murmurs and bowel sounds; S3 & S4; mitral stenosis

Answer 14

stethoscope bell (light pressure)

Question 15

incompetent valve leaflets; blood goes wrong way in a one way valve

Answer 15

regurgitation

Question 16

incompetent sclerotic valves; scar tissue/stiff; only allows blood to go one way, berudgingly

Answer 16

stenosis

Question 17

general physical wasting w/ loss of weight and muscle mass due to a disease

Answer 17

cachexia

Question 18

Beck’s Triad

Answer 18

1. distended neck veins
2. decreased or muffled heart sounds
3. decreased blood pressure or hypotension due to cardiac tamponade or pericarditis

Question 19

Corneal Arcus, aka “arcus senilis”

Answer 19

white, grey, or blue opaque ring around the iris; if present in elderly, assoc w/ hyperlipidemia; have an underlying cardiac issue

Question 20

clubbing

Answer 20

bulbous swelling of the ends of the fingers and toes; associated w/ cardio, pulmonary, and endocrine issues

Question 21

Causes of peripheral cyanosis

Answer 21

1. cold
2. obstruction (DVT, peripheral vascular disease)
3. LVF & shock (decreased cardiac output)

Question 22

Causes of central cyanosis

Answer 22

1. arterial blood desaturation/abnormal hemoglobin (polycythemia, altitude, lung disease, methemoglobinemia, sulfhemoglobinemia, shunt)

Question 23

murmur

Answer 23

a noise produced by turbulent flow of blood in the HEART

Question 24

What is the “timing” of heart sounds?

Answer 24

S4, S1, S2, S3 heart sounds

Question 25

cardiac tamponade

Answer 25

accumulation of fluid in the pericardial space, resulting in reduced ventricular filling b/c of decreased space;

Question 26

tamponade

Answer 26

tourniquet

Question 27

splinter hermorrhages

Answer 27

tiny blood clots running vertical under nail beds; commonly causes by sub-acute bacterial endocarditis (SBE)

Question 28

What are some causes of spinter hemorrhages

Answer 28

1. sub-acute bacterial endocarditis 2. trichinosis (round worms) 3. systemic lupus erythermatosus 4. Rheumatoid arthritis 5. Trauma

Question 29

pain caused by insufficient blood flow, usually during exercise

Answer 29

Claudication

Question 30

Janeway Lesions

Answer 30

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)

Question 31

Osler Nodes

Answer 31

Red-purple lumps, slightly raised, TENDER, typically found on fingers and/or toes; common cause: gonococcal infection

Question 32

Prinzmetal angina

Answer 32

aka: variant angina, typically happens at rest, but in cycles.

Question 33

common signs/symptoms of SBE

Answer 33

splinter hemorrhage, Janeway lesions,

Question 34

orthostatic hypotension #'s (take measurements in 3 min increments)

Answer 34

drop in systolic BP of 20 mmHg drop in diastolic pressure of 10 mmHg Pulse increase by 20 beats/minute

Question 35

orthopnea

Answer 35

SOB that occurs when lying flat

Question 36

Paroxysmal Nocturnal Dyspnea

Answer 36

severe SOB, esp. at night

Question 37

Ascites

Answer 37

Abnormal build-up of fluid in the abdomen

Question 38

If you are checking pulses and get a "regularly irregular" pulse, what underlying conditions could this be indicative of?

Answer 38

1. 2nd degree heart block 2. ventricular bigeminy 3. trigeminy 4. quardrigeminy

Question 39

If you are checking pulses and get a "irregularly irregular" pulse, what underlying condition could this be indicative of?

Answer 39

1. a-fib | 2. frequent ventricular ectopics

Question 40

When ascultating the apex, what valve are you listening to?

Answer 40

Mitral

Question 41

When asculatating the LSB, what valve are you listening to?

Answer 41

Tricuspid

Question 42

When ascultating the Pulmonic area, what valve are you listening to?

Answer 42

Pulmonic

Question 43

When ascultating the aortic area, what valve are you listening to?

Answer 43

Aortic

Question 44

FAT CLAM

Answer 44

conditions associated with an S3

Question 45

What does FAT CLAM stand for?

Answer 45

``` Fever, fetus Anemia Thyrotoxicosis Constrictive pericarditis Left ventricular failure Acute mocardial infarction Mitral or tricuspid regurgitation ```

Question 46

my "4-H CAPE"

Answer 46

conditions associated with an S4

Question 47

What does "4-H CAPE" stand for?

Answer 47

``` Hypertrophic cardiomyopathy Hypertensions Hyperthyroidism Heart blocks Certain anemias Acute myocardial infarction Pulmonic & aortic stenosis Elderly7877777m ```

Question 48

regurgitations

Answer 48

aortic insufficiency