CVS

Question 1

How to inspect JVP

Answer 1

1. prop up to 45 degree
2. turn left
3. shine light on area near calvicle for pulsation
4. inspect distension

Question 2

JVP inspection abnormal result

Answer 2

visible jucular vein, indicate right heart faliure

Question 3

JVP inspection normal result

Answer 3

non-visible jucular vein

Question 4

Carotid pulse palpation procedure

Answer 4

1. finger pad on to sternocleidomastoid on the neck
2. do not palpate both side at the same time

Question 5

Carotid pulse palpation normal result

Answer 5

equally strong pulsation on right & left arteries

Question 6

Carotid pulse palpation abnormal result

Answer 6

absent of pulse: may indicate cardiac arrest/ arteries diseases

Question 7

Carotid arteries auscultation procedure

Answer 7

1. use bell side of the stethoscope to ausculatate the carotid arteries
2. ask pt not to breathe for a moment

Question 8

Carotid arteries auscultation normal result

Answer 8

no swishing/ bruit/ blowing sound

Question 9

Carotid arteries auscultation abnormal result

Answer 9

bruit: may indicate narrowed arteries

Question 10

Apical impulse inspectoin abnormal result

Answer 10

other seen out area (other than 4th/ 5th intercostal space) may indicate left heart failure/ ventricle enlargement

Question 11

Apical impulse inspectoin normal result

Answer 11

impulse locate at 4th/ 5th intercostal space at midcalvicle line

Question 12

Apical impulse pulpation normal result

Answer 12

impulsation within fiftycent size, like a gentle tap

Question 13

Apical impulse pulpation abnormal result

Answer 13

forceful, more significant than a fifty cent size, or pulsation shft to 6th intercostal space or further: may indicate caridac enlarement

Question 14

Heaves & Thrills palpation normal result

Answer 14

no vibration is palpated

Question 15

Heaves & Thrills palpation abnormal result

Answer 15

thrills is palpated: may indicate valve stenosis

Question 16

When is perussion of pericardium needed

Answer 16

when evidence (CXR/ enchocardiogram) shows heart enlargement to see whether the heart is larger in size

Question 17

Abnormal result of the 6 points heart ausculatation

Answer 17

Diaphragm: high pitched S1 & S2 sound, indicate aortic murmurs/ mitral regurgitation
Bell: low-pitched S3 & S4 sound, indicate murmurs of mital stenosis

Question 18

Apical rate normal range & se which side of stethoscope

Answer 18

60-100 bpm, diaphragm

Question 19

5 steps of ECG interpretation

Answer 19

1. R wave
2. Heart Rate
3. R wave
4. PR interval
5. QRS interval

Question 20

ECG interpretation: normal R wave

Answer 20

regular

Question 21

ECG interpretation: normal Heart Rate

Answer 21

60-100bpm
(ie. 6beat/3 sec = 6*40/3)

Question 22

ECG interpretation: normal P wave

Answer 22

P:R ratio 1:1
rounded, regular, upright, alike, precede each QRS complex

Question 23

ECG interpretation: normal PR interal

Answer 23

0.12-0.2s, constant

Question 24

ECG interpretation: normal QRS interval

Answer 24

<0.2s, look alike, constant

Question 25

s/s of asystole

Answer 25

1. pupil dilation
2. no BP, peripheral pulse, heart sound
3. most serious form of cadiac arrest, usually irreversible
4. no tissue contraction from the heart muscle
5. electrical activity cessation
6. ununconscious
7. no blood flow to the rest of the body

Question 26

7 types of cardiac rhythm

Answer 26

1. Sinus rhythm
2. Sinus tachycardia
3. Sinus bradycardia
4. Atrial Fibrillation
5. Atrial Flutter
6. Ventricular Tachycardia
7. Ventricular Fibrillation

Question 27

Ventricular Fibrillation s/s & intervention

Answer 27

1. no caridac output, lead to pupil dilation, unconscious, cyanosis, repspiraotry arrest
2. no BP, heart sound, peripheral pulse
3. life threatening, need immediate intervention, early defibrillation

Question 28

s/s of ventricular tachycardia & intervention

Answer 28

rapid heart rate, angina, dyspnea, lighteadednesss, palpitation, may lead to cardiac arrest
need immediate resuscitation & defibrillation, no cardiac output & unstable pulse