Examination & Investigation Flashcards
What causes the a wave of JVP?
Atrial systole
What causes the c wave of JVP?
Closure of the tricuspid valve, not normally visible
What causes the x descent of JVP?
Fall in atrial pressure during ventricular systole
What causes the v wave of JVP?
Atrial filing against a closed tricuspid valve
What causes the y descent of JVP?
Opening of tricuspid valve
Janeway lesions
Non-tender, small erythematous or haemorrhagic macular or nodular lesions on the palms or soles only a few millimeters in diameter that are indicative of infective endocarditis
Osler’s nodes
painful, red, raised lesions found on the hands and feet. They are associated with a number of conditions, including infective endocarditis, and are caused by immune complex deposition.
Roths spots
Retinal haemorrhages with central white spots, associated with endocarditis.
Quincke’s sign
Alternate blanching and flushing of the nail bed, may be a sign of aortic valve insufficiency.
Elevated JVP with absent pulsation.
Dianosis?
Superior vena cava obstruction
Giant systolic ‘v’ waves.
Diagnosis?
Tricuspid regurgitation
Large ‘a’ waves and slow ‘y’ descent in JVP. Patient has ascites.
Diagnosis?
Tricuspid stenosis
Cannon ‘a’ waves
Complete heart block
Raised JVP that rises on inspiration
Constrictive pericarditis
How are premature ectopic beats felt by the patient?
Why are they felt like this?
A pause followed by a forceful beat
Because premature beats are usually followed by a pause before the next normal beat, as the heart resets itself. The next beat is more forceful as the heart has had a longer diastolic period and is therefore filled with more blood before this beat.
