Gen Med: Lecture 7- Cardiovascular Assessment Flashcards
What is the equation for MAP?
CO x TPR
What is normal value for MAP?
70-110 mmHg
What is normal for pulse pressure?
40 mmHg
What are normal BP values for the Pulmonary Artery?
15-30 mmHg Systolic
5-15 mmHg Diastolic
What are normal BP values for Cantral Venous Pressure?
0-8 mmHg
What are normal BP values for Right Atrial Pressure?
0-8 mmHg
What are normal BP values for Pulmonary Capillary Wedge Pressure?
4-15 mmHg
What BP is considered a hypertensive crisis?
Systolic greater than 180
-or-
Diastolic greater than 120
Why is hypertension dangerous?
Creates pressure overload on left ventricle causing left ventricular hypertrophy
What is an aneurysm?
Stretching of vessel wall to 150% normal
What causes an aneurysm?
Weakening of the vessel wall
What increases risk of an aneurysm?
Hypertension
Atherosclerosis
Smoking
Family history
Male
Age
How are aneurysms named?
Location, size, and appearance
Can aneurysms be asymptomatic?
Yes, often are
What are some symptoms of aneurysms?
Persistent vague pain
Pulsating mass
Bruits
Claudication
Numbness in distal tissues
Poor distal pulses
Excessive fatigue
What can an aneurysm lead to?
Thrombosis
Dissection
Rupture
What exercises should be done in patients with an aneurysm?
Moderate to low intensity aerobic
Low resistance strengthening
What exercise intervention should be completely avoided in cerebral aneurysms?
Strengthening
How does size of aneurysm affect exercise?
Increased size of aneurysm= decreased exercise
What usually happens to aneurysms over time?
Usually progress
When should aneurysms be surgically repaired?
When they are greater then 5 cm
What are some PT consideration post aneurysm repair?
Possible ROM restrictions
WB restrictions
Lifting restrictions
BP restrictions
Abdominal incision affects coughing
What is characterized as orthostatic hypotension?
Drop in systolic BP by 20 mmHg or diastolic by 10 mmHg within 3 minutes of standing
What causes orthostatic hypotension?
Pooling of blood in LE
What causes blood to pool in LE leading to orthostatic hypotension?
Conditions that decrease vascular volume
Impaired muscle pump
Impaired cardiovascular reflexes
What would indicate a volume depletion related orthostatic hypotension?
Fall in BP with increase in HR
What would indicate a baroreflex impairment related orthostatic hypotension?
Fall in BP with less than 10 bpm increase in HR
What are some exercises that help with orthostatic hypotension?
Ankle pumps
UE/LE ROM
Diaphragmatic breathing
Crossing legs
What can be given to a patient to help with orthostatic hypotension?
Elastic stockings
Abdominal binders
What medications are used to treat PAD?
Antithrombotic
Lipid control (Statins)
BP control
Vasodilators
What procedures are used as endovascular management of PAD?
Endarterectomy
Bypass surgery
Angioplasty
Stent
When is endovascular management indicated for PAD?
Ischemic rest pain
Tissue death
Pain interferes with ADLs/Work
What are Peripheral Vascular Bypass grafts made of?
Saphenous vein
Synthetic material
What creates the S1 heart sound?
Closing of AV valves
Where is S1 heart sound the loudest?
At apex
What creates the S2 heart sound?
Closing of semilunar valves
Where is the S2 heart sound the loudest?
Near base
How does the time between S1 to S2 differ from S2 to S1?
S1 to S2 is shorter
Where do you place the stethoscope to listen to the Aortic area?
Right second intercostal space, just lateral to sternum
Where do you place the stethoscope to listen to the pulmonary area?
Left second intercostal, just lateral to the sternum
Where do you place the stethoscope to listen to the tricuspid area?
Inferior left sternal margin
Where do you place the stethoscope to listen to the mitral area?
Left 5th intercostal space
Where is the apex beat located?
Mitral area
Left 5th intercostal space
What does S3 heart sound indicate?
Early ventricular filling
When does S3 heart sound occur?
Early in diastole
Who is an S3 heart sound normal in?
Children and young adults
Who is an S3 heart sound abnormal in?
People over 40
What conditions is an S3 heart sound a classic sign of?
CHF
What is an S4 heart sound associated with?
Resistance to ventricular filling
When does an S4 heart sound occur?
Late in diastole, immediately before S1
What are possible causes of an S4 heart sound?
Hypertension
Coronary Artery Disease
Myocardial Infarction
Pulmonary Disease
CABG
What causes murmurs?
Vibrations from turbulent airflow
Commonly due to regurgitation or stenosis
How are murmurs described?
Based on position in cardiac cycle
What is valvular stenosis?
Valve narrowing, unable to fully open
What is valvular insufficiency?
Valves do not close properly and allow regurgitation
What causes a pericardial friction rub?
Pericardial inflammation
What is a pericardial friction rub?
An irregular, creaky, scratchy noise
When are vesicular lung sounds primarily heard?
During inspiration
What do vesicular lung sounds sound like?
Soft, low pitched
What do crackles sound like when auscultating the lungs?
Discontinuous sounds, similar to brief bursts of popping bubbles
What causes crackles when auscultating the lungs?
Sudden opening of closed airways
Movement of secretions
When are crackles typically heard while auscultating?
Inspiration
What do wheezes sound like when auscultating?
Continuous sounds, high or low pitched
What causes wheezes during auscultation?
Airway obstruction caused by mucus, spasm, or foreign body
When are wheezes typically heard during auscultation?
Expiration
What causes pleural rub when auscultating?
Friction between viscera and parietal pleura (Pluerisy)
When is pleural rub heard during auscultation?
Inspiration and expiration
What does pleural rub sound like?
2 balloons rubbing against each other
What equation is used to measure Myocardial oxygen consumption?
RPP= HR x SBP
