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Year 2 Cardiovascular > Harvey > Flashcards

Harvey Flashcards

1
Q

what generates heart sounds?

A

blood velocity changes / valve closure

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2
Q

what are the good and bad causes of a split heart sound?

A

good - larger volume

bad - slower contraction speed

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3
Q

S3 - when, sound, why

A

when - early-mid diastolic
sound - groaning
why - ventricular wall noise from resistance to filling

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4
Q

S4 - when, why

A

when - late diastolic, end of ventricular filling

why - ventricular wall resistance to atrial kick

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5
Q

what are the best ways to hear S3 and S4?

A

apex with the bell in left lateral recumbent position

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6
Q

RA pressure

A

0 - 5 mm Hg

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7
Q

RV pressure

A

30 / 5

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8
Q

pulmonary mean pressure

A

20

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9
Q

the pulmonary wedge pressure is equal to the pressure in what chamber? what is the pcwp?

A

LA

15

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10
Q

LV pressure

A

120/10

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11
Q

what is the order of naming convention for heart murmurs?

A

grade - cycle - intensity - radiation

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12
Q

what are the left sided systolic murmurs?

A

aortic stenosis
mitral regurgitation
hypertrophic cardiomyopathy

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13
Q

what are the right sided systolic murmurs?

A

pulmonic stenosis

tricuspid regurgitation

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14
Q

what are the causes of aortic stenosis?

A 
age, calcification 
congenital disease (bicuspid valve) 
infective endocarditis
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15
Q

is aortic stenosis a left-sided or right-sided murmur? is it systolic or diastolic?

A

left sided

systolic

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16
Q

what is the cause of hypertrophic cardiomyopathy?

A

left ventricular outflow tract obstruction

17
Q

is aortic regurg a left-sided or right-sided murmur? is it systolic or diastolic?

A

left sided

diastolic

18
Q

what are the causes of aortic regurg?

A

endocarditis
root dilation
congenital (bicuspid valve)
CT disorder

19
Q

is mitral stenosis a left-sided or right-sided murmur? is it systolic or diastolic?

A

left sided

diastolic

20
Q

where does mitral stenosis radiate?

A

precordial area

21
Q

what are the causes of mitral stenosis?

A

infectious endocarditis

calcific changes

22
Q

does mitral regurg permit backward flow during systole or diastole?

A

systole

23
Q

what are the causes of mitral regurg?

A 
MVP from myxomatous degeneration 
endocarditis, rheumatic fever 
CT disease 
MI with papillary rupture 
pulmonary HTN
24
Q

when is MV prolapse heard?

A

late systole

25
Q

what is an austin flint murmur?

A

severe aortic regurgitation

26
Q

is an austin flint murmur systolic or diastolic? where is it best heard?

A

mid-diastolic or pre-systolic

apex

27
Q

what does an austin flint murmur sound like?

A

low pitched rumbling

28
Q

what is the direction of flow in an austin flint murmur?

A

mixing of antegrade mitral valve blood and regurgitant blood from the aorta

29
Q

what does a pericardial friction rub sound like? how is it heard best?

A

cabasa

leaning forward and exhaling

30
Q

which condition is heard better upon doing a valsalva maneuver?

A

HCM

31
Q

what does the hand squeeze do? which murmurs increase when doing a hand squeeze?

A

increases systolic gradient and intraventricular pressures

AR, MR, TR, VSD

32
Q

what is the effect of hand squeezing on aortic stenosis?

A

decrease in intensity

33
Q

what is the effect of hand squeezing on HCM?

A

decrease in intensity

34
Q

the hand grip maneuver will decrease murmur intensity in what conditions?

A

aortic stenosis
HCM
mitral valve prolapse

35
Q

the hand grip maneuver will increase murmur intensity in what conditions?

A

aortic regurg
mitral regurg
VSD

36
Q

what is the effect of valsalva on blood return?

A

reduces return and LV volume

37
Q

what is the effect of valsalva on stenoses?

A

increase

38
Q

where / how is MR augmentation heard best?

A

left lateral recumbent

39
Q

where / how is AS augmentation heard best?

A

reverse semi-fowler’s in exhalation (lean forward and exhale)

Year 2 Cardiovascular (43 decks)

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