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T3 - IPES unit 2 > Heart > Flashcards

Heart Flashcards

1
Q

6 procedures in the physical exam of the heart

A 
heart rate/pulse
BP
chest inspection
heart percussion
heart palpation
heart auscultation
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2
Q

7 complaints leading to a heart exam

A
  • chest pain
  • symptoms extending fromt he left jaw/arm
  • “strange” sensation in chest/palpation
  • shortness of breath, orthopnea, dyspnea
  • VBI symptoms
  • swelling of extremities or abdomen
  • unexplained mid-back pain
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3
Q

VBI

A

vertebral-basilar insufficiency

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4
Q

abdominal obesity defining level

  • men: >___cm (__in)
  • female: >____cm (___in)
A

102; 40

88; 35

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5
Q

BMI: ___ you are the more its inaccurate

A

shorter

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6
Q

carotid pulse

  • inspect __ to SCM
  • palpate for ___, ___ or ___
  • avoid ___ ___
A

medial
amplitude, contour, thrills
carotid sinus

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7
Q

___: humming vibrations like a purring cat

A

thrills

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8
Q

____: hear this if an artery is 50% or more occluded

A

bruit

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9
Q

right ventricle occupies most of ___ cardiac surface; ___ and to the ___ of the sternum

A

anterior
behind
left

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10
Q

cardiac ____ is at the 2nd intercostal spaces parasternally left and right, where the right ventricle meets the pulmonary artery

A

base

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11
Q

left ventricle is located behind the right ___and extends ____ to the left, forming the left lateral border of the heart

A

ventricle

inferiorly

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12
Q

apex located….

A

5/6 intercostal space on the left at the midclavicular line

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13
Q

right ____ comprises the right lateral border

A

atrium

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14
Q

left ___ lays ont he posterior aspect of the heart

A

atrium

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15
Q

point of maximal impulse (PMI) aka ___ __

A

apical impulse

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16
Q

PMI produced by the ___ ___

A

cardiac apex

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17
Q

PMI normally __-__cm lateral to sternum at ___ ICS at the ___ line

A

7-9
5th
midclavicular

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18
Q

PMI is usually __-___ cm wide

A

1-2.5

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19
Q

____ heart: diameter increases, location displaces laterally

A

hypertrophic

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20
Q

right ventricular hypertrophy may create a dominant impulse at ___/___ area

A

xyphoid/epigastric

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21
Q

2 atrioventricular valves

A

mitral on the left

tricuspid on the right

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22
Q

2 semilunar valves

A

aortic (R)

pulmonic (L)

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23
Q

positive findings for heart palpation

A

heaves
thrills
lifts

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24
Q

indications for heart palpation

A

valvular stenosis
regurgitation
CHF

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25
Q

rumbling murmur during palpation indications

A

aortic stenosis
ventricular septal defect
mitral stenosis

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26
Q

S1 and S2 heard at ectopic and epigastric areas indicitive of…

A

cardiomegaly

thin/frail human bc of descending aorta

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27
Q

auscultation

  • patient is ____ or at ___ degrees
  • patient ___ or ___ __ when needed
A

supine; 30

seated; side-lying

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28
Q

diaphragm of steth is for ___ pitched sounds

A

high

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29
Q

bell of steth is for ___ pitched sound

A

low

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30
Q

S1 and S2 are ___ pitched sounds

A

high

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31
Q

S3 and S4 are __ pitched sounds

A

low

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32
Q

if you have hypertrophic/ cardiomegaly, have to have patient do ____ ____ to elicit a murmur

A

valsalva’s manuever

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33
Q

___ ___ ___: brings left ventricle close to the chest; may accentuate S3, S4 and mitral murmurs

A

left lateral decubitus

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34
Q

patient seated and leaned forward, accentuates ___ murmurs

A

aortic

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35
Q

5 auscultatory points

A 
aortic
pulmonic
Erb's
tricuspid
mitral
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36
Q

2 parts to cardiac cycle

A

systole

diastole

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37
Q

___ - ventricular contraction

A

systole

38
Q

___ - ventricular relaxation

A

diastole

39
Q

___: pressure rises from 5-120mmHg

A

systole

40
Q

systole : following ejection into aorta, pressure ___

A

falls

41
Q

diastole: pressure declines and blood flows from ___ to ___

A

atrium

ventricle

42
Q

systole

  • aortic valve ___
  • mitral valve ___
  • pulmonic valve ___
  • tricuspid valve ____
A

open
closed
open
closed

43
Q

diastole

  • aortic valve ___
  • mitral valve ___
  • pulmonic valve ___
  • tricuspid valve ____
A

closed
open
closed
open

44
Q

S1 composed of 2 valves

A

mitral

tricuspid

45
Q

S2 composed of 2 valves

A

aortic

pulmonary

46
Q

split S2…

A

aortic and pulmonic are not synchronized

47
Q

__: mitral valve prolapse

A

clicks

48
Q

___ attributed to turbulent blood flow

A

murmurs

49
Q

murmurs may be ___ or indicative of ___ heart disease

A

innovent

valvular

50
Q

mitral valve located at the cadiac ___

A

ape

51
Q

tricuspid valve located at lower ___ sternal border

A

left

52
Q

pulmnic valve located at __/__ ICS at the ___ parasternal border

A

2/3

left

53
Q

aortic valve located at __/__ ICS at the ___ parasternal border

A

2/3

right

54
Q

___ ____: muscle is stretched and thin; doesnt pump as well

A

dilated cardiomyopathy

55
Q

____ murmur usually involves the aortic and pulmonic valves (semilunar)

A

midsystole

56
Q

____ murmurs typically represent regurgitant AV valves

A

pansystolic

57
Q

___ ____ murmurs indicate mitral valve prolapse

A

late systolic

58
Q

disastolic murmurs are always ___

A

abnormal

59
Q

___ ___ murmur suggest regurgitant semilunar vales

A

early diastolic

60
Q

____ murmur suggests turbulant flow across AV valves

A

middiastolic

61
Q

___ ____/___-___ murmur has systolic and diastolic compnents, consider pericadial friction rub or venous hum

A

late diastolic/pre-systolic

62
Q

S1 (lub) marks the beginning of ___ and loudest at the ___

A

systole

apex

63
Q

S2 (dub) marks the end of ___ and loudest at the ___

A

systole

base

64
Q

ejection clicks are most common early ___ sound

A

systolic

65
Q

ejection clicks results from abrupt halting of ___ valves

A

semilunar

66
Q

____ ejection click: loud high frequency sound, associated with murmur due to sam etiology; does not vary with respiration

A

aortic

67
Q

aortic ejection click best hear at the ___ valve with the ___ of the steth

A

aortic

diaphragm

68
Q

potential causes of aortic ejection click

A

aortic stenosis
bicuspid aortic valves
dilated aortic root

69
Q

___ ejection click: early systolic ejection sound with associated murmur; diminishes with inspiration

A

pulmonic

70
Q

location of pulmonic ejection click

A

2/3 ICS at edge of sternum

71
Q

potential causes of pulmonic ejection clicks

A

pulmonic stenosis
pulmonary hypertension
dilated pulmonary trunk

72
Q

___ ___: high frequency early diastolic sound associated with mitral stenosis

A

opening snap

73
Q

___ ___: sound occurs due to abrupt deceleration of mitral leaflets; associate murmur; diminishes with inspiration

A

opening snap

74
Q

opening snap located between cardiac ___ and ___ lower sternal border

A

apex

left

75
Q

cadence of opening snap

A

S1
S2
opening snap
murmur of mitral stenosis

76
Q

S3 heart sound is ___ frequency sound in early ____

A

low

diastole

77
Q

causes of S3 heart sound

A

increased atrial pressure - congestive heart failure

dilated cardiomyopathy

78
Q

S3 heart sound may be normal in patients less than ___

A

40

79
Q

S4 heart sound is a ___ frequency sound in ___ portion of diastole

A

low

presystolic

80
Q

causes of S4 heart sound

A

stiffened left ventricle

81
Q

chest pain due to 4 things

A

coronary heart disease
angina pectoris
myocardial infarction
dissecting aortic aneurysm

82
Q

stable angina

- pain on ___

A

exertion

83
Q

unstable angina

- pain during ____

A

everything

84
Q

myocardial infarction

- death of ___ ____

A

cardiac muscle

85
Q

___: unpleasant awareness of ones own heartbeat

A

palpitations

86
Q

___: irregular beat, rapid acceleration or deceleration, increased force of contraction, anxiety

A

palpitations

87
Q

___: uncomfortable awareness of breathing that is inappropriate for level of exertion

A

dyspnea

88
Q

___ - dyspnea when lying down which improves when seated

A

orthopnea

89
Q

___ ____ ___: episodes of sudden dyspnea/orthopnea that awaken patient

A

paroxysmal nocturnal dyspnea

90
Q

pericarditis can be due to ___ ___

A

syphilitic aortitis

T3 - IPES unit 2 (2 decks)

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