Heart Flashcards
How do you grade a murmur
1 very faint
2 quiet but heard with stethoscope
3 moderately loud
4 loud with palpable trhill
5 very loud with thrill, may be heard with stethoscope partially off chest
6 very loud with thrill, heard with stethoscope entirely off chest
which structure do you obtain the best jugular venous pressure
the right internal jug vein
what does the jugular venous pressure reflect
rigth atrial pressure
Describe the internal jugular vein pulse
biphasic, 2 troughs per heart beat
if your patient is hypervolemic how would you have them positioned for JVP?
hypovolemic?
hyper: raise table
hypo: lower table
how do you measure JVP
highest point of oscillation and ruler from sternal angle + 5cm for area from RA to sternal angle
What is an abnormal JVP
anything above 9 cm
What can cause and increased JVP
right CHF
tricuspid stenosis, superior vena cava obstruction
When does the a wave of jugular pressure occur in cardiac cycle
just before S1
a prominent a wave in the jugular pulsations indicates what
increased R to RA contraction so probably tricuspid stenosis or a 1st degree AV block
an absent a wave in jugular pulsations is most likely what
atrial fibrillation
large v waves in jugular pulsations indicate what
tricuspid regurgitation
to best hear low pitched sounds like S3 S4 bruits what part of the stethoscope do you use
bell and lightly on skin
where do you assess for carotid bruits
bell over carotid artery
What is a Still’s murmur
Mid-systolic, best left lower sternal border
musical quality
louder in supine position
innocent
