Heart Flashcards
What is closed during systole?
M and T
What is closed during diastole?
A and P
What gives the S1 sound?
M and T closing
What gives S2 sound?
A and P closing
When is S3 heard?
during filling of ventricles (beginning)
When is s4 heard?
atrial contraction at end of diastole
What is the electrical pathway of the heart?
SA nodes –> AV node –> R and L bundle branches –> purkinje fibers
Where are baroreceptors that monitor blood pressure located?
aortic arch and carotid sinus
Where is the location of angina?
retrosternal, diffuse
What is the radiation of angina?
left arm, jaw and back
What is the description of angina?
aching, dull, pressing, squeezing
What is the intensity of angina?
mild to severe
what is the duration of angina?
minutes
What is angina preciptated by?
effort, emotion, eating, cold
How is angina relieved?
rest, nitroglycerin
What are characteristics of non angina?
location - left inframammary, localized radiation - right arm description - sharp, shooting, cuttin intensity - excruciating, duration - s , hr, days precipitated - resp, posture, motion relief - nonspecfic
Substernal; provoked by effort, emotion, eating; relieved by rest and/or nitroglycerin; often accompanied by diaphoresis, occasionally by nausea
Cardiac
Precipitated by breathing or coughing; usually described as sharp; present during respiration; absent when breath held
Pleural
Burning, substernal, occasional radiation to the shoulder; nocturnal occurrence, usually when lying flat; relief with food, antacids, sometimes nitroglycerin
Esophageal
Almost always infradiaphragmatic and epigastric; nocturnal occurrence and daytime attacks relieved by food; unrelated to activity
peptic ulcer
Usually under right scapula, prolonged in duration; often occurring after eating; will trigger angina more often than mimic it
biliary
Usually lasts for hours; local tenderness and/or pain with movement
arthritis/bursitis
Associated with injury; provoked by activity, persists after activity; painful on palpation and/or movement
Cervical
Intensified or provoked by movement, particularly twisting or costochondral bending; long-lasting; often associated with focal tenderness
MSK
Associated with/after anxiety; poorly described; located in intramammary region
emotional
What is pathognomonic for familial hypercholesterolema?
xanthomata - hard yellow mass over extensors
Where is PMI?
5th MC ICS
What is fine palpable rushing vibration?
thrill
What are unexpected findings on papitation?
heaves and lifts
Where is aortic?
R 2nd IC
Where is pulmonic?
L 2nd IC
Where is second pulmonic?
L 3rd IC
Where is tricuspid?
L 4th IC
Where is mitral?
5ICS - MCL
Where is base of heart?
2nd IC
What is the most posterior portion of the heart?
left ventricle
Where is normal S1 good to hear?
apex
Where is split S1 heard?
tricuspid
Where is S2 best heard?
A or P
Where is split S2 best heard?
P
What causes S1 to increase?
increase blood velocity or stenosis
When is S1 decreased?
HTN, disease MV, obscuration
When is S2 increased?
Systemic HTN, exercise, excitement
AV syphilis
Pulm HTN, MS, CHF
When is S2 decreased?
Hypotension Valve disease Aortic stenosis Pulmonic stenosis Obscuration
When do you hear S3?
kids, YA, last trimester of preg
When is s3 bad?
over 40
What does s3 sound like?
ken tuck y
What does S4 mean?
HTN, CAD, AS, CMP, pulm HTN, PV stenosis
inflammation of pericardial sac, roughens parietal and visceral surfaces. May overlie normal cardiac sounds, or be difficult to distinguish from murmur.
pericardial friction rub
congenital opening persists between aortal and pulmonary artery
Continuous murmur, loudest in late systole. Harsh, medium pitch.
patent ductus arteriosus
benign, from turbulence of blood in the jugular veins (common in children)
Continuous murmur w/o a silent interval; loudest in diastole. Humming, roaring, low pitch.
venous hum
What does ejection sound indicate?
CVD
What does a systolic click mean?
MV prolapse, more common in women
What are normal changes in the heart during pregnancy?
increased thickness and mass of left ventricle
When is apical impulse most visible?
upright
Where do you percuss for heart size?
anterior axillary line
What is the best way to listen to diastolic?
LLD
