Heart

Question 1

What is closed during systole?

Answer 1

M and T

Question 2

What is closed during diastole?

Answer 2

A and P

Question 3

What gives the S1 sound?

Answer 3

M and T closing

Question 4

What gives S2 sound?

Answer 4

A and P closing

Question 5

When is S3 heard?

Answer 5

during filling of ventricles (beginning)

Question 6

When is s4 heard?

Answer 6

atrial contraction at end of diastole

Question 7

What is the electrical pathway of the heart?

Answer 7

SA nodes –> AV node –> R and L bundle branches –> purkinje fibers

Question 8

Where are baroreceptors that monitor blood pressure located?

Answer 8

aortic arch and carotid sinus

Question 9

Where is the location of angina?

Answer 9

retrosternal, diffuse

Question 10

What is the radiation of angina?

Answer 10

left arm, jaw and back

Question 11

What is the description of angina?

Answer 11

aching, dull, pressing, squeezing

Question 12

What is the intensity of angina?

Answer 12

mild to severe

Question 13

what is the duration of angina?

Answer 13

minutes

Question 14

What is angina preciptated by?

Answer 14

effort, emotion, eating, cold

Question 15

How is angina relieved?

Answer 15

rest, nitroglycerin

Question 16

What are characteristics of non angina?

Answer 16

location - left inframammary, localized
radiation - right arm
description - sharp, shooting, cuttin
intensity - excruciating,
duration - s , hr, days
precipitated - resp, posture, motion
relief - nonspecfic

Question 17

Substernal; provoked by effort, emotion, eating; relieved by rest and/or nitroglycerin; often accompanied by diaphoresis, occasionally by nausea

Answer 17

Cardiac

Question 18

Precipitated by breathing or coughing; usually described as sharp; present during respiration; absent when breath held

Answer 18

Pleural

Question 19

Burning, substernal, occasional radiation to the shoulder; nocturnal occurrence, usually when lying flat; relief with food, antacids, sometimes nitroglycerin

Answer 19

Esophageal

Question 20

Almost always infradiaphragmatic and epigastric; nocturnal occurrence and daytime attacks relieved by food; unrelated to activity

Answer 20

peptic ulcer

Question 21

Usually under right scapula, prolonged in duration; often occurring after eating; will trigger angina more often than mimic it

Answer 21

biliary

Question 22

Usually lasts for hours; local tenderness and/or pain with movement

Answer 22

arthritis/bursitis

Question 23

Associated with injury; provoked by activity, persists after activity; painful on palpation and/or movement

Answer 23

Cervical

Question 24

Intensified or provoked by movement, particularly twisting or costochondral bending; long-lasting; often associated with focal tenderness

Answer 24

MSK

Question 25

Associated with/after anxiety; poorly described; located in intramammary region

Answer 25

emotional

Question 26

What is pathognomonic for familial hypercholesterolema?

Answer 26

xanthomata - hard yellow mass over extensors

Question 27

Where is PMI?

Answer 27

5th MC ICS

Question 28

What is fine palpable rushing vibration?

Answer 28

thrill

Question 29

What are unexpected findings on papitation?

Answer 29

heaves and lifts

Question 30

Where is aortic?

Answer 30

R 2nd IC

Question 31

Where is pulmonic?

Answer 31

L 2nd IC

Question 32

Where is second pulmonic?

Answer 32

L 3rd IC

Question 33

Where is tricuspid?

Answer 33

L 4th IC

Question 34

Where is mitral?

Answer 34

5ICS - MCL

Question 35

Where is base of heart?

Answer 35

2nd IC

Question 36

What is the most posterior portion of the heart?

Answer 36

left ventricle

Question 37

Where is normal S1 good to hear?

Answer 37

apex

Question 38

Where is split S1 heard?

Answer 38

tricuspid

Question 39

Where is S2 best heard?

Answer 39

A or P

Question 40

Where is split S2 best heard?

Answer 40

P

Question 41

What causes S1 to increase?

Answer 41

increase blood velocity or stenosis

Question 42

When is S1 decreased?

Answer 42

HTN, disease MV, obscuration

Question 43

When is S2 increased?

Answer 43

Systemic HTN, exercise, excitement AV syphilis Pulm HTN, MS, CHF

Question 44

When is S2 decreased?

Answer 44

``` Hypotension Valve disease Aortic stenosis Pulmonic stenosis Obscuration ```

Question 45

When do you hear S3?

Answer 45

kids, YA, last trimester of preg

Question 46

When is s3 bad?

Answer 46

over 40

Question 47

What does s3 sound like?

Answer 47

ken tuck y

Question 48

What does S4 mean?

Answer 48

HTN, CAD, AS, CMP, pulm HTN, PV stenosis

Question 49

inflammation of pericardial sac, roughens parietal and visceral surfaces. May overlie normal cardiac sounds, or be difficult to distinguish from murmur.

Answer 49

pericardial friction rub

Question 50

congenital opening persists between aortal and pulmonary artery Continuous murmur, loudest in late systole. Harsh, medium pitch.

Answer 50

patent ductus arteriosus

Question 51

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.

Answer 51

venous hum

Question 52

What does ejection sound indicate?

Answer 52

CVD

Question 53

What does a systolic click mean?

Answer 53

MV prolapse, more common in women

Question 54

What are normal changes in the heart during pregnancy?

Answer 54

increased thickness and mass of left ventricle

Question 55

When is apical impulse most visible?

Answer 55

upright

Question 56

Where do you percuss for heart size?

Answer 56

anterior axillary line

Question 57

What is the best way to listen to diastolic?

Answer 57

LLD