Heart and Blood Vessels

Question 1

Aortic Valve chest location

Answer 1

2nd right intercostal space at right sternal border

Question 2

Pulmonic Valve chest location

Answer 2

2nd left intercostal space at left sternal border

Question 3

ERBS point chest location

Answer 3

3rd left intercostal space at left sternal border

Question 4

Tricuspid Valve chest location

Answer 4

4th left intercostal space at left sternal border

Question 5

Mitral Valve chest location

Answer 5

5th left intercostal space at midclavicular line, also apical

Question 6

Which valves are open during systole

Answer 6

aortic and pulmonic (APOS)

Question 7

Which valves are closed during systole

Answer 7

mitral and tricuspid (MTCS)

Question 8

What valves are open during diastole

Answer 8

mitral and tricuspid

Question 9

What valves are closed during disatole

Answer 9

aortic and pulmonic

Question 10

Systole

Answer 10

When the ventricles contract and blood is ejected

Question 11

S1

Answer 11

Beginning of systole (closure of mitral and tricuspid)

Question 12

S2

Answer 12

Beginning of diastole (closure of aortic and pulmonic)

Question 13

S3

Answer 13

Gallop (ken-tuck-ee)

Commonly in HF

Question 14

S4

Answer 14

Ten-ess-ee

Commonly pathologic

Question 15

S3 and S4 in children

Answer 15

• Common in children and benign
• Murmurs common in children up to age 7-8
• Pathologic if adults

Question 16

Holostolic murmurs in children

Answer 16

• Likely structural/pathologic

- Doesn’t disappear with position change

Question 17

Common benign murmurs in children

Answer 17

STLL Murmurs

• May be heard when child lays down and absent/disappear when sitting/standing
• Always good idea to assess heart when in a lying/sitting position (with both peds and adults)

Question 18

PMI

Answer 18

• Left 5th intercostal space at midclavicular line

Question 19

If PMI is shifted to ___ it indicates ____.

Answer 19

If PMI is shifted to LEFT it indicates CARDIOMYOPATHY

Question 20

PMI heaves and thrills???

Answer 20

Look at slide 10

Question 21

HFrEF

Answer 21

EF < 40%
Systolic (left)
Lack of pumping in heart

-BLE edema, rales, orthopnea, fluid overload, S3

Question 22

HFpEF

Answer 22

EF preserved
Diastolic (right)
Overworked ventricle: COPD, HTN, CAD

-abdominal bloating

Question 23

Child with coarc signs

Answer 23

radial and femoral pulses will be delayed

Question 24

PAD

Answer 24

claudication, muscle fatigue/cramps, dull ache, usually on exertion

Question 25

PVD

Answer 25

swelling, tenderness over muscles, engorgement of superficial veins, erythema or cyanosis

Question 26

normal heart sounds are best heard over the areas where the blood passes through a valve. If you hear a murmur over the apex during systole when the ventricle contracts it is most likely

Answer 26

mitral valve regurg

Question 27

a pateitn is admitted HFrEF (formerly known as systolic heart failure) The examiner would expect to find

Answer 27

BLE edema

Rales

Question 28

During systole/contraction of the ventricles, which valves are shut

Answer 28

mitral and tricuspid valves are shut

Question 29

the term claudication refers to

Answer 29

ischemia of the muscle

Question 30

at what angle should the patient be to measure JVD

Answer 30

30-45 degrees and normal is less than 9

Question 31

which nodes are most often associated with inflammation

Answer 31

tender nodes

Question 32

the practitioner is going to assess the heart’s PMI how is this assessed

Answer 32

fifth intercostal space at the midclavicular line

Question 33

endocarditis is a bacterial infection of the endothelial layer of the heart/valves usually seen in congenital valve disorder in persons using IV drugs. This condition can be life-threatening. S/s of endocarditis are:

Answer 33

Fever, murmur, sudden onset of HF

Question 34

some murmurs are innocent. in children ages 3-7 a grade 1 or 2 may be present. What is this type of murmur called:

Answer 34

STILL murmur

Question 35

In children with coarc of aorta should be suspected if

Answer 35

radial and femoral pulses are delayed