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Clin Med 3 > Heart - Lab > Flashcards

Heart - Lab Flashcards

1
Q

When assessing arteries, which part of the stethoscope should be used? Diaphragm or bell?

A

bell

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2
Q

What are some pathological conditions that can be detected by inspection and palpation of the heart?

A

cardiac or ventricular hypertrophy, murmurs, and congestive heart failure

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3
Q

In most patients, the apical impulse will correspond with what?

A

the palpated point of maximal impulse (PMI)

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4
Q

What are heaves?

A

unexpectedly vigorous cardiac impulses

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5
Q

What are thrills caused by?

A

they are fine vibrations caused by underlying turbulence

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6
Q

Where will you find the apical impulse?

A

visible in most adults around the midclavicular line in the 4th or 5th intercostal space

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7
Q

Describe the technique used to palpate the apical impulse

A

place hand in the expected area of the apical impulse, ask patient to exhale and hold while they lean forward to bring the apex closer to the chest wall

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8
Q

The apical impulse is displaced laterally to midclavicular line, what could this be indicative of?

A

left ventricular hypertrophy

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9
Q

Increased amplitude of the apical impulse could be result from…

A

hyperthyroidism, severe anemia, pressure overload of the left ventricle (aortic stenosis) or volume overload of the left ventricle (mitral regurgitation)

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10
Q

Enlarged right ventricle, dilated pulmonary artery, or an aneurysm of the aorta can cause…

A

PMI to be located somewhere other than the apical impulse

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11
Q

If right ventricular hypertrophy is suspected, where will the heave be located?

A

along the left sternal border

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12
Q

If left ventricular hypertrophy is suspected, where will the heave be located?

A

apex

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13
Q

What are the 5 designated areas of auscultation for the heart?

A

1) aortic
2) pulmonic
3) tricuspid
4) mitral
5) Erb’s point

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14
Q

Name this location of auscultation:

3rd intercostal space at the left sternal border

A

Erb’s point ( aortic and pulmonic sounds)

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15
Q

Name this location of auscultation:

5th left intercostal space at the midclavicular line

A

mitral

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16
Q

Name this location of auscultation:

2nd right intercostal space at the right sternal border

A

aortic

17
Q

Name this location of auscultation:

2nd left intercostal space at the left sternal border

A

pulmonic

18
Q

Name this location of auscultation:

4th left intercostal space at the left lower sternal border

A

tricuspid

19
Q

What are the 4 characteristics of heart sounds?

A

1) rate
2) rhythm
3) intensity
4) splitting

20
Q

What do you assess when listening to the heart?

A

character of the heart sounds (rate, rhythm, intensity, splitting)
presence or absence and quality of S1, S2, S3, and S4 sounds
presence or absence and quality of murmurs, rubs or clicks

21
Q

How should the patient be positioned in order to listen to high-pitched murmurs? What part of the stethoscope should be used?

A

seated, leaning slightly forward

diaphragm

22
Q

How should the patient be positioned in order to listen to low pitch filling sounds in diastole? What part of the stethoscope should be used?

A

left lateral recumbent

bell

23
Q

Which of 4 S sounds are normal?

A

S1 and S2

24
Q

Is splitting of S1 and S2 normal?

A

It can be a false positive, physiological splitting of S2 during inspiration is normal and particularly common in younger patients

25
Q

Is this a normal heart sound: variations to the spacing and intensity of S1 and S2?

A

no, this is not normal

26
Q

Ejection clicks and opening snaps are normal or abnormal heart sounds?

A

abnormal

27
Q

How should murmurs be documented?

A 
cardiac cycle
duration
pitch
intensity
quality
pattern
location where it is loudest 
does it radiate 
change during respiration
28
Q

Grade this murmur:

very loud, with thrill. may be heard when the stethoscope is partly off the chest

A

Grade V

29
Q

Grade this murmur:

very faint, heard only after listener has “tuned in”; may not be heard in all positions

A

Grade I

30
Q

Grade this murmur:

moderately loud

A

Grade III

31
Q

Grade this murmur:

quiet, but hear immediately after placing the stethoscope on the chest

A

Grade II

32
Q

Grade this murmur:

loud, with palpable thrill

A

Grade IV

33
Q

Grade this murmur:

very loud, with thrill. may be heard with stethoscope entirely off the chest

A

Grade VI

34
Q

Are all systolic murmurs pathologic?

A

no, murmurs found in the 2nd to 4th left intercostal spaces between the left sternal border and the apex during systole are very common in children and young adults
***ALL diastolic murmurs are pathologic!!

Clin Med 3 (11 decks)

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