INT MED II Flashcards
Methods of cardiac examination
- Xray!
- ECG!
- Echocardiography!
- Blood pressure measurement!
- Blood test!(ANP, BNP, troponin, endothelin)
- Phonocardiography!
- Nonselective angiocardiography!
- Cardiac catheterization!
- Radionuclide imaging!
- Serology!
- CT,
- MRI!
Indications of the ECG
- Arrhythmia!
- Cardiac!enlargement!
- Anesthesia!/surgery!
- Prescription and evaluation of therapy
- Systemic diseases!
- Myocardial damage!
What is FRIDA?
- Frequency (heart rate) = pulse rate
- Rhythm!
- Intensity (strength)
- Demarcation (distinctness)
- Adventitious sounds (mumurs)
Description of the thorax
- Symmetry
- Shape
- Pain!
Grades of murmurs
- Very soft
- Soft
- Moderate intensity
- Loud
- Very loud
- Loudest
Which animal has relative/absolute dullness
Absolute: horse, dog
Relative: Cattle, small Ru, Su, Cat
Which species has respiratory arrhythmia
?
When does the heart rate increase? Which nerve is responsible?
Vagus, during inspiration!
Inspection of the cardiac region
Abnormalities of the thorax (injury, malformation)
Heart beat
What can decrease the heart rate?
Cardiac insufficiency
Pericardial fluid
Peripleural fluid
Thickened chest wall
What can increase the heart rate
Exercise
Cardiac hypertrophy!
Dislocation!
Reasons for enlargements of cardiac dullness
- Dilation, hypertrophy!
- Dislocation!
- Pericardial effusion!
- False enlargement (neighboring organs, friction on auscultation)!
Reasons for decreasing dullness
- Lung emphysema!
- Skin emphysema!
- Pneumothorax!
- Cardiac dislocation!
What are the 4 always of murmurs?
- Pitch!
- Intensity!
- Relation to cardiac cycle!
- Location!
Causes of endocardial murmurs!
Morphological: valve deformities, septal or vessel deformation
Functional: anemia, innocent!
Indications of blood pressure measurements
- Reveal secondary hypertension in case of known predisposition factors!
- Find the cause of ocular, cardiac or CNS alterations!
- When using ACE inhibitors or hypotensive drugs
- Cases of severe diseases, shock!
- Anesthesia monitoring
- Thrombosis!
- Reveal essential hypertension!
Indications of echocardio
- Examination of cardiac chambers!
- Recognition of valvular disorders!
- Detection of shunts!
- Quantitative examination (valvular shortening)
- Defects of blood flow disorders!
- Detection of pericardial fluid!








Bronchial like sound

Moist (wet) Rhonchi

Crackling sound

Dry Rhonchi sound

Splashing sound

Metallic sound

Reason: Sound weaker than normal

Sound: Missing

Sound louder than normal

What is Venturi effect?

5 parameters to describe cough
- Origin
- Frequency
- Strength
- Tone
- Occurrence
- Duration
- Secretion content
- Painful or painless
- Deepness
- Localization of origin
- The quality of sputum
4 Things that differ intracardiac murmur from extra
Endo/intracardial Murmurs
- Caused by turbulence
- Within the heart
- Morphological or functional origin
- Most common
Extracardial Murmurs:
- Outside the heart
- Variable
- Can be caused by pleuritis
- Location, Intensity can be heard during different phases of the cardiac cycle
- Can be caused by effusions
Causes of Endo/Intracardial murmurs
MORPHOLOGICAL
- Valve deformities
- Septal or vessel malformations
FUCTIONAL
- Innocent murmurs
- Anemia: Decreased blood viscousity
Cause of extra cardial murmurs
DUE TO INFLAMATION
Adventious sounds from upper respiratory tract
- Moist (wet) Rhonchi = Non musical Rhonchi
- Crepitation
- Crackling sound
- Rattling sound
- Dry Rhonchi = Musical Rhonchi
- Whistling
- Wheezing
Classification of endo/intracardial murmurs
Localization
Intensity
+ 4 constant characteristics
- Timing (systole/diastole)
- Pitch (low,med.high) - blowing, whistling, crackling, rough, musical murmurs
- Quality, Shape - Continious, Crescendo, Decrescendo, crescendo-decrescendo (DIAMOND)
- Conduction: yes/no (Systole+pulse+murmur=Systolic murmur)
Signs of cardiac disease for owners
- Cyanosis
- Distended abdomen
- Dyspnoea
- Fainting
- Exercise intoreance
Signs of Right sided heart failure, Signs of left-sided heart failure
LEFT= Congestion and Pulmonary oedema
RIGHT= Congestions in periphery, Ascites
Abnormal sounds you hear during thorax auscultation
- Cracling
- Crepitation
- Weezing
- Metalic sound
- Splashing
Characterise a grade 6 murmur
- Palpable fremitus
- Very loud
- Can be heard even with stethoscope away from thorax