Key Cardio Facts

Question 1

What 4 things describe a pulse

Answer 1

Rate
Rhythm
Character
Volume

Question 2

What can rhythm of a pulse be

Answer 2

Regular
Regularly irregular
Irregularly irregular

Question 3

What can volume of a pulse be

Answer 3

Normal
Small
Large

Question 4

What is tachycardia

Answer 4

HR above 100bpm

Question 5

What is Bradycardia

Answer 5

HR below 60bpm

Question 6

When are heart sounds heard

Answer 6

When valves shut

Question 7

What is diastole

Answer 7

Heart ventricles are relaxed and fill with blood

Question 8

What is systole

Answer 8

Heart ventricles contract pumping blood into the aorta (LV) & pulmonary artery (RV)

Question 9

What are the 5 events of Cardiac cycle

Answer 9

1. Passive filling
2. Atrial contraction
3. Isovolumetric ventricular contraction
4. Ventricular ejection
5. Isovolumetric ventricular relaxation

Question 10

What valves close to produce 1st sound (signals what?)

Answer 10

Mitral & tricuspid
Systole beginning

Question 11

What valves close to produce 2nd sound (signalling what?)

Answer 11

Pulmonary & aortic
Diastole beginning

Question 12

What is 3rd heart sound

Answer 12

Additional sound, not always indicative of CVD -immediately after S2

Indicates low frequency early diastolic filling

Question 13

Where is 3rd heart sound best heard

Answer 13

Using bell of stethoscope at apex of heart

Question 14

What is 4th heart sound

Answer 14

Pathological - Indicative of ventricular stiffness i.e in left ventricular hypertrophy

Indicates low frequency late diastolic filling- heard just before S1

Question 15

Where are cardiac auscultation points

Answer 15

Tricuspid = 2nd ICS right sternal edge
Mitral = 2nd ICS on left sternal edge
Pulmonary = 4th ICS left sternal edge
Mitral = 5th ICS mid-clavicular line (left)

Question 16

What is the apex beat

Answer 16

Most inferior, lateral point the precordial cardiac impulse can be felt
Usually 5th left ICS mid-clavicular line

Question 17

What type of murmur coincides with carotid pulse

Answer 17

Systolic murmurs

Question 18

What type of murmur does NOT coincide with carotid pulse

Answer 18

Diastolic murmurs

Question 19

What is splitting of 2nd heart sound

Answer 19

Inspiration causes a drop in intrathoracic pressure so INCREASED VENOUS RETURN to right side of heart
↓
Prolongs ventricular ejection time
↓
pulmonary component (quieter) delayed behind aortic part (louder)

Question 20

Where is splitting of 2nd heart sound best heard, when is it normal?

Answer 20

2nd ICS left sternal border

Normal IF observed ONLY IN INSPIRATION

Question 21

What frequency and pressure of stethoscope is bell

Answer 21

Transmits low frequency sounds

Apply light pressure to hear these

Question 22

What frequency and pressure of stethoscope is diaphragm

Answer 22

Transmits high frequency sounds

Apply firm pressure to hear these

Question 23

What does full description of a cardiac murmur include

Answer 23

INTENSITY (GRADING),
CHARACTER & PITCH,
TIMING,
LOCATION
RADIATION

Question 24

What is a murmur, and what are the 2 types?

Answer 24

Audible turbulence of blood flow

Innocent or pathological

Question 25

What causes and innocent heart murmur

Answer 25

Is a systolic flow murmur usually caused by right ventricular outflow tract

Question 26

Characteristics of innocent murmur

Answer 26

Soft mid systolic Heard in pulmonary area Localised to 1 auscultatory area No radiation No other cardiac signs ( NO palpitations, irregular pulse e.t.c)

Question 27

What causes a pathological murmur

Answer 27

Turbulence of blood flow from structural abnormality Can be systolic or diastolic

Question 28

Characteristics of pathological murmurs

Answer 28

-Diastolic always pathological -Ejection systolic, Late peaking or pansystolic often pathological -Not localised to 1 area -May radiate (neck in aortic stenosis, axilla in mitral regurgitation) -Usually associated abnormalities (palpitations, irregular pulse)

Question 29

What is the range of murmur grades

Answer 29

I to VI

Question 30

What common murmur is 2nd sound splitting

Answer 30

Aortic stenosis

Question 31

What common murmur is 3rd sound

Answer 31

Aortic regurgitation

Question 32

What common murmur is 4th sound

Answer 32

Mitral stenosis

Question 33

What do B-blockers do to the heart

Answer 33

Decrease slope of pacemaker potential in SA nodal cells = Increase AV nodal delay =Slow HR

Question 34

What does Atropine do to the heart

Answer 34

Increases slope of pacemaker potential in SA nodal cells = Decreases AV nodal delay = Increases HR

Question 35

What are symptoms of postural hypotension

Answer 35

Light-headedness Dizziness Blurred vision Faintness Falls

Question 36

what receptors in the heart does noradrenaline work through - what stimulation?

Answer 36

β-1 adrenoreceptors sympathetic stimulation

Question 37

what receptors in the heart does acetylcholine work through- what stimulation?

Answer 37

Muscarinic M2 receptors parasympathetic stimulation

Question 38

Aortic regurgitation

Answer 38

Early diastolic murmur at left sternal edge

Question 39

Aortic Stenosis

Answer 39

Ejection systolic murmur

Question 40

Mitral regurgitation

Answer 40

Pan-systolic murmur to axilla `(displaced apex beat)

Question 41

Mitral stenosis

Answer 41

Diastolic murmur