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CardioPulmonary > Lecture 11: Cardiovascular Evaluation > Flashcards

Lecture 11: Cardiovascular Evaluation Flashcards

0
Q

What is tachycardia considered to be?

A

Over 100 bpm

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1
Q

What is the normal heart rate range?

A

60-80 bpm

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2
Q

What is bradycardia considered to be and who can it normally occur in?

A

Less than 60bpm and it can be a normal occurrence for athletes

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3
Q

How long should you take heart rate for (in determining bpm) for a normal heart? How about in arrhythmias? Exercise?

A

15 or 30 seconds for a normal heart
60 seconds for a irregular heart
10 seconds during exercise

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4
Q

What are the grading scales for arterial pulses?

A 
0 - absent 
1 - trace
2 - normal
3 - greater than normal
4 - bounding
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5
Q

You note that your patient’s pulse is weak. What are the possible reasons for this?

A

(1) peripheral occlusion
(2) dehydration
(3) low BP
(4) arrhythmia

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6
Q

What different locations can arterial pulses be taken on the body?

A
  • carotid, brachial, radial, femoral, popliteal, posterior tibial, dorsalis pedis , aortic (above umbilicus)
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7
Q

What is JVD a measurement for?

A

Jugular venous distribution measures right heart failure.

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8
Q

What distance is considered normal when measuring JVD vertically above the sternal angle? Abnormal?

A

Normal: less than 3-5 cm
Abnormal: greater than 5 cm

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9
Q

How far can one measure JVD?

A

Up to the angle of the jaw

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10
Q

How is BP indirectly measured?

A

With a sphygmomanometer at the arm or thigh

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11
Q

What % of the circumference of the arm/thigh is the bladder of the sphygmomanometer at the correct length and width?

A

Width - 40%

Length - 80%

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12
Q

If you use a BP cuff that is too small, how will this alter the reading?

A

BP will be too high - inadequate compression of the arm.

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13
Q

What is the technique for taking BP?

A

-Limb is relaxed and at heart level
-Palpate artery
-Place midpoint of cuff over the brachial artery
-Wrap cuff snugly
-Inflate cuff 20-30 mmHg above point when radial artery disappears
Deflate cuff 2 to 3 mmHg per second

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14
Q

If you miss a reading and or need to retake BP what do you do?

A

deflate cuff fully and wait 1-2 minutes before next measurement.

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15
Q

If you miss the reading and/or need to retake BP can you take the BP in the other arm?

A

No, because you want to stay consistent with the limb BP.

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16
Q

When you note a BP measurement in the chart, what must you specify?

A

Which limb the measurement was taken
Position (ie. sitting/supine/standing)
SBP/DBP

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17
Q

What are the 2 normal heart sounds? Two abnormal?

A

Normal: S1-S2
adventitious: S3-S4

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18
Q

For listening for normal heart sounds, what part of the stethoscope should you use?

A

Diaphragm

19
Q

For listening for adventitious heart sounds, what part of the stethoscope should you use?

A

The bell

20
Q

What is the S1 heart sound signify? What does it sound like? Where is it best heard?

A
  • AV valve closure
  • lower pitch, softer, longer
  • heard best at the apex
21
Q

What is the S2 heart sound signify? What does it sound like? Where is it best heard?

A

Pulmonary and aortic valve closure
Higher pitch, louder, shorter
Heard best at base

22
Q

What is S2 splitting? When can S2 splitting normally occur?

A

When the pulmonic valve closes a little after aortic

Can occur normally during inspiration as blood flows to right heart increases

23
Q

What is S3 signify? Who can it occur in normally?

A

Ventricular gallop, like rumble

Is normal during diastole in children and young adults

24
Q

What does an S3 heart indicate?

A

Right heart failure or mitral regurgitation

25
Q

What does it mean if a S3 heart sound is heard during exercise and not at rest?

A

The heart isn’t keeping up with activity

26
Q

Can a S3 heart sound can be induced when doing cardiac auscultation?

A

Yes. Lay the patient on their left hand side

27
Q

What is an S4 heart sound? When does it occur?

A

An atrial gallop

Occurs during diastole; before S1

28
Q

When is S4 heart sound considered normal?

A

Never. It’s always abnormal

29
Q

What does an S4 heart sound indicate?

A
  • stiffness in the left ventricle (hypertrophy)

- cardiomyopathy or chronic hypertension

30
Q

What sound can be best heard at the base of the heart?

A

S2

31
Q

Where is the aortic area during auscultation?

A

Right 2nd ICS, parasternal

32
Q

Where is the pulmonic area in auscultation?

A

Left 2nd ICS parasternal

33
Q

What sound are you looking for when listening to the pulmonic area?

A

Physiologic splitting of S2 heart sound

S2 sound is split during inspiration

34
Q

What sound can be best heard at the apex of the heart?

A

S1

35
Q

Where is the tricuspid area?

A

Right 4th or 5th ICS parasternal

36
Q

Where is the mitral area?

A

The apex of the heart. Left 5th intercostal space mid-clavicular line

37
Q

Where is Erb’s point?

A

Left 3rd ICS parasternal

38
Q

What is the significance of Erb’s point?

A

S1 and S2 can be heard with approximate equal intensity

39
Q

What is the best way to listen for a murmur?

A

Listen to Erb’s point and ask the patient to lean forward to maximize the sound of the murmur

40
Q

When is a systolic murmur heard?

A

Between S1 and S2

41
Q

What is a systolic murmur caused by?

A 
Mitral insufficiency (results in regurgitation)
Aortic valve stenosis (or even less common- pulmonic valve stenosis)
42
Q

When is diastolic murmur?

A

Occurs between S2 and S1 (lub dub sh)

43
Q

What is cardiac rales?

A

Crackles that occur because and individual has right heart failure - fluid into the alveoli

44
Q

How is cardiac rales best heard?

A

If patient is seated upright or standing, cardiac rales are heard best at the apex is the heart

CardioPulmonary (13 decks)

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