Lecture 3 8/22/24 Flashcards
What is mucus membrane pallor?
-pale mucus membranes due to decrease in oxyhemoglobin
-results from anemia or vasoconstriction
What is peripheral cyanosis?
-stasis of blood
-abnormal extraction of O2 from blood
What is central cyanosis?
deoxyhemoglobin entering circulation
What causes peripheral cyanosis?
-low cardiac output
-thrombosis
What causes central cyanosis?
-lung disease
-heart defects
What does each heart sound correlate with?
S1: AV valve closure
S2: semilunar valve closure
S3: early diastolic filling
S4: atrial contraction
What is sound splitting?
when the two sounds that make up S1 or S2 can be discerned
What are systolic clicks?
-high frequency systolic sounds associated with mitral valve prolapse
-precursor of mitral valve regurg.
When are gallop sounds (S3/S4) audible?
when patients have cardiomyopathy
What are murmurs?
prolonged series of vibrations that originates from the cardiovascular system
When do murmurs arise?
when laminar blood flow breaks down, resulting in disturbed flow
What are the determinants of blood flow character?
-velocity
-viscosity
-diameter
What are the important characteristics of murmurs?
-intensity/loudness
-timing with respect to cardiac cycle
-point of maximal intensity with respect to heart anatomy
What are the different murmur grades?
Grade 1: very soft and focal
Grade 2: soft intensity
Grade 3: intermediate intensity
Grade 4: loud intensity with no/intermittent thrill
Grade 5: loud intensity with associated thrill
Grade 6: loud intensity with associated thrill that is audible without stethoscope on chest
What are the potential timing descriptions of murmurs?
-systolic (S1-S2)
-diastolic (S2-S1)
-continuous
-to-and-fro (systolic and diastolic murmurs)
Which murmur timing is most common?
systolic
What can cause diastolic murmurs?
aortic/pulmonary valve regurg.
What is the important cause of continuous murmurs?
PDA
Which murmurs are best heard on the left dorsal aspect?
left heart base; aortic/pulmonic
Which murmurs are best heard on the left ventral aspect?
left apex; mitral
What are the possible configurations of murmurs?
-ejection: diamond-shaped, possible to hear second heart sound
-regurgitant: plateau-shaped, second heart sound often obscured
What are the characteristics of innocent murmurs?
-occur in the absence of structural disease
-always soft
-always systolic
-labile/intensity changes in response to changes in loading conditions
What are the characteristics of flow/functional murmurs?
-high velocity flow
-generally related to non-cardiac disease
