Module 2 Flashcards
Components of Cardiovasc Exam
General inspection, take pulse and BP, assess JVP, palpation, ausculation, and check vital signs (ECG)
Body Mass Index (BMI)
BMI= kg X m^2; normal is btw 18.5-24.9
Marfans
aortic dissection or regurgitation
Down Syndrome
Atrial/ventricular septal defect
Tuner’s Syndrome
coarctation of aorta (narrowing)
Pulsus Paradoxus
large fall in pulse volume on inspiration
Bounding Pulse
large volume; caused by anemia, respiratory failure
Pulsus Alternans
alternating large and small volume pulses
Jugular Venous Pressure (JVP)
Identifies right heart failure and pulmonary embolism
Large A Wave (JVP abnormality)
caused by tricuspid stenosis, pulmonary stenosis and pulmonary hypertension
Cannon Wave (JVP abnormality)
caused by atrial fibrillation, complete heart block, VVI pacing, ventricular tachycardia
STEEP X,Y, Descent (JVP abnorm)
caused by constrictive pericarditis, cardiac tamponade
Large V Wave, CV wave (JVP abnorm)
from tricuspid regurgitation
Kussmaul’s Sign (JVP abnorm)
increased JVP on inspiration, constrictive pericarditis, cardiac tamponade
Palpation
determines edema; apply hands to exterior surface to detect evidence of disease
Heaving
high afterload
Thrusting
high preload
Ausculation
listening with stethescope to heart sounds
First Heart sounds (S1)
located in the Apex, high pitched; is the normal closure of the mitral and tricuspid (AV) valves
Second Heart Sound (S2)
located in the base; high pitched; is the normal closure of the aortic and pulmonic (semilunar) valves; on inspiration have early aortic sound (A2) and delayed pulmonic (P2)
Third Heart Sound (S3)
located in apex, low pitched; normal in children and young adults otherwise inidicates heart failure or volume overload (ventricular gallop)
Fourth Heart Sound (S4)
located in apex, low pitched; caused by reduced ventricular compliance
Ejection Click
irregular heart sound; extra early systolic heart sound (after S1); from pulmonary/aortic stenosis or dilation
Opening Snap
irregular heart sound; extra diastolic heart sound after A2’ from the calcification of heart valve opening; from mitral/tricuspid stenosis
Mid-Late Systolic Click
irregular heart sound; extra mid-late systolic sound; from AV leaflets bowing into atrium during ventricular systole
Summation Gallop
irregular heart sound; mid-systolic merging of S3 and S4, and S1 and S2; many factors involved
Pericardial Knock
irregular heart sound; early diastole soon after S2; Abrupt cessation of ventricular filling in early diastole
Vesicular Breathing Sound
low pitch; heard over most of lung field; soft and short expiration
Bronchial/Tracheal Breathing sound
heard over trachea, high pitched loud and long expiration
Bronchovesicular breathing sound
heard over main bronchus area and upper Right lung field medium pitched; expiration is equal to inspiration
Consolidation
abnormal breathing sound; normally aerated tissues are filled with fluid, mucus or pus; only brachial sounds are heard
Crackles/Rales
abnormal breathing sound; discontinued sounds at end of inspiration; airways pop open late in inspiration due to fluid build up
Rhonchi
abnormal breathing sound; on expiration a deep rumble; air passing through obstruction
Wheezes
abnormal breathing sound; musical whistling through respiratory cycle; air passing through narrowed passageway
Stridor
abnormal breathing sound; crowning sound heard after exhaling; from inflammation and edema of larynx/trachea
Pleural Friction Rubs
abnormal breathing sound; from pleurae inflammation, causing membrane to rub
Dyspnea
shortness of breath not proportionate to level of exertion
Chest discomfort
pain, pressure tightness
Angina Pectoris
chest pain
Stable Angina
patterned transient angina pectoris with exericise
Variant Angina
occurs at rest; from coronary artery spasm
Unstable Angina
unpredictable pattern with increased frequency and duration; occurs with decreased exercise
Silent Ischemia
episodes of myocardial ischemia absent of symptoms
Palpitations
awareness of pulsations, fluttering, rapid heart beating
Syncope
transient loss of consciousness from inadequate blood flow to brain (assoc with ANS)
Peripheral Edema
large amounts of tissue fluid accumulation; increases JVP
Cyanosis
peripheral; blue-colour on toes/fingers due to decrease blood flow
central: entire body; abnormal saturation of venous blood
Clubbing
thickening of fingers/toes
Heart Murmur
vibrations caused by turbulent blood flow; from obstruction, abnormal shunting of blood and increased flow through structures
Continous Murmur
start at systole and continue through diastole; venous hum and patent ductus arteriosis
