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Medical History and Physical Examination > Module 5: Cardiovascular System > Flashcards

Module 5: Cardiovascular System Flashcards

1
Q

Silver & Copper Wiring

A

Narrowing & thickening of the retinal arteriolar walls resulting in the central portion appearing as thin, bright wires on ophthalmoscopic examination

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2
Q

AV Nicking

A

The appearance of retinal venules being pinched off due to compression by overlying arterioles that are hardened with atherosclerotic plaque

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3
Q

Jugular Pulsations

A

Visible wave-like fluctuations of blood in the jugular veins that reflect right atrial functioning

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4
Q

Exaggerated “a” Wave

A
  • Increased pressure from atrial contraction

- Sign of tricuspid stenosis or myxoma

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5
Q

Absent “a” Waves

A
  • Most commonly would be atrial fibrillation

- Could also mean dilated right atrial cardiomyopathy

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6
Q

High-Amplitude “v” Waves

A
  • Normal amplitude is slightly less than “a”

- Most commonly tricuspid regurgitation

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7
Q

Tricuspid Regurgitation

A

Backflow of blood from the right ventricle into the right atrium

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8
Q

Elevated Jugular Venous Pressure

A
  • Higher than 10 cm

- Usually means increased pressure in the right atrium

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9
Q

Low Jugular Venous Pressure

A
  • Less than 1 cm
  • If patient must be lowered to supine position before jugular venous column can be seen, pressure is low
  • Reflects low-volume status
  • Can be found w/ dehydration or anemia
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10
Q

Point of Maximal Impulse

A

The location where the apex of the heart, the tip of the left ventricle, taps against the anterior chest wall during systole

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11
Q

Diagnose PMI displacement inferiorly and to the left

A
  • Hypertrophic cardiomyopathy

- Chronic hypertension or aortic stenosis

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12
Q

Diagnose PMI left displacement

A
  • Mitral regurgitation
  • Pulmonary fibrosis
  • Right-sided tension pneumothorax
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13
Q

Diagnose PMI Displacement to the right and inferiorly

A
  • COPD

- The flattened diaphragm allows the heart to shift medially

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14
Q

Diagnose PMI on the right side of the chest

A

Presence of dextrocardia

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15
Q

Where do you auscultate the Aortic valvular area?

A

2nd right intercostal space (ICS) along the sternal border

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16
Q

Where do you auscultate the Pulmonic valvular area?

A

2nd left ICS along sternal border

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17
Q

Where do you auscultate the Tricuspid valvular area?

A

4th or 5th left ICS along sternal border

18
Q

Where do you auscultate the Mitral valvular area?

A

4th or 5th ICS mid-clavicular line

19
Q

S1 is sound created by the ____ and marks the onset of ____ ____where contraction of the ventricles causes the ____ & _____ to close

A
  • Closure of the atrioventricular (AV) valves
  • Ventricular systole
  • Mitral and tricuspid valves
20
Q

S1 is one audible heart sound, but includes the sounds of _____ & _____ closure at the same time

A

Mitral & tricuspid

21
Q

S2 is created by the closure of the _____, marking the onset of ______ and the closure of the ______ & _____ valves

A
  • Semilunar valves
  • Ventricular diastole
  • Aortic and pulmonic
22
Q

S3 is a ___ frequency sound occurring early in _____ _____ as a result of _____

A
  • Low
  • Ventricular diastole
  • Turbulence
23
Q

What could cause the S3 gallop?

A
  • Enlargement of the chamber ventricles
  • Associated w/ heart failure
  • Could be a normal finding in younger patients
24
Q

S4 is a ___ frequency sound occurring late in ____ _____ as a result of _____

A
  • Low
  • Ventricular diastole
  • Turbulence
25
Q

What could cause the S4 heart sound?

A
  • Commonly seen in aging
  • Could be associated w/ hypertension
  • Could be associated w/ aortic valve stenosis
26
Q

What are ejection sounds & clicks?

A
  • High-frequency sharp, clicking sounds

- Happen during ventricular systole

27
Q

Where is midsystolic click found?

A

Midway through the ventricular systole

28
Q

When do “opening snaps” occur?

A

During diastole

29
Q

Key components used to identify a murmur are

A
  • Radiation
  • Location
  • Quality
  • Timing
  • Intensity
  • Pitch
  • Shape
  • Think “Real Life QTIPS”
30
Q

Intensity of murmur is defined using

A

A grading system representing both the volume of blood and the velocity at which it flows over the structural disorder

31
Q

Murmur Intensity Grade 1

A

Faint, may not be heard with each contraction

32
Q

Murmur Intensity Grade 2

A

Quiet but heard easily

33
Q

Murmur Intensity Grade 3

A

Moderately loud

34
Q

Murmur Intensity Grade 4

A

Loud with palpable thrill

35
Q

Murmur Intensity Grade 5

A

Loud with thrill, may be heard with stethoscope partially off of the chest

36
Q

Murmur Intensity Grade 6

A

Loud with thrill, may be heard with stethoscope off of the chest

37
Q

The most accurate way to grade peripheral edema is to…

A

Quantify the amount of edema according to how far up the extremity the edema extends

38
Q

1+ edema =

A

Edema at the ankle

39
Q

2+ edema =

A

Edema to the mid tibia

40
Q

3+ edema =

A

Edema to the mid femur

41
Q

4+ edema =

A

Edema to the sacrum

Medical History and Physical Examination (9 decks)

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