Normal Heart

Question 1

five finger method of normal heart exam

Answer 1

History, Physical, ECG, X-ray, Labs

Question 2

important family history problem and also can be induced by drugs

Answer 2

prolonged QT syndrome

Question 3

Barrel chested is indivative of

Answer 3

COPD

Question 4

what is a thrill

Answer 4

turbulent blood flow causing murmur

Question 5

percussing heart

Answer 5

start left then go medially

should be resonant when on lungs then dull when you reach the heart

Question 6

point of maximal impulse

Answer 6

4th-5th intercostal space at mid-clavicular line

Question 7

measuring JVP

Answer 7

• put patient in supine position 10-15 minutes then have them sit up 30-45 degrees
• measure from top out and down to sternal angle. add 5 cm plus what you got. should be 0-9

Question 8

most common cause of an elevated JVP is?

Answer 8

an elevated RV diastolic pressure

Question 9

A wave

Answer 9

due to atrial contractino and increased pressure in atrium

Question 10

what causes Giant A wave

Answer 10

pulmonary stenosis, emboli, hypertension, increased RV pressure, tricuspid stenosis, A-V dissociation (complete heart block) RA tumor

Question 11

V wave

Answer 11

atrial filling, increase in volume and pressure in RA when TV closed

Question 12

when is there a prominent V wave present

Answer 12

in tricuspid regurgitation and pulmonary hypertension

Question 13

increased JVP in what?

Answer 13

SVC obstruction, cardiac tamponade, RV infarction, severe heart failure, resticitve cardiomyopathy

Question 14

Positive hepatojugular reflux where liver is engorged in?

Answer 14

poorly compliant RV, RV failure, constrictive pericarditis, ovstructive RV filling by TS or RA tumor

Question 15

S2 split sound during?

Answer 15

inspiriation

Question 16

murmur: 1

Answer 16

barely audible

Question 17

grade 2 murmur

Answer 17

soft but easily heard

Question 18

where is needle decompression done

Answer 18

2nd intercostal space, just superior to the 3rd rib margin, at the midclavicular line

Question 19

where should the chest tube be inserted

Answer 19

4th intercostal space at mid or anterior axillary line

Question 20

where is the endotracheal tube on a chest x-ray

Answer 20

T4

Question 21

7th intercostal space

Answer 21

landmark for thoracentesis

Question 22

what is the diaphragm used for

Answer 22

high pitched sounds, heart and lungs, S1,S2,AR,MR,Friction rubs

Question 23

what is the bell used for

Answer 23

low pitched sounds: S3,S4, MS, carotid bruit

Question 24

assessment of carotid pulse

Answer 24

medial to SCM

Question 25

what is capillary refill testing?

Answer 25

arterial occlusion, hypovolemic shock, hypothermia