Normal Heart Flashcards
five finger method of normal heart exam
History, Physical, ECG, X-ray, Labs
important family history problem and also can be induced by drugs
prolonged QT syndrome
Barrel chested is indivative of
COPD
what is a thrill
turbulent blood flow causing murmur
percussing heart
start left then go medially
should be resonant when on lungs then dull when you reach the heart
point of maximal impulse
4th-5th intercostal space at mid-clavicular line
measuring JVP
- 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
most common cause of an elevated JVP is?
an elevated RV diastolic pressure
A wave
due to atrial contractino and increased pressure in atrium
what causes Giant A wave
pulmonary stenosis, emboli, hypertension, increased RV pressure, tricuspid stenosis, A-V dissociation (complete heart block) RA tumor
V wave
atrial filling, increase in volume and pressure in RA when TV closed
when is there a prominent V wave present
in tricuspid regurgitation and pulmonary hypertension
increased JVP in what?
SVC obstruction, cardiac tamponade, RV infarction, severe heart failure, resticitve cardiomyopathy
Positive hepatojugular reflux where liver is engorged in?
poorly compliant RV, RV failure, constrictive pericarditis, ovstructive RV filling by TS or RA tumor
S2 split sound during?
inspiriation
murmur: 1
barely audible
grade 2 murmur
soft but easily heard
where is needle decompression done
2nd intercostal space, just superior to the 3rd rib margin, at the midclavicular line
where should the chest tube be inserted
4th intercostal space at mid or anterior axillary line
where is the endotracheal tube on a chest x-ray
T4
7th intercostal space
landmark for thoracentesis
what is the diaphragm used for
high pitched sounds, heart and lungs, S1,S2,AR,MR,Friction rubs
what is the bell used for
low pitched sounds: S3,S4, MS, carotid bruit
assessment of carotid pulse
medial to SCM
what is capillary refill testing?
arterial occlusion, hypovolemic shock, hypothermia
