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PCM II Exam 1 > Normal Heart & Cardiovascular Exam > Flashcards

Normal Heart & Cardiovascular Exam Flashcards

1
Q

When approaching an assesment for the heart, what 5 things should you remember?

A

History

Physical

ECG

X-ray

Lab Tests

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2
Q

What is the proper sequence of events when performing a physical exam of the heart?

A

Inspection

Palpation

Percussion

Auscultation

In PaPer A

NOTE: PT can be sitting, supine, leaning forward, left lateral decubitus

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3
Q

In which of the following locations should you find the apex of the heart under normal circumstances?

A. 3rd intercostal space on the left; 1 cm medial to the midclavicular line

B. 4th intercostal space on the left; 1 cm medial to the midclavicular line

C. 5th intercostal space on the left; 1 cm medial to the midclavicular line

D. 7th intercostal space on the left; 1 cm medial to the midclavicular line

A

5th intercostal space on the left; 1 cm medial to the midclavicular line

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4
Q

When percussing to estimate cardiac size, start far ______ to find resonance and move medially to find cardiac dullness

A. Left

B. Right

C. Sideways

D. upside down

A

Left

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5
Q

Auscultation of S1 can be described as which of the following? (select all that apply)

A. End of ventricular systole

B. Closure of the mitral and tricuspid valve

C. Closure of the aortic and pulmonic valves

D. Beginning of diastole

E. Beginning of ventricular systole

A

B. Closure of the mitral and tricuspid valve

E. Beginning of ventricular systole

S1: Let 1 in S1 indicate the beginning and the S indicate Systole

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6
Q

Auscultation of S2 can be described as which of the following? (select all that apply)

A. End of ventricular systole

B. Closure of the mitral and tricuspid valve

C. Closure of the aortic and pulmonic valves

D. Beginning of diastole

E. Beginning of ventricular systole

A

A. End of ventricular systole

C. Closure of the aortic and pulmonic valves

D. Beginning of diastole

  • S2: Let 2 signify the end and S represent Systole*
    • end of systole is beginning of diastole*
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7
Q

Which of the following locations is the normal location to find the Point of Maximum Impule (PMI)?

A. 3-4th intercostal space at the mid clavicular line

B. 4th-5th intercostal space at the midclavicular line

C. 5-6th ICS at the midclavicular line

D. Anywhere

A

4th-5th intercostal space at the midclavicular line

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8
Q

Which side of the heart do the Jugular Veins detect?

A. Left side of the heart

B. Right side of the heart

C. Underside of the heart

D. the side of love

A

Right side of the heart

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9
Q

The level of the Jugular Venous Pulse (JVP) indicates teh RAP (Right Atrial Pressure). To determine the level of the pulse, you place the PT in a supine position, let the veins engorge, and elevate them to about 30-45 degrees. What range is considered normal for JVP?

A

0-9

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10
Q

What is the most common cause of an elevated JVP?

A. Elevated Left Ventricular diastolic pressure

B. Elevated Right Ventricular diastolic pressure

C. Elevated Right Atrial diastolic pressure

D. Depressed Right Ventricular Diastolic Pressure

A

Elevated Right Ventricular diastolic pressure

  • i know it’s confusing since I just said JVP helps indicate the RAP, but the slide says JVP is often caused by RV diastolic pressure

NOTE: Internal Jugular > External Jugular for the JVP

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11
Q

T/F: Internal Jugular V. is better for testing JVP than External Jugular V.

A

True

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12
Q

The A-wave is a R atrial contraction (Tricuspid Valve Open) that coincides with S1, and preceeds carotid pulsation. In what 5 scenarios might you see a giant A wave?

A
  1. obstruction between RA and RV (right atrial myxoma)
  2. increased pressure in RV
  3. pulmonary hypertension

4, recurrent pulmonary emboli

  1. A-V dissociation (complete heart block- Right atrium contracts against a closed Tricuspid valve)
    * Might be hard to memorize, but these all make sense. Just think about things that would make it hard for the Right Atrium to push blood out*
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13
Q

The “C” wave is the slight backwards push of blood against a closed Tricuspid valve during which of the following?

A. Isovolumetric Systole

B. Isovulemtric Diastole

A

A. Isovolumetric Systole

CIS

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14
Q

Which of the following heart sounds is due to high pressire and abrupt deceleration of inflow across the mitral valve at the end of the rapid filling phase?

A. S1

B. S2

C. S3

D. S4

A

S3

NOTE: pathologic in people over 40

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15
Q

Which of the following heart sounds is an atrial gallop from forceful contraction of atria against a stiff ventricle (low compliance)?

A. S1

B. S2

C. S3

D. S4

A

S4

NOTE: it can be normal in trained athletes.

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16
Q

Which of the following valves is best heard on the left side of the 4th intercostal space at sternal border?

A. Mitral

B. Tricuspid

C. Aortic

D. Pulmonic

A

Tricuspid

“All Physicians Take Money”

AP-2

T-4

M-5

17
Q

What is the Murmurs Grading System? 1-6

A
  1. Barely audible
  2. Soft, but easily heard
  3. Loud w/out thrill
  4. Loud w/ thrill
  5. Loud w/ minimal contact between stethoscope and chest- thrill
  6. Loud and heard w/out stethoscope- thrill
18
Q

A murmur with thrill that can be detected with your stethoscope barely hovering over the chest is said to have what grade?

A

5/6 (5)

19
Q

What does R/R/A stand for?

A

Rate/ Rhythym/ Amplitude

20
Q

Edema is on a 0-4 scale

A

PCM II Exam 1 (9 decks)

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