OSCE CARDIOVASCULAR SYS

Question 1

What is parietal pericardium

Answer 1

Thin fluid filled sac the heart is enclosed in

Question 2

Forms right border of the heart, usually not identifyable on physical exam. Accepts deoxy blood from vena cavae, contains SA node

Answer 2

Right atrium

Question 3

Occupies most of anterior cardiac surface, narrows superiorly to meet pulmonary artery at the level of third left costal cartilage. Accepts deoxy blood through tricuspid valve

Answer 3

Right ventricle

Question 4

Lies mostly posterior and cannot be examined directly. Accepts oxy blood from pulmonary veins

Answer 4

Left atrium

Question 5

Forms left border of the heart, lies to the left and behind right ventricle. Produces apical impulse

Answer 5

Left ventricle

Question 6

Initiates cardiac cycle by by conduction of impulse in right atrium

Answer 6

Sinoatrial node (SA)

Question 7

Follows SA node, propegates electrical impulse to bundle of his

Answer 7

Atrioventricular node (AV)

Question 8

Closure of mitral and tricuspid valves is heard as…. Occurs at onset of systole, contraction of ventricles

Answer 8

S1

Question 9

Interventricular pressure decreases with relaxation of ventricles, closing mitral and tricuspid valves and opening aortic and pulmonary valves (diastole) producing heart sound…

Answer 9

S2

Question 10

What causes splitting of heart sounds?

Answer 10

Difference in pressure between left and right side of heart, more pressure on left so right sided events happen slightly later

Question 11

Pulse between tendons of extensor hallucis longus and extensor digitorum longus

Answer 11

Dorsalis pedis pulse

Question 12

Pulse 2-3cm posterior to medial malleolus

Answer 12

Posterior tibial pulse

Question 13

Pulse inferior to inguinal ligament, midway between pubic symphysis and anterior superior iliac spine

Answer 13

Femoral pulse

Question 14

Pulse on Anterolateral aspect of wrist

Answer 14

Radial pulse

Question 15

Pulse on anteromedial aspect of wrist

Answer 15

Ulnar pulse

Question 16

Pulse medial to biceps tendon in cubital fossa

Answer 16

Brachial pulse

Question 17

Pulse between trachea and sternocleidomastoid muscle at the level of thyroid cartilige

Answer 17

Carotid pulse (* never palpate both carotid arteries at once)

Question 18

Shortness of breath brought on or made worse by lying flat

Answer 18

Orthopnea

Question 19

Shortness of breath brought on by left side heart failure with mobilization of fluid from dependent areas after lying down leading to pulmonary congestion. Appears suddenly at night

Answer 19

Paroxysmal noctural dyspnea

Question 20

Accumulation of fluid in cells or tissues

Answer 20

Edema

Question 21

Edema that retains indentation upon palpation

Answer 21

Pitting edema

Question 22

Loss of consciousness caused by decreased cerebral blood flow

Answer 22

Syncope (* may be presenting feature of dysrhythmia or aortic stenosis)

Question 23

Pulse contour with slow upstroke and downstroke, blunted peak

Answer 23

Pulsus tardus

Question 24

Pulse contour with rapid upstroke and collapse

Answer 24

Water hammer pulse (* characteristic of aortic regurgitation)

Question 25

Pulse with double beat, occurs in pt with significant AR

Answer 25

Pulsus bisferiens (* can find by palpating carotid, or auscultation of conpressed bracial artery)

Question 26

Pulse that alternates amplitude often indicating serious myocardial dysfunction

Answer 26

Pulsus alternans

Question 27

Jugular venous pressure that paradoxically increases with inspiration

Answer 27

Kussmauls sign

Question 28

BP less than 120 systolic and 80 diastolic

Answer 28

Normal BP

Question 29

Systolic 120-139 or diastolic 80-89

Answer 29

Pre hypertension

Question 30

Systolic 140-159 or diastolic 90-99

Answer 30

Stage 1 hypertension

Question 31

Systolic greater than 160, or diastolic greater than 100

Answer 31

Stage 2 hypertension

Question 32

Difference in value between systolic and diastolic. Less than 30 considered NARROW, 30-40 considered WIDE

Answer 32

Pulse pressure

Question 33

Pain classically caused by ischemia of muscles, commonly characterized by calf pain

Answer 33

Claudication

Question 34

Sharp pain, originating in parietal pleua or parietal pericardium, somatically innervated

Answer 34

Parietal chest pain

Question 35

Pain felt at level of somatic innervation that the sympathetic nerves innervate. Pain from thoracic viscera can be felt anywhere from epigastrium to mandible

Answer 35

Referred pain

Question 36

Pain originating in thoracic organs, poorly localized and indistinct

Answer 36

Visceral chest pain