OSCE CARDIOVASCULAR SYS Flashcards
What is parietal pericardium
Thin fluid filled sac the heart is enclosed in
Forms right border of the heart, usually not identifyable on physical exam. Accepts deoxy blood from vena cavae, contains SA node
Right atrium
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
Right ventricle
Lies mostly posterior and cannot be examined directly. Accepts oxy blood from pulmonary veins
Left atrium
Forms left border of the heart, lies to the left and behind right ventricle. Produces apical impulse
Left ventricle
Initiates cardiac cycle by by conduction of impulse in right atrium
Sinoatrial node (SA)
Follows SA node, propegates electrical impulse to bundle of his
Atrioventricular node (AV)
Closure of mitral and tricuspid valves is heard as…. Occurs at onset of systole, contraction of ventricles
S1
Interventricular pressure decreases with relaxation of ventricles, closing mitral and tricuspid valves and opening aortic and pulmonary valves (diastole) producing heart sound…
S2
What causes splitting of heart sounds?
Difference in pressure between left and right side of heart, more pressure on left so right sided events happen slightly later
Pulse between tendons of extensor hallucis longus and extensor digitorum longus
Dorsalis pedis pulse
Pulse 2-3cm posterior to medial malleolus
Posterior tibial pulse
Pulse inferior to inguinal ligament, midway between pubic symphysis and anterior superior iliac spine
Femoral pulse
Pulse on Anterolateral aspect of wrist
Radial pulse
Pulse on anteromedial aspect of wrist
Ulnar pulse
Pulse medial to biceps tendon in cubital fossa
Brachial pulse
Pulse between trachea and sternocleidomastoid muscle at the level of thyroid cartilige
Carotid pulse (* never palpate both carotid arteries at once)
Shortness of breath brought on or made worse by lying flat
Orthopnea
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
Paroxysmal noctural dyspnea
Accumulation of fluid in cells or tissues
Edema
Edema that retains indentation upon palpation
Pitting edema
Loss of consciousness caused by decreased cerebral blood flow
Syncope (* may be presenting feature of dysrhythmia or aortic stenosis)
Pulse contour with slow upstroke and downstroke, blunted peak
Pulsus tardus
Pulse contour with rapid upstroke and collapse
Water hammer pulse (* characteristic of aortic regurgitation)
Pulse with double beat, occurs in pt with significant AR
Pulsus bisferiens (* can find by palpating carotid, or auscultation of conpressed bracial artery)
Pulse that alternates amplitude often indicating serious myocardial dysfunction
Pulsus alternans
Jugular venous pressure that paradoxically increases with inspiration
Kussmauls sign
BP less than 120 systolic and 80 diastolic
Normal BP
Systolic 120-139 or diastolic 80-89
Pre hypertension
Systolic 140-159 or diastolic 90-99
Stage 1 hypertension
Systolic greater than 160, or diastolic greater than 100
Stage 2 hypertension
Difference in value between systolic and diastolic. Less than 30 considered NARROW, 30-40 considered WIDE
Pulse pressure
Pain classically caused by ischemia of muscles, commonly characterized by calf pain
Claudication
Sharp pain, originating in parietal pleua or parietal pericardium, somatically innervated
Parietal chest pain
Pain felt at level of somatic innervation that the sympathetic nerves innervate. Pain from thoracic viscera can be felt anywhere from epigastrium to mandible
Referred pain
Pain originating in thoracic organs, poorly localized and indistinct
Visceral chest pain
