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Phys Diag 2 > PD 2 > Flashcards

PD 2 Flashcards

1
Q

preload

A

initial stretching of cardiac myocytes prior to contraction

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2
Q

afterload

A

“load” that heart must eject blood against, closely related to aortic pressure

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3
Q

systole

A

vent. cont. resulting in forceful flow of blood into system and pulm circ

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4
Q

diastole

A

between 2 contractions - relaxation - allowing vent to fill w blood

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5
Q

S1 heart sound

A

closure of mitral and tricuspid (AV) valves

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6
Q

S2 heart sound

A

closure of aortic & pulmonic valves

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7
Q

S3 gallop heart sound

A

at the end of ventricular filling, if the vol of blood being transferred is abnormally large (mitral regurg), the blood “sloshing” up against vent. walls causes S3 sound

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8
Q

S4 gallop heart sound

A

late stage diastole is marked by atrial contraction. if vent. is stiff and noncompliant, will cause “atrial kick” pushing the remaining blood into the vent.

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9
Q

murmur

A

abnormal turbulent flow of blood when a valve is stenotic or damaged.

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10
Q

bruit

A

unexpected, audible swishing sound or murmur over an artery or vascular organ (low pitched, best heart w bell of steth.)

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11
Q

point of max. impulse (PMI)

A

beat of L vent. during systole. usually generated by the apex. May be produced by enlarged or hypertrophied RV, a dilated aorta or plum. artery, or LV wall motion abnormality

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12
Q

thrill

A

palpable murmur - signifies turbulent blood flow, associated w congenital and valvular abnormalities

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13
Q

heave/lift

A

Heave/Lift: are sustained palpable movements of localized areas of the precordium due to increased intensity of systolic contraction of one or more cardiac chambers
Heave: a more pronounced lift
Lift: RV hypertrophy

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14
Q

situs inversus/dextrocardia

A

the inversion or transposition of the body viscera so that the heart is on the right and the liver is on the left; the chest and abdominal contents become mirror images of the usual.

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15
Q

gallop heart sounds

A

S3, S4

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16
Q

Rub heart sound

A

audible through stethoscope - resulting from rubbing of opposed, inflamed, serous surfaces(ex: pericarditis)

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17
Q

Click

A

classic finding in mitral valve prolapse. Usually heard during mid or late systole. usually accompanied w a late systolic murmur indicative of mitral regurgitation.

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18
Q

Snap

A

associated w aortic stenosis. if thickening or deformities of the leaflets occur, a sound is generated in early diastole that corresponds to the opening of the valves.

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19
Q

ejection sounds

A

abnormal dilation or calcification of the aortic and pulmonic valves can cause an abnormal early systolic ejection sound as they open during systole.

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20
Q

claudication

A

Pain, burning, fatigue in legs/ buttocks, occurs w/ walking, better with rest, symptom of narrowing of artery or blockage, may be able to hear bruit (atherosclerosis is the most common cause of arterial blockage which can cause claudication)

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21
Q

paroxysmal nocturnal dyspnea

A

sudden onset of SOB after sleeping

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22
Q

xanthelasma

A

irregular shaped yellow lesions on periorbital tissues representing deposition of lipids indicating pt has abnormality of lipid metabolism

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23
Q

pulsus alternans

A

pulse has constant rate & rhythm but amplitude alternates between small/large - indicative of vent. dysfunction/failure.

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24
Q

pulsus bigeminus

A

normal pulse beat followed by a premature beat (due to premature vent. cont.) and a pause. Premature beat’s amp is less than the amp of the normal beat. indicative of heart disease

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25
Q

pulsus bisferiens

A

pulse has 2 peaks during systole - first is normal pulse during vent. cont., 2nd is an early diastole due to back flow of blood. best noted on carotid palpation.

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26
Q

pulsus paradoxus

A

atypical decrease in systolic BP and amp. during inspiration. Usually there is a slight decrease here, but should be <10mmHg. Can be indicative of emphysema, asthma, premature heart cont., tracheobronchoral obstruction, or effusion.

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27
Q

pulse deficit

A

difference between rates in pulse when auscultating heart’s apex vs palpating peripheral artery. Occurs when vent. contraction doesn’t eject a sufficient amount of blood to produce a pulse wave in arteries.

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28
Q

tracheal lung sounds

A

high pitched, harsh, heard over trachea/neck

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29
Q

bronchovesicular lung sounds

A

med pitched, heard mostly at 1st &2nd interspaces anteriorly and between scapulae

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30
Q

Bronchial lung sounds

A

relatively high pitched, heard over manubrium

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31
Q

vesicular lung sounds

A

soft, relatively low pitched sound heard over most of lungs

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32
Q

fine crackles lung sounds

A

heard during end of inspiration, high-pitched, discrete, crackling sound not cleared by cough

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33
Q

medium crackles - lung sounds

A

heard during mid-step of inspiration. lower, more moist, not cleared by cough

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34
Q

course crackles - lung sound

A

heard during inspiration, loud, bubbly, not cleared by cough

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35
Q

wheezes

A

expiration>inspiration, musical, high-pitched, hissing, squeak, continuous
In lower airways is suggestive of narrowing of airways

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36
Q

stridor

A

a wheeze that is predominately inspiratory, indicating partial obstruction of trachea

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37
Q

rhoncus

A

continuous through inspiration&expiration, loud, low, course sound similar to snore or honk

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38
Q

vocal fremitus/resonance

A

auscultate apices/anterior/lateral/posterior lung fields w stetho. as the pt says “99”. muffled, indistinct words= normal. clarity and increased loudness= bronchophony (possible consolidation of lungs)

39
Q

egophony

A

auscultate apices/anterior/lateral/posterior lung fileds w stetho. as pt says “E”. “E” becomes “A” = abnormal

40
Q

whispered pectoriloquy

A

auscultate apices/anterior/lateral/posterior lung fields w stetho as pt whispers “1, 2, 3”. increased intensity and pitch= abnormal (possible pneumonia or fibrosis)

41
Q

tactile fremitus

A

palpable vibrations on chest. gives insight to density of lungs

42
Q

barrel chest

A

increased AP diameter of chest, abnormally large ribcage - seen w COPD

43
Q

flail chest

A

flapping, unfixed chest wall caused by loss of stability of thoracic cage after fracture of sternum or ribs

44
Q

scoliosis

A

lateral curvature of spine

45
Q

kyphosis

A

increased convex curvature of thoracic spine

46
Q

gibbus

A

anterior angular deformity of lower back due to hypoplasia or wedging of one or more lower thoracic or upper portions of vertebral bodies – humpback

47
Q

lordosis

A

accentuation of lumbar curvature

48
Q

pectus carinatum

A

forward protrusion of sternum (pigeon chest

49
Q

pectus excavatum

A

depression of sternum (funnel chest)

50
Q

hemoptysis

A

coughing up blood

51
Q

pleural rub

A

palpable, course, grating vibration

52
Q

cyanosis

A

blue color of skin due to oxygen deprivation

53
Q

stridor

A

harsh, high pitched sound during respiration caused by laryngeal or tracheal obstruction

54
Q

cullen sign

A

bluish color of/around umbilicus indicated intraperitoneal hemorrhage, pancreatitis, or ectopic pregnancy

55
Q

ballottement

A

to assess for presence or size of a mass: pressing down on suspected are at 90 degree angle to abdomen. push in toward organ/mass w fingertips. if mass is freely moveable, it will float up and touch fingertips.

56
Q

grey turner sign

A

eccymosis of flanks indicates hemoperitoneum or pancreatitis

57
Q

shifting dullness

A

determine border of tympany and dullness by percussion while supine, mark this border. have pt shift to side and reassess. if ascites present, the dullness will shift to the lowered side. 3 cm or more difference in those borders indicates fluid presence.

58
Q

murphys sign

A

abrupt cessation of inspiration while palpating gallbladder indicates cholecystitis

59
Q

fluid wave

A

pt uses own hand as barrier in mid-abdomen. tap one side of abdomen while palpating the other. wave transmitted accross= + ascites

60
Q

rovsing sign

A

RLQ pain intensified by LLQ abdominal palpation

61
Q

iliopsoas test

A

painful RLQ suggests irritation of peritoneal by flexion of psoas muscle

62
Q

mcburney sign

A

pain w palpation at mcburney point (RLQ midway between umbilicus and R anterior superior iliac spine) - indicative of appendicitis or other peritoneal inflamm

63
Q

obturator sign

A

testing for irritation from obturator muscle

64
Q

rebound tenderness (Blumberg sign)

A

pressing gently and deeply into abdomen in region remote to pain, when pressure released, underlying structures rebounding back to original position causes pain - indicates peritoneal inflamm/irritation

65
Q

borborygmi

A

rumbling, gurgling, tinkling noises heard on auscultation due to hyperactive intestinal peristalsis

66
Q

heel jar test

A

pt stands on tip toes then drops to heels. if this causes pain, indicates peritoneal inflamm

67
Q

hematochezia

A

passage of bright red blood through stool

68
Q

hematemesis

A

vomitting of blood

69
Q

dysphagia

A

difficulty or painful swallowing

70
Q

melena

A

passage of dark, tarry stool

71
Q

globus

A

persistant or intermittent nonpainful sensation of a lump or foreign body in throat. occurring between meals.

72
Q

singultus

A

hiccup (having reflex spasm of diaphragm accompanied by a rapid closure of the glottis producing an audible sound)

73
Q

reflux

A

backwards flow of contents of stomach into esophagus that causes heartburn

74
Q

gastroparesis

A

delayed gastric emptying: condition consisting of a partial paralysis of the stomach, resulting in food remaining in stomach for an abnormally long time

75
Q

eructation

A

belch

76
Q

lymphadenopathy

A

swollen or enlarged nodes due to infectious, autoimmune, or malignant disease

77
Q

lymphedema

A

edematous swelling due to excess lymph fluid in tissues caused by inadequate lymph drainage

78
Q

lymphadenitis

A

infection and inflamm of nodes

79
Q

lymphangitis - acute

A

inflamm of one or more lymph vessels. red streaks following ducts, indurated, and palpable

80
Q

paraphimosis

A

foreskin becomes trapped behind the glans penis

81
Q

hypospadias

A

urethral opening is on underside of penis

82
Q

chancre

A

painless ulceration formed during primary stage of syphilis

83
Q

condyloma

A

presence of warts caused by HPV

84
Q

peyronie disease

A

connective tissue disorder, chronic infammation and scar tissue formation in the tunica albuginea

85
Q

hydrocele

A

collection of fluid in scrotum

86
Q

spermatocele

A

benign, sperm-filled cyst at head of epididymis

87
Q

varicocele

A

enlargement of veins within the scrotum

88
Q

epididymitis

A

inflammation or infection of epididymis; generally caused by chlamydia, gonorrhea, or E coli

89
Q

testicular tumor

A

cancer that develops in the testicles

90
Q

epispadias

A

urethral deformity. can open on top, side, or be open along length of penis

91
Q

indirect inguinal hernia

A

most common abd hernia - internal opening of inguinal canal remains open and a portion of the intestines slip through the canal, generally congenital, often diagnosed early in life.

92
Q

direct inguinal hernia

A

portion of intestine bulges through and wall along inguinal canal

93
Q

femoral hernia

A

bulging of intestines into femoral canal

94
Q

cryptochidism

A

undescended testicles

Phys Diag 2 (1 decks)

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