Pedia 3B - Applied Cardio Flashcards
Systolic murmur starting a few ms into systole, peaking in mid-systole and ending before second heart sound =
Mid-systolic murmur “Flow Murmur”
Early systolic = Ejection murmur
Splitting of 2nd heart sound is best appreciated
Pulmonic Area
2nd Upper left sternal border
Louder murmur w/thrill
Grade IV
INSERT Grades here I II III loudest w/o thrill IV louder w/thrill V Audible w/portion of diaphragm off chest VI Audible w/stethoscope held off chest
Thrill and radiation of murmur away from point of origin indicate an ______ murmur
Organic
Twaning string murmur of Still is musical and best heard
Mid-precordium
Left of lower sternum
Apex beat corresponds to ___-most and ____-most point of cardiac impulse
Lowermost
Outermost
High frequency heart sounds are best heard w/the ____ of the stethoscope
Low frequency heart sounds are best heard w/the ____ of the stethoscope
High frequency - Diaphragm
Low frequency - Bell
Clicking sound in diastole immediately ff 2nd sound (indicating stenotic mitral valve w/mobile anterior leaflet:
Opening snap
Purring sensation under palm over precordium in the presence of certain organic heart diseases is called
THRILL
First heart sound is short and sharp and caused by simultaneous closure of the
Mitral
Tricuspid valve
2nd Heart Sound - Pulmonary and Aortic Valves
3rd -
4th -
Chest circumference < Head in the first _____ months
4-6 or 9-12 depending on where in Silverman
Dullness of percussion is noticed normally over the liver on the right side at the
10th intercostals space on midclavicular line
8th rib on mid-axillary line
10th rib posteriorly
3rd Heart sound
- Normally heard during _____ over the ____ area
- Best heard when patient is in the _____ position
- Loudest during ______
- _______ intensity is often associated w/hyperdynamic state
3rd Heart sound
- Normally heard during diastole over the apex area
- Best heard when patient is in the LLD position
- Loudest during EXP
- INC intensity is often associated w/hyperdynamic state
Continuous musical sound which may be high-pitched or low-pitched
Wheezes
To-and-fro murmur over L infra-clavicular area radiating to 2nd and 3rd L intercostal spaces para-sternally is seen in
PDA
Clinical Observation: 4 month old w/head > chest
Clinical Conditions:
Normal
H>C up to 6 months
Clinical Observation: 12 month old w/Head > Chest
Clinical Conditions:
Marasmus
Hydrocephalus
Clinical Observation: Rapid pulse during INSP and slower at EXP
Clinical Conditions:
Sinus arrhythmia
Clinical Observation: Noisy musical sound on respiration heard even w/o stethoscope
Clinical Conditions:
Wheeze
Clinical Observation: Unsteady gait secondary to failure of muscle coordination
Clinical Conditions:
Ataxia
Vocal Fremitus DEC in which
- Atelectasis
- Pleural Effusion
- Consolidation
Atelectasis
Pleural effusion
Percussion is a ______ method in examining heart size
- Poor
- Preferred
POOR
Splitting of 2nd heart sound is best heard over the
Pulmonary Area
Murmur heard throughout systole
Holosystolic
- VSD
- MR
______ murmur ALWAYS indicates a PATHOLOGICAL state
Diastolic Murmur = ABNORMAL
Abdominal Breathing is normal until ____ years old
4-5 years old
Pigeon chest
Rickets
Head bobbing is synchronous w/patient’s respiration
Bobbing - Respiration
Nodding - Heart Rate
DOUBLE CHECK
Manifests w/visible pulsations on R side of chest
- Dextrocardia
- Scoliosis
- R Pneumothorax
- Enlarged R V
Dextrocardia
Scoliosis
Enlarged R V
2nd heart sound accentuated in
Pulmonary HPN
3rd heart sound is heard in
Normal adolescent
_____ ????
Percussion in children may be useful in finding
- Heart size
- AR
- Pericardial effusion
- MS
Pericardial effusion
PDA characterized by
CONTINUOUS murmur
Murmur: Pulmonary Stenosis
Systolic/Diastolic:
Systolic
Murmur: Aortic Stenosis
Systolic/Diastolic:
Systolic
Murmur: Mitral stenosis
Systolic/Diastolic:
Diastolic
Murmur: Aortic regurgitation
Systolic/Diastolic:
Diastolic
Murmur: Mitral Regurgitation
Systolic/Diastolic:
Systolic
Murmur: Functional murmur
Systolic/Diastolic:
Systolic
Murmur: Atrial Septal Defect
Systolic/Diastolic:
Systolic
Fremitus: INC
Clinical Implication:
Consolidation
Lobar Pneumonia
Fremitus: DEC/Absent
Clinical Implication:
Pleural Effusion
Pleural Thickening
Pneumothorax
Atelectasis
Vocal resonance is ____ in emphysema
DECREASED
__________ crackles are indicative of restrictive lung disease
End/Late INSP crackles
End/Late INSP crackles are indicative of
Restrictive lung disease
Interstitial
Pneumonia
Abdominal respiration is expected until _____ years old
4-5 years old
Chest expansion can be accurately measured using a
Tape measure
In ______ brochovesicular breath sounds are normally heard over the entire chest wall
Neonates
Indications of upper airway obstruction (3)
INSP stridor
Supra-sternal retractions
Supra-clavicular retractions
