Physical Exam Flashcards
1
Q
Cannon A Wave
A
Different dysrhythmias may cause cannon A waves.
- Heart block may lead to cannon a waves, in particular, third-degree (complete) heart block.
- ventricular tachycardia as a result of the inherent AV dissociation of the arrhythmia.
- Pacemaker syndrome without proper synchronization of atria and ventricles.
2
Q
Giant A Wave (technically C and V with tricuspid regurg)
A
occur in right heart structural changes such as tricuspid valvulopathies, right ventricular hypertrophy, and pulmonary hypertension
-difficult to differentiate from cannon A waves
3
Q
Mitral Regurgitation Auscultation
A
- S1 is diminished, delayed P2 (pulm htn), early A2 (reduced LV forward stroke volume) - widely split A2
- Murmur usually holosytolic (but can extende beyond and obscure A2)
- Apex and radiates to axilla
- ** special circumtances: posterior leaflet is predominantly involved (due to prolapse or chordal rupture), the murmur may radiate anteriorly toward the sternum and is heard well at the base. This type of murmur is often confused with aortic stenosis but does not radiate to the carotid arteries
4
Q
Murmur Description
A
- Sys Grades:
- 1: faint
- 2: soft
- 3: louder than 2 but w/o palpable precordial thrill
- 4: 3+ thrill
- 5: Can hear off chest
- 6: Loudest murmur
- Diastolic:
- Grades I-IV
- Configuration and timing:
- Crescendo/decrescndo/platuea
- Early/mid/late
*location and radiaton
5
Q
Tricuspid Regurgitation
A
-Early systolic with decrescendo
6
Q
Ventral septal defect
A
- holosytolic
- Left lower sternal border and radiates to right lower sternal border
7
Q
Systolic Ejection Mumur
A
- Innocent: Short and soft, normal s1 and s2
- Aortic sclerosis: short and soft w/ possible “grunting” quality, normal s1,s2,
- Uncomplicated bicuspid: short and soft +/- early aortic diastolic mumur
- Can be caused by anemia, pregnancy, and thyrotoxicosis
