PT Tests And Measures For Cardiovascular And Pulmonary Systems: BP and Auscultation of Heart

Question 1

What are the grades for the Angina Pain Scales?

Answer 1

1) Mild, barely noticeable
2) Moderate, bothersome
3) Moderately severe, very uncomfortable
4) Most severe or intense pain ever experienced

Question 2

What is the Ankle-Brachial Index (ABI) do?

Answer 2

It compares systolic BP at the ankle and arm to CHECK FOR PERIPHERAL ARTERY DISEASE (PAD)

Measure both brachial arteries and both tibialis posterior arteries

Question 3

How is the Ankle-Brachial Index (ABI) calculated?

Answer 3

Divide the higher of the 2 BP measurements in the ankles by the higher of the 2 BP measurements in the arms

(Higher Ankle) / (HigherArm)

Question 4

What does a >1.30 ABI indicate?

Answer 4

Indicates a RIGID ARTERIES and the need for an US test to check for peripheral artery disease.

Question 5

What dies a 1.0 - 1.30 ABI indicate?

Answer 5

Normal; no blockage

Question 6

What does a 0.8 - 0.99 ABI indicate?

Answer 6

Mild blockage; beginnings of peripheral artery disease

Question 7

What does a 0.4 - 0.79 ABI mean?

Answer 7

Moderate blockage; may be assoc with intermittent claudication during exercise

Question 8

What does a <0.4 ABI mean?

Answer 8

SEVERE BLOCKAGE suggesting PAD; may have claudication pain at rest

Question 9

If the bladder of a BP cuff occurs, what could happen?

Answer 9

False HIGH readings may result. If in doubt, use a larger cuff

Question 10

What are the phases of Korotkoff sounds when taking a BP with a cuff?

Answer 10

Phase I) first appearance of clear tapping sounds corresponding to palpable pulse; Phase I corresponds to SBP

Phase II) sound becomes softer and longer

Phase III) Sound becomes crisper and louder

Phase IV) Sound becomes muffled and softer

**Phase V) sounds disappear completely; the diastolic pressure (DBP) is THE PRESSURE AT THE LAST AUDIBLE SOUND

Question 11

What are the BP standards for normal/prehypertensive etc.

Answer 11

Check this!

<120/<80

Question 12

What are the 4 designated auscultation areas?

Answer 12

1) aortic area
2) pulmonic area
3) mitral area (bicuspid)
4) tricuspid area

Question 13

Where is the AORTIC AREA located

Answer 13

2nd intercostal space at the R eternal border

Question 14

Where is the PULMONIC AREA located?

Answer 14

2nd intercostal space at the L eternal border

Question 15

Where is the MITRAL (bicuspid) AREA located?

Answer 15

5th intercostal space, medial to the L mid clavicular line

Question 16

Where is the TRICUSPID AREA located?

Answer 16

4th intercostal space at the L sternal border

Question 17

Auscultation of Heart Sounds - Interpretation: What is the S1 (lub) sound indicate?

Answer 17

1st heart sound - CLOSURE OF MITRAL AND TRICUSPID (atrioventricular) valves at onset of VENTRICULAR SYSTOLE.

• Higher frequency sound with lower pitch and LONGER DURATION THAN S2.

Question 18

Auscultation of Heart Sounds - Interpretation: What does the S2 (dub) sound mean?

Answer 18

2nd heart sound - CLOSURE OF AORTIC AND PULMONIC (SEMILUNAR) VALVES at the onset of VENTRICULAR DIASTOLE

High frequency sound with HIGHER PITCH AND SHORTER DURATION THAN S1

Question 19

Auscultation of Heart Sounds - Interpretation: What does the S3 heart sound mean?

Answer 19

Vibrations of distended ventricle walls due to passive flow of blood from the atria during rapid filling phase of diastole

Question 20

Auscultation of Heart Sounds - Interpretation: what does an abnormal S3 sound in adults mean?

Answer 20

May be associated with HEART FAILURE, often called “ventricular gallop”

Question 21

Auscultation of Heart Sounds - Interpretation: What does an S4 heart sound mean?

Answer 21

PATHOLOGICAL SOUND of vibration of the ventricular wall with ventricular filling and ATRIAL CONTRACTION.

Question 22

Auscultation of Heart Sounds - Interpretation: What can an S4 heart sound be associated with?

Answer 22

Hypertension

Stenosis

Hypertensive heart disease or myocardial infarction

This S4 sound usually referred to as “ATRIAL GALLOP”

Question 23

Auscultation of Heart Sounds - Interpretation: What are heart murmurs? And what cause them?

Answer 23

They are vibrations of longer duration than the heart sounds.

They are often due to DISRUPTION OF BLOOD FLOW PAST A STENOTIC OR REGURGITANT VALVE

Question 24

Auscultation of Heart Sounds - Interpretation: what do heart murmurs sound like?

Answer 24

Soft, blowing or swishing

Question 25

Auscultation of Heart Sounds - Interpretation: With murmurs, if the heart valves are thickened then….

Answer 25

…the forward flow of blood is restricted

Question 26

Auscultation of Heart Sounds - Interpretation: With murmurs, if the leaflets lose competency and fail to close tightly…

Answer 26

…blood can flow backwards (REGURGITATION)