SM02 Mini1 Flashcards
biphasic pulsation
two upstrokes/heartbeat (or ventricle contraction)
JVP
jugular venous pressure
JVP= right atrial pressure
b/c no valves present between them
when patient is flat (0º) pressure is equalized, so there is no pulsation
normal measure is between 3-4cm
how is the JVP measured?
measure length of visible pulsing righ internal jugular vein to sternal angle
gives cmH2O of R atrium
x1.3539 to give mmHg
normal measure is between 3-4cm
sternal angle
angle of Louis
joint of manubrium & body of sternum
important precordial landmark to identify 2nd rib & therefore the intercostal spaces
apical pulse
pulsation observed or palpated in the mitral area (midclavicular 5th intercostal space)
only palpable in 25-40% of normal healthy adults in supine position
left lateral decubitis position
laying on the left side of the body
chronic venous insufficiency
most common cause of pitting edema of lower extremities
caused by venous dilation or vein obstruction
can cause fibrosis of subcutaneous tissue/skin, blotchy brown pigmentation, or stasis dermatitis (scaly rash or frank ulcerations)
pitting edema
deprssion of skin after applying pressure to dorsu of foot, medial malleolus, or pretibial area
sign of chronic venous insufficiency, heart failure, hypoproteinemia, or advanced liver dz
stasis dermatitis
scaly rash or more advance frank ulceration caused by chronic venous insufficiency
very slow to heal due to poor perfusion
pectus excavatum
sunken or funnel chest
congenital deformity of anterior chest wall
causes: genetic?, increased pressure in utero, rickets, increased traction due to diaphragm abnormality
common in Marfan & Loeys-Dietz syndrome
can effect cardiac & respiratory function & cause chest & back pain
pectus carinatum
pigeon chest; protuberant sternum
causes: overgrowth of cartilage
seen in pubertal males (11-14yo) more frequently than females, @ birth, w/Rickets, post open heart sx, or children w/poorly controlled asthma
rarely associated w/syndrome
kyphosis
forward curvature of the spine
usually thoracic
“hunchback”
scoliosis
lateral curvature of the spine
barrel chest
increased anterior-posterior diameter of chest wall, usually associated w/emphysema
causes: 1. increased compliance of lungs→accumulation of air pockets inside thoracic cavity 2. increased compliance of lungs→ increased intrathoracic pressure→ increased chest wall outward
crackles
alveolar sounds produced as air displaces fluid from alveoli
if watery fluid→ “fine” crackles caused by pulmonary edema
if thick fluid→ “coarse” crackles caused by pneumonia
