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examinations > the cardiac examination > Flashcards

the cardiac examination Flashcards

1
Q

cardiac muscle is supplied by

A

three coronary arteries

  • left anterior descending artery
  • circumflex artery
  • right coronary artery
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2
Q

causes of cachexia

A

malignant disease

secere cardiac failure (cardiac cachexia)

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3
Q

marfan syndrome

A

tall stature, thoracic kyphosis, pactus excavatum, arachnodactyly (spider fingers), long limbs, aortic regurgitation and a high arched palate

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4
Q

osler’s nodes

A

rare manifestation of endocarditis
red, raised, tender palapable nodules on the pulps of the fingers or toes
or on thenar or hypothenar eminences

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5
Q

janeway lesions

A

non tender erythematous maculopapular lesions containing bacteria, which occur very rarely on the palms or pulps of the fingers in patients with infective endocarditis

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6
Q

tendon xanthomata

A

yellow orange deposits of lipid in the tendons that occur in type 2 hyperlipidaemia
can be seen over the tendons of the hand or arm

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7
Q

palmar xanthomata

A

xanthomata over the elbows

indicative of type 3 hyperlipidaemia

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8
Q

tuberuptive xanthomata

A

xanthomata of the knee in type 3 hyperlipidaemia

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9
Q

type 2 hyperlipidaemia

A

elevated LDL or elevated VLDL

choleserol alone or both cholesterol and tryglycderides are elevated

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10
Q

regullar rhythm bradycardia

A

physiological eg. ahletes
drugs eg. beta blockers, digoxin, amiodarone
hypothyroidism eg. decreassed sympathetic actvitiy
hypothermia
raissed ICP
third degree atrioventricular (AV) block or third degree AV block
MI
vasovagal syncope
jaundice - in severe cases

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11
Q

irrugularly irregular rhythm bradycardia

A

AF
alcohol, post thoracotomy, idiopethic
mitral valve disease or any cause of left atrial enlargemnt

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12
Q

regularly irregular rhythm

A

sinus arrythmia

second degree AV block

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13
Q

regular rhythm tachycardia

A 
hyperdynamic circulation due to exercise, emotion, fever, pregnancy, thyrotoxicosis, anaemia, arteriovenous fistula, ber-beri
congestive heart failure
costrictuve pericarditis 
drugs 
normal variant denervated heart eg. diabetes 
hypovolaemic shock 
supraventricular tachycardia 
atrial flutter 
ventricular tachycardia

sinus tachycardia due to thyrotoxicosis, pulmonary empbolism, myocarditis, mycardia ischamia, fever, acute hypoxia or hypercapnia,

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14
Q

cause of atrial fibrullation

A

bombardment of the atrioventricular node with impulses, some of which are conducted to the ventricles because the AV node is unable to conduct at such high rates
ventricles beat irregularly at rates of 150-180 per minute

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15
Q

bigeminy

A

every second beat is an ectopic one

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16
Q

trigeminy

A

every third beat is an ectopic one

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17
Q

radial radial delay usually due to

A

large arterial occlusion by an atherosclerotic plaque or anuerysm or to subclavian artery stenosis on one side

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18
Q

pulsus alternans

A

alternating strong and weak pulse

19
Q

grade 1 hypertension

A

mild

140-159/90-99

20
Q

grade 2 hypertension

A

moderate

160-179/100-109

21
Q

grade 3 hypertension

A

severe

>180/>110

22
Q

after measuring BP in both arms

A

use the arm with the highest blood pressure

23
Q

arcus senilis

A

half or complete grey circle seen around the outer perimeter of the pupil and is probably associated with some increase in cardiovascular risk

24
Q

marfan syndrome

A

aortic root dilatation causing aortic regurg

mitral valve prolapse causing mitral regurgitation

25
Q

height of the JVP

A

if the JVP is more than 3cm above the sternal angle then the right heart filling pressure is increased

26
Q

abdominojugular reflux test

A

if there is right ventricular failure or left ventricular failure the JVP will remian elevated after 10 seconds of abdominal pressure

27
Q

funnel chest

A

pectus excavatum

28
Q

hunchback

A

hyphoscoliosis

29
Q

the apex beat is located

A

at the 5th intercostal space medial to te midclavicular line

30
Q

if the apex beat is displaced laterally or inferiorly

A

enlargement

31
Q

pressure loaded apex beat

A

heaving
forceful
aortic stenosis or hypertension

32
Q

volume loaded

A

displaced, diffuse, non sustained

advanced mitral regurgitation or dilated cardiomyopathy

33
Q

dyskinetic apex

A

uncoordinated impulse felt over a larger area due to left ventricular dysfunction

34
Q

double impulse apex beat

A

two distinct impulses are felt with each systole

characteristic of hypertrophic cardiomyopathy

35
Q

tapping apex beat

A 
felt when the first heart sound is palpable 
mitral or (rarely) tricuspid regurgitation
36
Q

parasternal impulse

A

in cases of right ventricular enlargement or severe left atrial enlargement
right ventricle becomes pushed anteriorly
impulse is felt by the heel of the hand being lifted of the chest with each systole

37
Q

presence of a thrill indicates

A

severe valve lesion

38
Q

pansystolic murmur may be

A

mitral regurgitation
tricuspid regurgitation
ventricular septal defect
aotropulmonary shunts

39
Q

midsystolic murmur may be

A

aortic stenosis or sclerosis
pulmonary stenosis
hypertrophic cardiomyopathy
pulmonary flow murmur of aan atrial septal defect

40
Q

late systolic murmur may be

A

mitral valve prolapse

papillary muscle dysfunction (due usually to ischaemia of hypertrophic cardiomyopathy)

41
Q

early diastolic murmur may be

A

aortic regurgitation

pulmonary regurgitation

42
Q

mid diastolic murmur may be

A

mitral stenosis
tricuspid stenosis
atrial myxoma
austin flint murmur of aortic regurgitation
carey coombs murmur of acute rheumatic fever

43
Q

pre systolic murmur may be

A

mitral stenosis
tricuspid stenosis
atrial myxoma

44
Q

continuous murmur may be

A

patent ductus arteriosus
arteriovenous fistula (coronary artery, pulmonary, systemic, haemodialysis fistula)
aortopulmonary connection
venous hum
rupture of sinus of valsalva into right ventricle or atrium
mammary souffle

examinations (6 decks)

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