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[OS 205] 3rd Exam > Trans - Pediatric Cardiac PE > Flashcards

Trans - Pediatric Cardiac PE Flashcards

1
Q

Harrison’s groove

A

rib deformity and sign of chronic heart failure with diaphragm enlargement

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2
Q

palpating for heaves - movement on which part of the hand indicates LV heave? RV heave?

A

[1] RV heave - palm/sternum

[2] LV heave - fingers

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3
Q

cause of thrills

A

turbulence of underlying murmurs

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4
Q

thrills can first be felt at what grade of murmurs

A

4/6

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5
Q

the stethoscope diaphragm is useful for picking up which sounds?

A

high pitched sounds - S1, S2, murmurs of aortic and mitral regurgitation, pericardial friction rubs

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6
Q

the stethocscope bell is useful for picking up which sounds?

A

low pitched sounds - S3, S4, murmur of mitral stenosis

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7
Q

how is ascultation of the pediatric patient done? why?

A

C manner (infraclavicular –> parasternal –> apex –> axilla), because most pediatric heart conditions are congenital

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8
Q

where is the normal splitting of S1 detected?

A

lower left sternal border

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9
Q

physiological splitting of S2 occurs when?

A

during inspiration

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10
Q

why does the physiological splitting of S2 occur?

A

During inspiration, the increase in negative intrathoracic pressure causes increased central venous return. Because this increased volume passes through the pulmonary trunk, causing the pulmonic valve to close a bit later than normal.

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11
Q

components of S2

A

A2, P2

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12
Q

which is louder? A2 or P2?

A

A2

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13
Q

[T/F] S3 or S4 in an athlete is an abnormal finding

A

F

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14
Q

how are murmurs differentiated from normal heart sounds?

A

murmurs have a longer duration

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15
Q

things to evaluate in auscultation [6]

A 
[1] rate
[2] rhythm
[3] quality of heart sound
[4] S1/S2
[5] extra heart sounds
[6] murmur
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16
Q

where is S1 louder?

A

apex

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17
Q

where is S2 louder?

A

base

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18
Q

midsystolic murmur - description

A

begins after S1, stops before S2; gaps between murmur and heart sound

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19
Q

midsystolic murmur - lesions

A

deals with blood flow across semilunar valves

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20
Q

holosystolic murmur - description

A

starts with S1 and stops at S2

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21
Q

holosystolic murmur - lesions

A

often due to regurgitant flow across AV valves

22
Q

late systolic murmur - description

A

in mid- late- systole persisting up to S2

23
Q

late systolic murmur - lesions

A

mitral valve prolapse (may or may not be preceeded by systolic click)

24
Q

early diastolic murmur - description

A

starts right after S2 without gap, fades into silence before next S1

25
Q

early diastolic murmur - lesions

A

often accompany regurgitant flow across incompetent semilunar valves

26
Q

middiastolic murmur - description

A

begins quickly after S2

27
Q

middiastolic murmur - lesion

A

turbulent flow across AV valves

28
Q

S3 rumbles - description

A

middiastolic murmur associated with S3, associated with torrential inflow

29
Q

Austin Flint murmur - description

A

begin in middiastole, may be confined to middiastole or continue through presystole

30
Q

S3 rumbles - lesion

A

AV regurgitation, ASD

31
Q

Austin Flint murmur - lesion

A

aortic regurgitation

32
Q

pericardial friction rub - causes

A

inflammation of pericardial sac

33
Q

pericardial friction rub - components [3]

A

[1] atrial systole
[2] ventricular systole
[3] ventricular diastole

34
Q

patent ductus arteriosus

A

open channel persists between aorta and pulmonary artery

35
Q

patent ductus arteriosus - type of murmur

A

continuous murmur with silent interval late in diastole and loudest in late systole

36
Q

[T/F] friction rubs are a type of heart murmur

A

F, not caused by flow

37
Q

crescendo-decrescendo murmur - lesions

A

present in obstructive lesions

38
Q

crescendo-decrescendo murmur - why?

A

crescendo - ventricles try to pump blood through obstruction

decrescendo - blood passes through, pressure is released

39
Q

aortic regurgitation - type of murmur

A

diastolic

40
Q

aortic stenosis - type of murmur

A

systolic

41
Q

pulmonic regurgitation - type of murmur

A

diastolic

42
Q

pulmonic stenosis - type of murmur

A

systolic

43
Q

mitral stenosis - type of murmur

A

diastolic

44
Q

mitral regurgitation - type of mumur

A

systolic

45
Q

tricuspid regurgitation - type of murmur

A

systolic

46
Q

tricuspid stenosis - type of murmur

A

diastolic

47
Q

ventricular septal defect - type of murmur

A

uniform holosystolic murmur (due to pressure gradient present in systole)

48
Q

patent ductus arteriosus - type of murmur

A

continuous murmur (due to pressure difference in both systole and diastole)

49
Q

atrial septal defect - ascultatory findings [3]

A

[1] diastolic rumble in tricuspid (stenosis)
[2] pulmonic murmur (due to increased blood flow from right ventricle to pulmonic valve)
[3] widely fixed split S2 (due to increased blood flow through pulmonic valve)

50
Q

atrial myxoma

A

mass in atrium causing mitral inflow obstruction

51
Q

atrial myxoma - type of murmur

A

crescendo-decrescendo murmur in diastole

[OS 205] 3rd Exam (6 decks)

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