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Q2 Physical Diag card, ab, LE, neuro, privates > Cardio > Flashcards

Flashcards in Cardio Deck (68)
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1
Q

AV valves are?

A

Mitral

Tricuspid

2
Q

Semilunar valves?

A

Aortic

Pulmonary

3
Q

First Heart Sound?

A

closing of AV valves
S1
Systole (vents contract)

4
Q

Second Heart Sound?

A

closing of aortic and pulmonic valves
S2
diastole (vents relax

5
Q

Third Heart Sound?

A

rapid distension of vent walls during filling
S3
low-pitch
heard w/ bell at apex

6
Q

Fourth Heart Sound?

A

atrial systole
S4
low-pitch
heard w/ bell at apex

7
Q

Systolic or Diastolic Murmur?

A

blood rushing thru narrow/leaky valve or chamber walls

8
Q

Thrill?

A

palpable murmur

(U) vibrations of loud murmur

9
Q

Lift/Heave?

A

vigorous cardiac impulse palpable through chest wall

10
Q

Apical Impulse (Point of Maximal Impulse) is?

Felt where?

What size?

A

systolic pulse of LV

5th ICS, medial to MCL

1-2 cm across

Palp w/ pt both seated and supine

11
Q

Examine pt from which side?

A

Pt’s right

12
Q

Palpate for Lifts and Thrill where?

A

L sternal border

Base of heart

13
Q

Steth diaphragm best for what sound?

A

high-pitched

S1/2

14
Q

Steth bell best for what sounds?

A

Low-pitched

S3/4

15
Q

Aortic sounds heard where?

A

2nd ICS, RSB

16
Q

Pulmonic sounds hear where?

A

2nd ICS, LSB

17
Q

Second Pulmonic sounds heard where?

A

3rd ICS, LSB

18
Q

Tricuspid sounds heard where?

A

4th/5th ICS, LSB

19
Q

Mitral sounds heard?

A

apex

5th ICS, MCL

20
Q

What sound is at 2nd ICS, RSB ?

A

Aortic

21
Q

What sound is at 2nd ICS, LSB?

A

Pulmonic

22
Q

What sound is at 3rd ICS, LSB?

A

Second Pulmonic

23
Q

What sound is at 4th/5th ICS, LSB?

A

Tricuspid

24
Q

What sound is at 5th ICS, MCL?

A

Mitral

25
Q

Palp of Axillary Nodes in what 4 places?

A

Anterior axillary line
Midaxillary line
Posterior axillary line
Medial upper arm

26
Q

JVD is sign of?

A

fluid overload in heart

27
Q

Measure jugular venous pressure how?

A

head at 30º

find point of highest pulse in internal jugular vein

measure from sternal angle (~5cm above R atrium)

> 4cm above sternal angle = elevated heart pressure

28
Q

Hepatojugular reflux exam tests for?

How is exam performed?

A

test for fluid cardiac overload

apply pressure RUQ over liver
JVP will increase then decrease when released

29
Q

Cardiac impluse felt lateral to MCL indicates what?

A

LV enlargement

30
Q

Cardiac Percussion of L border tests for?

Exam performed how?

A

use to estimate size of heart

percuss from 5th ICS at MAL medially
listening for onset of dullness

31
Q

Auscultation sitting up/lean forward tests for what?

Exam performed how?

A

aortic and pulmonic regurge

Pt sitting, leans forward
Exhale and hold breath
Listen at base and apex

32
Q

Best way to hear low-pitch filling sounds (gallops, murmurs)?

A

L lateral decubitus position:

Pt on L side, arm above head
listen w/ bell at apical impulse

33
Q

S1 should be > S2 where?

A

at apex

34
Q

S1 should be < S2 where?

A

at base

35
Q

Louder than normal S1 due to?

A

disease AV valve or

more forceful closure of AV valve

36
Q

Softer than normal S1 due to? (3)

A

1) weak heart contractions
2) thick chest wall
3) emphysematous lungs

37
Q

S2 splits when?

A2 sound is?

P2 sound is?

A

plumonic valve closure is delayed

A2 = aortic valve closure

P2 = pulmonic valve closure

38
Q

S2 split is normal when?

Heard where?

A

during inspiration

2nd/3rd ICS

39
Q

Wide S2 split due to? (2)

A

1) pulmonic stenosis

2) R bundle branch block (RBBB)

40
Q

Fixed S2 splitting: “Fixed” means?

Due to? (2)

A

“fixed” means does not vary w/ respiration

1) atrial septal defect
2) RV failure

41
Q

Paradoxical S2 splitting: “Paradoxical” means?

Due to?

A2/P2 sounds present in what order?

A

“paradoxical” means happens during expiration, but not insp

delayed contraction of LV from LBBB

A2 follows P2

42
Q

S1 + S2 + S3 =

A

ventricular gallop rhythm

43
Q

Pathologic S3 vent gallop? (4)

A
>40yo from:
HF
anemia
vol overload of vents
decreased contractility
44
Q

S1 + S2 + S4 =

A

atrial gallop rhythm

45
Q

Pathologic S4 atrial gallop?

A

from resistance to vent filling
stiff heart mm
typical heart diseases cause this

46
Q

Route of cardiac inpulse?

A
SA node ->
R atrium ->
AV node ->
atrial septum ->
bundle of His ->
Purkinje fibers in vents
47
Q

Tachycardia bpm?

A

> 100

48
Q

Normal bpm?

A

60-100

49
Q

Bradycardia bpm?

A

<60

50
Q

Arrhythmia definition?

A

irregular or lost rhythm

51
Q

Aortic/Pulmonic Ejection Click sounds like what?

Heard where?

Caused by (3)?

A

high-pitch

just after S1

1) valve disease
2) dilated aorta/pulm artery
3) pulmonary HTN

52
Q

Late Systolic Murmur happens when?

Sounds like?

Cause by?

A

pre S2

variable pitch

mitral prolapse into L atrium

53
Q

Systolic Ejection Murmur happens when?

Heard where?

Sounds like?

Cause by?

A

HIGH PRESSURE TO HIGH PRESSURE
b/w S1/S2

heard at base, R & LSB

(U) crescend-decrescendo

(U) from blood flow across semilunar valves,
Aortic/Pulmonic stenosis

54
Q

Pansystolic Murmur happens when?

Sounds like?

Caused by?

A

HIGH PRESS TO LOW PRESS
b/w S1/S2

(U) sound remains same connecting S1/S2

(U) from regurge across AV valves
or ventricular septal defect

55
Q

Innocent Systolic Murmur sounds like?

Caused by?

A

(U) grade 1-2, medium pitch

turbulent blood flow
no narrowing/obstruction or disease
(C) kids, young adults

56
Q

Mitral Insufficiency (Regurge) from?

A

Rheumatic HD

57
Q

Atrial Septal Defect (ASD) from?

A

congenital anomaly
blood flow LA -> RA
enlarged RV
inc flow thru pulmonic valve

58
Q

ASD murmur is?

A

Systolic ejection:

fixed splitting S2

59
Q

Ventral Septal Defect causes what kind of shunt?

A

L to R shunt

60
Q

VSD murmur sounds like?

Heard where?

A

harsh pansystolic

heard and felt at low LSB

61
Q

Early Diastolic Murmur sounds like?

Heard when?

Caused by?

A

(U) decrescendo

just post S2

(U) regurge across leaky semilunar valves
(aortic regurge)

62
Q

Mid Diastolic Murmur sounds like?

Heard where?

Caused by?

A

low decresc

b/w S2/S1

from turbulent flow across AV valves,
mitral/tricuspid stenosis

63
Q

Late Diastolic Murmur sounds like?

Heard when?

A

(presystolic)
low decresc

from S2 to S1

64
Q

Opening Snap Diastolic Rumble sounds like?

Heard when?

Caused by?

A

high snap, low rumble

b/w S2/S1

mitral stenosis

65
Q

Aortic Stenosis and Aortic Insufficiency (Regurge) murmur sounds like?

Heard when?

Caused by?

A

Crescendo-decres

Syst-Diast murmur (to-fro)

reduced outflow from narrowed valve
leakage from failure to close

66
Q

Patent Ductus Arteriosus

A

failure of channel b/w aorta/pulm artery to close

67
Q

Strain phase of Valsalva does?

A

↓ LV vol
↓ vascular tone
↓ BP and peripherial vascular resistance

68
Q

Squatting or release of Valsalva does?

A

opposite of strain