10.2 Flashcards

(58 cards)

1
Q

What specific questions who you ask someone coming in with chest pain?

A
  • what factors influence the pain?
  • does the pain radiate?
  • is there position related relief?
  • any dizziness/ cyanosis?
  • any use of nitroglycerin?
  • cough, dyspnea, syncope, leg pain/cramps, severe HA, swollen ankles
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2
Q

What pertinent FMHx are you looking for with chest pain?

A
  • DM
  • heart disease
  • hyperlipidemia
  • hypertension
  • obesity
  • congenital heart defects
  • sudden death
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3
Q

What are some associated sx to look out for with chest pain?

A
  • Anxiety
  • Dyspnea
  • Diaphoresis
  • Dizziness
  • Nausea
  • Vomiting
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4
Q

SoHx to consider with chest pain

A
  • employment risks
  • tobacco
  • alcohol
  • diet
  • exercise
  • stress
  • drug use
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5
Q

Who are at greater risk for cardiac problems?

A
  • Pregnant women
  • Elderly
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6
Q

What are the 4 components of a heart examination?

A
  1. Inspection
  2. Palpation
  3. Percussion
  4. Auscultation
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7
Q

What are you inspecting the chest wall, carotid arteries and jugular veins for?

A
  • pulsations
  • lifts
  • heaves
  • thrusts
  • symmetry
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8
Q

What are you inspecting the skin for?

A
  • cyanosis of the nailbeds
  • capillary refill
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9
Q

Where can you palpate the apical pulse?

A

Midclavicular line, 5th intercostal

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10
Q

What are the 6 places you palpate?

A
  1. the base
  2. left sternal border
  3. right sternal border
  4. apex
  5. epigastrium
  6. left axillae
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11
Q

What positions should you have the patient in for auscultation?

A
  • Sitting
  • Supine
  • Left lateral recumbent
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12
Q

What are you describing while auscultating?

A
  • rate
  • rhythm
  • duration of cycle
  • timing
  • intensity
  • frequency
  • splitting
  • murmurs
  • quality
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13
Q

What are you auscultating the carotid arteries for?

A
  • bruits
  • murmurs
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14
Q

What basic heart sounds are you listening for?

A
  • S1
  • S2
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15
Q

What valves are closed during S1?

What valves are open during S1?

A

Closed: (M)itral and (T)ricuspid

Open: (A)ortic and (P)ulmonic

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16
Q

What valves are closed during S2?

What valves are open during S2?

A

Closed: (A)ortic and (P)ulmonic

Open: (M)itral and (T)ricuspid

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17
Q

What is a normal resting HR for an adult?

A

60 - 90bpm

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18
Q

In a slender person the heart is more…

A

vertical and central

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19
Q

In a stocky person the heart lies

A

horizontally and to the left

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20
Q

Wide apical pulsation may indicate what?

A

Left ventricular hypertrophy

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21
Q

Loss of palpable apical pulsation may indicated what?

A

fluid, air, or displacement

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22
Q

Thrills are associated with what pathology?

A
  • failure of semilunar valve to close
  • aortic/pulmonary stenosis
  • atrial septal defect
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23
Q

Loud S1 could suggest what?

A

Increased blood velocity

mitral stenosis

heart block

hypertension

calcification of mitral valve

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24
Q

Loud S2 suggests?

A

hypertension

valve disorder

stenosis

fluid

25
Frictional rubs can be caused by? what do they sound like?
pericardial sac inflammation grating, machine-like rubbing
26
What should you be inspecting for in the veins?
* JVD * varicose veins
27
Inspect extremities for findings of arterial and venous insufficiencies, what are you looking for?
* edema * erythema * absence of hair * cyanosis * pallor * ulcers * cool skin
28
What 8 arteries are we palpating?
1. Temporal 2. Carotid 3. Brachial 4. Radial 5. Femoral 6. Popliteal 7. Posterior tibialis 8. Dorsalis pedis
29
What are you comparing while palpating pulses?
Contralateral pulses lower and upper extremities
30
What is pulse pressure?
the difference between systolic and diastolic pressures.
31
What 4 variables contribute to the characteristics of the pulse?
1) Volume of blood ejected (stroke volume) 2) Distension of the aorta and large arteries 3) Viscosity of the blood 4) Peripheral arteriolar resistance
32
What are bruits?
turbulent blood flow
33
Inspect the chest wall, carotid arteries and jugular veins for
* pulsations * lifts * heaves * thrills * symmetry
34
Inspect extremities for…
* color * hair distribution * venous distention
35
Inspect the nailbeds for
cyanosis capillary refill
36
What is the scale for amplitude of pulse?
4= Bounding, aneurysmal 3= Full, increased 2= Expected 1= Diminished 0=Absent
37
What is the scale for pitting edema?
1+ Slight pit (2-3mm) 2+ Somewhat deep pit (10-15sec or 4-5mm) 3+ Noticeable deep pit (longer than 1min or 6-7mm) 4+ Very deep pit (2-5min or 8-9mm)
38
Palpate and assess for thrombosis
* Redness, thickness of the vein, tenderness along superficial vein, and warmth * Can be indicated through taking a good history and exam * Homan's sign (discomfort behind the knee upon forced dorsiflexion of the foot) * Use Doppler for confirmation of diagnosis
39
What is the way we test for varicose veins?
Have the patient do 10 calf raises
40
What are normal findings on an adult?
no visible pulsations, or heaving of chest pulses symmetric bilat 2+ extremities warm and pink with hair present Systolic: 100-140 Diastolic: 60-90
41
What happens to your BP when you stand up?
Systolic pressure drops, diastolic pressure rises
42
Jugular distention \<9cm suggests
ventricular failure
43
Positive Homan's sign indicates
venous thrombosis
44
Fluid always reflects what color on an ultrasound?
BLACK
45
Tissue is always what color on an ultrasound?
GRAY
46
What color will bone appear on an ultrasound?
WHITE
47
What operating mode is a two-dimensional image is generated that portrays moving reflectors in color simultaneously with images.
Color Flow Doppler
48
What regulates the amplification (brightness) of returning echoes to compensate for loss of transmitted sound caused by absorption and reflection?
Gain
49
What is a relative term that refers to the echoes returned from a structure?
Hyperechoic
50
What refers to structures that contain fewer or weaker echoes than surrounding tissues.
Hypoechoic
51
What is the ability to distinguish between two adjacent structures (interfaces)?
Resolution
52
What is an electromechanical device that is part of an ultrasound system, that contacts the patient and converts electrical energy into mechanical energy and vice versa?
Transducer
53
What Color represents TOWARD the probe?
Red
54
What color indicates flow going AWAY from the probe?
Blue
55
What are the 3 main types of ultrasound probes?
1. Curvilinear probe 2. Linear probe 3. Phased array probe
56
Which probe is used for abdominal and obstetric imaging?
Curvilinear probe
57
Which probe is used for soft tissue and small parts imaging?
Linear probes
58
Which probe is used to “bend” the US beam from flat, small footprint to a wider pie-shaped wedge distally.
Phased array probes