17 – Clinical Tests

Question 1

Hands to check pulse:

Answer 1

-feel carotid or femoral arteries
>facial arteries in horse
-basic assessment
Ex. if weak rapid pulse, maybe an increase in sympathetic stimulation

Question 2

Stethoscope:

Answer 2

-listen to heart through thoracic cavity
-heart sounds
-arrythmia

Question 3

Apex (stethoscope)

Answer 3

-mitral valve
>where beat is the strongest

Question 4

Base (stethoscope):

Answer 4

-aortic valve
-slightly up and cranial to apex

Question 5

Cranial (stethoscope):

Answer 5

-pulmonic valve
-move up rib cranially

Question 6

Stenosis:

Answer 6

-narrowing of valve opening
>causes greater pressure differentials/gradients

Question 7

Regurgitation:

Answer 7

-valvular insufficiency
>causes backward flow of blood and turbulent flow

Question 8

Systolic murmurs:

Answer 8

-crescendo between S1-S2
-holosystolic (or pansystolic)
*between S1 and S2

Question 9

Crescendo between S1-S2:

Answer 9

-caused by aortic (or pulmonic) valve stenosis
>turbulent flow

Question 10

Holosystolic (or pansystolic):

Answer 10

-sound intensity remains constant
-caused by mitral (or tricuspid) regurgitation OR ventricular septum defect
>back flow

Question 11

Diastolic murmurs:

Answer 11

-decrescendo between S2-S1
-delayed beyond S2, decrescendo with an uptick with atrial contraction
*between S2 and S1

Question 12

Decrescendo between S2-S1:

Answer 12

-caused by aortic (or pulmonic) regurgitation
>backflow during diastole

Question 13

Delayed beyond S2, decrescendo with an uptick with atrial contraction:

Answer 13

-caused by mitral (or tricuspid) valve stenosis
>turbulent flow across the valve

Question 14

ECG:

Answer 14

-electrical information
-localize problems
-timing of events

Question 15

What are the most common arrythmias in dogs?

Answer 15

-atrial fibrillation
-premature ventricular complexes
*affect on different organs might have greater consequences
*60% of dogs have arrythmias

Question 16

What can you use to look at heart mechanics?

Answer 16

-echocardiogram
-CT or MRI

Question 17

Echocardiogram:

Answer 17

-structure/function
-ultrasonography (doppler ultrasound)

Question 18

CT or MRI:

Answer 18

-more and in-depth info
-muscular/vascular information
-non-invasive mostly
-contrast used in both

Question 19

Contrast used for CT:

Answer 19

-iodine

Question 20

Contrast used for MRI:

Answer 20

-gadolinium
>less common

Question 21

What can be used to check BP?

Answer 21

-hands
-doppler
-oscillometer
-arterial line

Question 22

Hands to check BP:

Answer 22

-manually fell arteries (pulse check)
-capillary refill time
-basic assessment

Question 23

Doppler (BP):

Answer 23

-non-invasive
-put probe distal to where cuff is
>when tighten cuff: ‘no sound’
>when sound comes back=systolic BP
-systolic BP only

Question 24

Oscillometer (BP):

Answer 24

-non-invasive
-similar to doppler but this is trying to assess the pulse of the artery
-systolic and diastolic BP
-not validated for all species
*good at measuring changes in BP for an animal

Question 25

Oscillometer and different pressures:

Answer 25

-when cuff pressure just below systolic pressure=sharp spike in pressure=systolic BP
-peak oscillation=MAP
-when major oscillations stop=diastolic BP

Question 26

Arterial line:

Answer 26

-invasive
>use in certain surgeries
*gold-standard

Question 27

Most animals MAP is in the range of:

Answer 27

-80-120mmHg

Question 28

When diagnosing hypertension:

Answer 28

-often just use systolic BP using doppler ultrasonography

Question 29

Capillary refill time:

Answer 29

-hands on
-quick
-less than 2 sec=poor circulation

Question 30

Doppler ultrasound for peripheral blood flow:

Answer 30

-more, and in-depth info
-calculate flow rates and resistance
-examine arterial wall structure

Question 31

Jugular vein distension:

Answer 31

-visual test
-non-invasive
-hands on
-various reasons (previous lectures)