1 - Introduction to Clinical Physiology

Question 1

Why would a 115/90mmHg blood pressure be considered unusual?

Answer 1

Low pulse pressure

Question 2

Pulse pressure

Answer 2

The difference between systolic and diastolic pressure

Question 3

Implications of a low pulse pressure

Answer 3

Either excessive arterial compliance or decreased stroke volume

Question 4

Factors determining pulse pressure

Answer 4

Stroke volume (amount of blood ejected form the heart), arterial compliance)

Question 5

Steps in examining angina patient 1) 2) 3) 4)

Answer 5

1) Take blood pressure 2) Examine carotid waveform with fingers 3) Feel left ventricular impulse 4) Listen to heartbeat with stethoscope

Question 6

Where do you feel left ventricular pressure?

Answer 6

On mid-clavicular line

Question 7

Types of left ventricular pressures 1) 2) 3)

Answer 7

1) Normal 2) Volume overload 3) Pressure overload

Question 8

How does a normal left ventricular impulse feel?

Answer 8

Forceful, sustained, localised

Question 9

Implications of a left ventricular impulse feeling too weak

Answer 9

Pressure overload in left ventricle. Implies blockage downstream

Question 10

What does a heart murmur imply?

Answer 10

Turbulent blood flow

Question 11

What can be inferred from the patient’s carotid pressure vs left ventricular pressure?

Answer 11

There is a blockage between the left ventricle and the aorta/carotid.

Need to think of a place between the LV and aorta.

The most likely is a stenosis (block) of the aortic valve.