Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

USMLE > Cardiac Maneuvers > Flashcards

Cardiac Maneuvers Flashcards

1
Q

Inspiration

A

Increases intensity of right heart sounds

Increased preload

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Hand grip

A

Increased systemic vascular resistance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Valsalva (phase II) and standing

A

Decrease venous return

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Rapid squatting

A

Increased venous return, preload, and afterload with prolonged squatting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Effect of valsalva (phase II) and standing on intensity of most murmurs?

A

Decreased intensity of most murmurs (including AS)

Decreased venous return

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Effect of valsalva (phase II) and standing on intensity of hypertrophic cardiomyopathy murmur?

A

Increased intensity of HCM

Decreased venous return = increases stenosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Effect of valsalva (phase II) and standing on MVP?

A

Decreased murmur intensity, earlier onset of click/murmur

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Effect of hand grip on intensity of MR, AR, and VSD murmurs?

A 
Increased intensity
(Increased systemic vascular resistance)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Effect of hand grip on intensity of AS, HCM murmurs?

A 
Decreased intensity 
(Increased systemic vascular resistance)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Effect of hand grip on MVP?

A

Increased murmur intensity, later onset of click/murmur

Increased systemic vascular resistance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Effect of rapid squatting on intensity of hypertrophic cardiomyopathy murmur?

A

Decreased intensity of HCM

Increased venous return, preload, and afterload = decreases stenosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Effect of rapid squatting on intensity of AS murmur?

A 
Increased intensity
(Increased venous return, preload, and afterload)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Effect of rapid squatting on MVP?

A

Increased murmur intensity, later onset of click/murmur

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Effect of respiration

A

Right sided murmurs (TR) increase with inspiration due to increased venous return to the right heart

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Effect of abrupt standing

A

Most murmurs diminish in intensity due to reduced venous return and subsequently reduced R/L ventricular diastolic volumes
Murmur of HCM becomes louder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Effect of squatting

A

Most murmurs become louder (also with passive leg raising)

Murmur of HCM becomes softer

17
Q

Effect of valsalva maneuver

A

Most murmurs decrease in intensity

Murmur of HCM becomes louder

18
Q

Effect of sustained hand grip

A

Most useful in differentiating AS from MR
AS = decreased intensity
MR = increased intensity

19
Q

Respiration physiology

A

Venous return to RV increases during inspiration resulting in increased volume
Venous return to LV decreases during inspiration resulting in decreased volume
Primarily alters intensity of murmurs that originate from right side of heart

20
Q

Abrupt standing physiology

A

Decreases venous return to heart = decreases RV and LV diastolic volumes and SVs
Can lead to a fall in arterial pressure and a reflex increase in HR

21
Q

Valsalva maneuver physiology phase 1

A

Onset = transient increase in LV output

22
Q

Valsalva maneuver physiology phase 2

A

Straining = decrease in venous return, RV and LV volumes, SVs, MAP, and PP
Associated with reflex increase HR

23
Q

Valsalva maneuver physiology phase 3

A

Release = further reduction in LV volume

24
Q

Valsalva maneuver physiology phase 4

A

Increase in stroke volume and arterial pressure

Reflex slowing of HR (overshoot)

25
Q

Which phase of valsalva is most useful and practical for differentiating heart sounds?

A

Phase 2 = straining

26
Q

Hand grip physiology

A

Increase in systemic vascular resistance, arterial pressure, CO, and LV volume/filling pressure

27
Q

Expiration

A

Increases return to left heart

28
Q

Effect of inspiration on TR?

A

Enhanced (increased RA return)

29
Q

Effect of squatting and hand grip on MR?

A

Enhanced (increased TPR)

30
Q

Effect of hand grip on VSD?

A

Enhanced (increased afterload)

31
Q

Effect of midsystolic click in MVP with maneuvers that decrease venous return (standing, Valsalva)?

A

Decreased volume = occurs EARLIER

32
Q

Effect of midsystolic click in MVP with maneuvers that increase venous return (squatting)?

A

Increased volume = occurs LATER

33
Q

Effect of hand grip on AR?

A

Increased intensity

34
Q

Effect of vasodilators on AR?

A

Decreased intensity

35
Q

Effect of expiration on MS?

A

Enhanced (increased LA return)

USMLE (38 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions