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Health Assessment > Cardiac > Flashcards

Flashcards in Cardiac Deck (63)
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1
Q

dextrocardia

A

location of heart in right hemithorax, either by displacement from disease or congenital mirror-image reversal

2
Q

S1

A

First heart sound, “Lubb”

Closure of the atrioventriclar valves (systole)

3
Q

S2

A

Second heart sound, “Dubb”

Closure of semilunar valves (diastole)

4
Q

S3

A

Passive filling of the ventricle during diastole

5
Q

S4

A

Contraction of atria to complete filling of ventricle

6
Q

Split S2

A

A2 then P2

Same events occur first on left, then right

7
Q

Depolarization

A

Spread of stimulus through the heart muscle

8
Q

Repolarization

A

Return of the stimulated heart to a resting state

9
Q

P wave

A

spread of a stimulus through the atria (atrial depolarization)

10
Q

PR Interval

A

The time from initial simulation of the atria to initial simulation of the ventricles
0.12-0.20 second

11
Q

QRS Complex

A

Spread of a stimulus through the ventricles (ventricular depolarization)
Less than 0.10 second

12
Q

ST segment and T wave

A

Return of stimulated ventricle muscle to a resting state (ventricular repolarization)

13
Q

U wave

A

small deflection sometimes seen just after the T wave

14
Q

QT Interval

A

Time elapsed from the onset of ventricular depolarization until the completion of ventricular repolarization. The interval varies with the cardiac rate.

15
Q

Fetal heart circulation

A

Umbilical vessels compensate for nonfunctioning lungs
Blood flows right to left atrium via foramen ovale
Right ventricle pumps blood through the patent ductus ateriosus

16
Q

Changes of fetal circulation at birth

A

Closure of ductus arteriosus within 24 to 48 hours after birth

17
Q

Maternal cardiac

A

Blood volume increases 40-50%, mainly due to increase in plasma volume
CO increases 30-40%

18
Q

Anginal CP

A

Substernal, provoked by effort, relieved by rest

19
Q

Pleural CP

A

Precipitated by breathing or coughing, sharp, present during respiration, absent when breath held

20
Q

Esophageal CP

A

Burning, substernal, occasional radiation to shoulder, nocturnal, usually lying flat
Relieved with food, antacids

21
Q

CP from peptic ulcer

A

Infradiaphragmatic and epigastric, nocturnal occurence and daytime attack relieved by food

22
Q

Biliary CP

A

Under right scapula, occurs after eating

Will trigger angina more often than mimic it

23
Q

Arthritis/Bursitis

A

Lasts for hours, local tenderness and/or pain with movement

24
Q

Cervical

A

Assc with injury, provoked by activity, painful on palpation/movement

25
Q

Musculoskeletal CP

A

Provoked by movement, particularly twisting or costochondral bending, assc with focal tenderness

26
Q

Psychoneurotic

A

After anxiety, poorly described, located intramammary region

27
Q

Cardiac Inspection

A

Apical Impulse-miclavicular, 5th left intercostal

Look for cyanosis, venous distension

28
Q

Heave or Lift

A

Vigorous apical impulse, forceful, widely distributed, fills systole or is displaced laterally and downward

29
Q

Thrill

A

fine, palpable, rushing vibration, palpable murmur

Usually related to defect in closure of semilunar valves (aortic or pulmonic stenosis)

30
Q

Aortic Valve Area

A

2nd right intercostal space at right sternal border

31
Q

Pulmonic Valve Area

A

2nd left intercostal space, left sternal border

32
Q

Second pulmonic area

A

3rd left intercostal space, left sternal border

33
Q

Tricuspid area

A

4th left intercostal space, lower left sternal border

34
Q

Mitral (apical) area

A

Apex of heart in 5th left intercostal space, midclavicular

35
Q

Mitral Stenosis

A

Bell at apex, left lateral ducbitus

Narrowed valve restricts forward flow, forceful ejection into ventricle

36
Q

Aortic Stenosis

A

Aortic area, ejection sound 2nd right intercoastal

Restricts forward flow, forceful ejection into aorta

37
Q

Subaortic Stenosis

A

Apex, left sternal border

Fibrous ring below aortic valve

38
Q

Pulmonic Stenosis

A

Pulmonic area, radiates left and into neck, thrill in 2nd and 3rd intercostals

Restricts forward flow, almost always congenital

39
Q

Tricuspid Stenosis

A

Bell, tricuspid area

Restricts forward flow, forceful ejection

40
Q

Mitral Regurgitation

A

Apex, high pitched, parasystolic murmur transmitted to left axilla

Valve incompetence allows backflow from ventricle to atrium

41
Q

Mitral Valve Prolapse

A

Apex and left lower sternal border. Listen with patient upright

prolapses into atrium later in systole, develops into a holosystolic murmur

42
Q

Aortic Regurgitation

A

Diaphragm, patient sitting and leaning forward
Austin Flint heard with bell, 2nd intercostal
Valve incompetence allows backflow into aorta

43
Q

Pulmonic regurgitation

A

Valve incompetence allows backflow from PA into ventricle

Difficult to distinguish on physical exam

44
Q

Tricuspid regurgitation

A

Left lower sternum, holosytolic murmur

Valve incompetence allows backflow from ventricle to atrium

45
Q

Heart rates of children

A
Newborn 120-170
1 year 80-160
3 years 80-120
6 years 75-115
10 years 70-110
46
Q

Systolic ejection murmur in pregnany

A

heard in pulmonic area in over 90%

Should not be louder than grade II

47
Q

Bacterial endocarditis

A

bacterial infection of endothelial layer of heart and valves

fever, murmur, neuro dysfunction
Janeway lesions, osler nodes

48
Q

CHF

A

Heart fails to propel blood

Systolic CHF= narrow pulse pressure
Diastolic CHF= wide pulse pressure

49
Q

Pericarditis

A

Sudden inflammation of pericardium

Can result in cardiac tamponade, friction rub

50
Q

Cardiac Tamponade

A

Excessive accumulation of fluids/blood between pericardium

Constrains cardiac relaxation, impairs access of blood to right heart, Becks triad

51
Q

Becks Triad

A

JVD, hypotension, muffled heart sounds

52
Q

Cor Pulmonale

A

Enlargement of right ventricle secondary to pulmonary malfunction

Usually chronic= COPD
Acute cause= PE, ARDS

Crackles, cyanosis, parasternal systolic heave

53
Q

Myocardial Infarction

A

Ischemic myocardial necrosis by abrupt decrease in coronary blood flow

S4, thready pulse, soft systolic blowing apical murmur

54
Q

Myocarditis

A

Focal or diffuse inflammation of the myocardium

Results from infection, toxin, autoimmune

Cardiac enlargement, murmurs, pulsus alternans, gallop rhythms

55
Q

Tetralogy of Fallot

A

4 defect: VSD, pulmonic stenosis, dextroposition of the aorta, right ventricular hypertrophy
“Tetralogy Spell”=paroxysmal dypnea, loss of conciousness and central cyanosis

56
Q

Ventricular Septal Defect

A

Opening between left and right ventricles
30-50% close spontaneously

Holosystolic murmur, s/s chf

57
Q

Patent Ductus Arteriosus

A

Failure of ductus arteriosus to close after birth

Blood flows through ductus during systole and diastole, increases pulmonary pressure and workload on right heart

58
Q

Atrial Septal Defect

A

Congenital Defect in septum dividing left and right atria

Brief, early, rumbling murmur

59
Q

Acute Rheumatic Fever

A

Systemic connective tissue disease occurring after streptococcal pharyngitis or skin infection

Mitral regurg, aortic insufficiency, CHF, friction rub

60
Q

Kawasaki Disease

A

Inflammation in walls of small and medium-sized arteries throughout the body, including coronaries

Diagnosis: Fever 5+ days and 4/5 of the following

Painless bulbar conjunctival lesion without exudate
Changes in extremities (erythema, edema, desquamation)
Polymorphous erythematous rash of trunk and extremities
Changes in lips and oral cavitiy, “strawberry” tongue
Cervical lymphadenopathy, usually unilateral

61
Q

Atherosclerotic Heart Disease

A

deposition of cholesterol, complex inflammatory process

62
Q

Senile Cardiac Amyloidosis

A

Amyloid, fibrillary protein produced by chronic inflammation or neoplastic disease

s/s heart failure. small. thickened left ventricle

63
Q

Aortic Sclerosis

A

Thickening and calcification of aortic valves

Midsystolic ejection murmur