Cardiac EXAM

Question 1

Where is aortic focus?

Answer 1

2nd right ICS

Question 2

Where is pulmonic focus?

Answer 2

2nd and 3rd left ICS

Question 3

Erb’s point

Answer 3

3rd left ICS

Question 4

Tricuspid location

Answer 4

4th left ICS/LLSB

Question 5

Mitral location

Answer 5

4th or 5th left ICS in MCL

Question 6

What is Levine’s sign?

Answer 6

Pt holding their hand over their mid chest

Question 7

What is a lift

Answer 7

Palpable movement of chest due to increased pressure usually from RV hypertrophy

Question 8

What is a heave?

Answer 8

A more pronounced life

Question 9

What is a thrill?

Answer 9

A palpable murmur

Question 10

Having a pt fully exhale while leaning forward accentuates ____________

Answer 10

S2 and aortic murmurs

Question 11

Having Pt lie on left side while listening over apex accentuates __________

Answer 11

S1 and mitral murmurs

Question 12

What is the precordium?

Answer 12

The area of the chest overlying the heart

Question 13

What is preload?

Answer 13

ventricular volume at the end of diastole prior to contraction for systole

Question 14

What makes S1

Answer 14

closing of tricuspid and mitral valve during systole

Question 15

What makes S2

Answer 15

Closing of aortic and pulmonic valves during diastole

Question 16

Explain: “All Physicians Eat Tender Meat”

Answer 16

Aortic --> R 2nd ICS -- S2
Pulmonic --> L 2nd ICS -- S2
Erb's --> L 3rd ICS
Tricuspid --> 4th ICS -- S1
Mitral --> 5th ICS mid clavicular -- S1

Question 17

What causes physiologic splitting of S2?

Answer 17

On inspiration, increased pressure causes more blood to enter from vena cavae and rt. atrium making the pulmonic valve stay open longer.

Question 18

Xanthelasma is?

Answer 18

waxy fat deposits from hypercholesterolemia

Question 19

What is the pericardium?

Answer 19

Fibrous sac encasing the heart

Question 20

Precordium?

Answer 20

Area of the chest overlaying the heart.

Question 21

Systole

Answer 21

ventricles are contracting

Question 22

Diastole

Answer 22

Ventricles filling w/ blood

Question 23

What is pathological splitting?

Answer 23

When there is a split between aortic and pulmonary valves regardless of inspiration of expiration, or when the aortic and pulmonary valves are split wide on expiration and are closer during inspiration

Question 24

What is preload?

Answer 24

The amount the ventricles stretch out due to blood prior to contraction

Question 25

What is after load?

Answer 25

What the ventricles have to work against to pump out blood during contraction - forces that oppose ejection of blood

Question 26

Gallop

Answer 26

either s3 or s4, or both

Question 27

When does s3 arise?

Answer 27

Mitral regurgitation

Question 28

When does s4 arise?

Answer 28

During the atrial “kick”

Question 29

What is a rub?

Answer 29

When the heart rubs against the pericardium, is generally continuous throughout s1 and s2. Sounds like creaking leather.

Question 30

What is a click?

Answer 30

A adventitious sound due to mitral valve prolapse

Question 31

What is a snap?

Answer 31

Adventitious sound due to mitral valve stenosis.

Question 32

What are ejection sounds?

Answer 32

Adventitious sounds due to aortic valve stenosis.

Question 33

What is the electrical current route in the heart?

Answer 33

SA node, AV node, Bundle of His, Purkinje Fibers, then contraction starts at the apex of the heart and goes north.

Question 34

Claudication

Answer 34

Cramping pain in the leg induced by exercise, typically caused by obstruction in the arteries

Question 35

Intensity of a heart murmur goes from 1-6. In which level does a palpable thrill become apparent?

Answer 35

Level 4 out of 6