Cardiac (lecture and objects- doesn't include tables) Flashcards Preview

Clinical Assessment 2 > Cardiac (lecture and objects- doesn't include tables) > Flashcards

Flashcards in Cardiac (lecture and objects- doesn't include tables) Deck (36):
1

What is the ROS for cardiovascular system?

Chest pain
DOE
orthopnea
PND (paroxysmal nocturnal dyspnoea)
palpitations
edema

2

What population do you really want to screen for major risk factors of CVD?

African Americans
Females

3

When should you begin screening for diabetes?

45 years old and every 3 years after

4

What are risk factors for DM?

BMI >25
CVD, insulin resistance, HTN, sedentary, ethnicity, hx GDM, dyslipidemia, PCOS (polycystic ovary syndrome), elevated fasting glucose or Hgb A1c, 1st degree relatives

5

According to ATP III LDL guidelines, for a high risk individual what should their LDL be?

<100

6

According to ATP III LDL guidelines, for a moderate high risk or moderate individual what should their LDL be?

<130

7

According to ATP III LDL guidelines, for a low risk individual what should their LDL be?

<160

8

What are the 5 guidelines for metabolic syndrome?

WC: males > 102 cm; females > 88 cm
fasting Glucose: > 100mg/dl or on Rx
HDL: males < 40 mg/dl; females < 50 mg/dl; on Rx
TG: > 150 mg/dl or on Rx
BP: > 130/> 85 or on Rx

9

What artery is to the left of the sternum?

Pulmonary artery

10

Where does the R ventricle sit?

Inferior border of R ventricle is below the junction of the sternum and the xiphoid process

11

Where is the PMI normally found

the 5th intercosatal space 7 cm to 9 cm lateral to the midsternal line (not always palpable)

12

What does a PMI greater than 2.5 cm indicate?

Left ventricular hypertrophy (seen in hypertension and aortic stensosis)

13

What does displacement of the PMI lateral to midclavicular line or greater than 10 cm lateral to midsternal line suggest?

LVH (left ventricular hypertrophy)

14

Where does the aorta arch back to the left then downward?

Sternal angle

15

What does S1 indicate?

Beginning of systole
Closure of mitral valves, ejection of blood from LV

16

What does S2 indiciate

Beginning of diastole
It may split with respiration

17

What type wave deflection are the Q and S waves?

Negative

18

What type reflection is the R wave?

Positive

19

In normal physiologic splitting, what accentuates the split? When does it disappear?

Accentuated on inspiration
Disappears on expiration

20

What does pathological splitting involve?

Splitting during expiration and suggests heart disease

21

What type splitting could mean these things "delayed closure of pulmonic valve (pulmonic stenosis or R bundle branch block) Can also be caused by early closure of the aortic valve, as in mitral regurg "

Wide splitting

22

What type splitting doesn't vary with respiration and occurs in ASD and R ventricular failure?

Fixed splitting

23

What is the name of the type of pathologic splitting that appears on expiration and disappears on inspiration. The closure of the aortic valve is abnormally delayed so A2 follows P2 in expiration. Common cause is L bundle branch block.

paradoxical or reversed splitting

24

What will a thrill feel like?

Buzzing or vibratory sensation when you press the ball of your hand to the chest

25

What sound should the PMI correspond with?

Early systole (S1)

26

Where is the PMI located?

4th-5th LICS MCL

27

What is the amplitude of the PMI?

Gentle, brisk tap

28

What type sounds can the Bell hear?

Low pitched
S3 and S4
Stenosis murmur

29

What type sounds can the diaphragm hear?

High pitched sounds
S1 and S2
aortic and mitral regurg
murmurs
rubs

30

These sounds are accentuated in what position : S3, S4, mitral valve murmurs?

Left lateral decubitus (LLD)

31

What position accentuates aortic valve murmurs?

Sit and lean forward

32

What can you hear upon stand and strain phase of valsalva?

decreased venous return, decreased arterial BP

33

What can you hear on the release phase of Valsalva?

increase LV volume
increased arterial Bp

34

What grade must a thrill have?

4-6

35

What murmurs radiate downward (think MRTAPS)

Mitral and tricuspid regurg

36

What murmurs radiate up (think MRTAPS)

Pulmonic (L side of neck)
Aortic (Carotids)