Cardio

Question 1

pulse rate

Answer 1

bpm; right radial pulse

Question 2

rhythm

Answer 2

regular

irregular : atrial fibrillation or ectopic beat

Question 3

character and volume?

Answer 3

carotid artery closest to heart

Question 4

radial artery where?

Answer 4

at wrist - thumb side

Question 5

ulnar where?

Answer 5

wrist pinky finger side

Question 6

brachial artery

Answer 6

cubital fossa

medial side of biceps muscle - when elbow is fully extended

Question 7

axillary artery

Answer 7

medial side of humerus
lateral wall of axilla
posterior to the tendon of the short head of biceps

Question 8

axilla region

Answer 8

anterior border: pectoralis major/minor
lateral border: intertubercular sulcus
medial border: serratus anterior and thoracic wall
posterior border: scapularis , teres major, latissimus dorsi

Question 9

apex beat?

Answer 9

left 5 ICS at MCL

Question 10

shift in apex beat?

Answer 10

enlargement - cardiomegaly

Question 11

heaves?

Answer 11

Since the apex beat is a result of the left ventricle beating, hypertrophy of the left ventricle produces a forceful beat called a ‘heave’ and may extend outwards towards the axilla.

Question 12

thrills?

Answer 12

palpable vibration hyperkinetic
sustained beat
= volume overload HF, Aortic regurg/ mitral regurg

Question 13

aortic ausculation

Answer 13

R 2ICS Diaphragm

Question 14

Pulmonary ausculation

Answer 14

L ICS next to sternum diaphragm

Question 15

tricuspid asuculation

Answer 15

Diaphragm

left 5ICS near sternum

Question 16

mitral auscultation?

Answer 16

bell

left 5th ICS at MCL

Question 17

aortic stenosis

Answer 17

Ejection systolic murmur
Auscultate at the carotid artery
between S1-2

Question 18

aortic regurgitation

Answer 18

early diastolic murmur

auscultate at aortic valve w patient leaning forward

Question 19

mitral stenosis

Answer 19

Mid diastolic murmur
Auscultate at the apex beat with the patient in the left lateral decubitus position (lying on their left side)

s3

Question 20

mitral regurgitation

Answer 20

Pansystolic murmur

Auscultate at the apex beat with the patient in the left lateral decubitus position (lying on their left side)

Question 21

Borders of the heart

Answer 21

3CC 1 cm from sternal border on the R, to the 6th CC 1cm from sternal border to the 5th ICS at MCL and up to the 2 ICS 2.5cm from sternal border

Question 22

Right border of the heart

Answer 22

Lateral to right sternal border at 3CC to 6CC lateral to right sternal border

Question 23

Inferior border

Answer 23

Lateral to right sternal border at 6th CC to medial to MCL in 5th ICS

Question 24

Surface mark arch of aorta

Answer 24

Begins at 2CC R sternal angle [ascending aorta] end of arch is thoracic arch at level of left 2 CC
Top of arch midway between jugular notch and sternal angle

Question 25

What branches off arch of aorta

Answer 25

R > L | Brachiocephalic ,subclavian, common carotid

Question 26

Routine sites for venepuncture | Reasons?

Answer 26

Antebrachial vein in cubital fossa Obtain blood Monitor blood components Administer therapeutic treatments like medication

Question 27

main cause of oedema?

Answer 27

congestive heart failure

Question 28

cap refill time?

Answer 28

normal is 2 seconds | greater than 2= poor peripheral perfusion

Question 29

normal hr

Answer 29

60-100 bradycardia >60 tachycardia<100

Question 30

tachycardia causes?

Answer 30

anxiety | hypovolaemia

Question 31

bradycardia causes?

Answer 31

healthy athletes | AV block

Question 32

Pectus escavatum - chest appearance

Answer 32

marfans EDS sunken in chest

Question 33

pectus carinatum

Answer 33

chest protrudes out

Question 34

surgical scar | mitral valve?

Answer 34

lateral thoracotomy

Question 35

midline sternotomy scar?

Answer 35

CABG / valve

Question 36

left subclavicular scar?

Answer 36

pacemaker/ AED

Question 37

malar flush?

Answer 37

mitral stenosis

Question 38

pt has a narrow pulse pressure with a slow rising pulse what is this? what murmur would you hear and where?

Answer 38

aortic stenosis | ejection systolic murmur which radiates to carotids and accentuates at expiration

Question 39

cardiac causes of clubbing?

Answer 39

endocarditis atrial myxoma congenital cynotic heart disease

Question 40

palmar erythema?

Answer 40

hyperthyroid | polychythaemia

Question 41

thready pulse?

Answer 41

shock

Question 42

in aortic regurg why does the the stroke volume _____ diastolic blood pressure ___ which causes pulse pressure to ___

Answer 42

stroke volume increases in aortic regurg- as blood leaks out during diastole so the L ventricle has to pump out more blood- so more pressure is required this in turn means that systolic blood pressure increases diastolic bp decreases however - as some leaks back causing pulse pressure to increase

Question 43

what does a large pulse pressure cause? what sign on the nail bed can be seen? what condition causes this and what is the mx?

Answer 43

hyperdynamic circulation - the character of the pulse is bounding or 'waterhammer' as the blood slams against walls of arteries with each heartbeat head bobbing capillary beds of fingernails to pulsate - quinckes sign replacement of valve after left ventricular dysfunction occurs

Question 44

waterhammer pulse why ? what is it caused by?

Answer 44

aortic regurgitation creates a hyperdynamic circulation so when arm is raised, increases velocity of return to the heart so accentuates the collapsing nature

Question 45

how to accentuate aortic murmur?

Answer 45

listen on expiration on aortic region | leaning forward