Cardio Flashcards
(45 cards)
Which patients typically have a PMI in the xiphoid or epigastric area?
COPD patients who have a right ventricular hypertrophy
What produces the sounds S1 and S2?
S1 – closure of mitral (AV) valve
S2 – closure of aortic (semilunar) valve
What produces an S3 sound?
Deceleration of inflow into left ventricle across mitral valve (due to dilated ventricle)
What produces an S4 sound?
Blood entering a ventricle with decreased compliance (diastolic stiffness)
What does systolic blood pressure measure?
Maximal left ventricular pressure
Which generally occurs first, right sided heart sounds or left sided heart sounds?
Left side heart sounds usually occur slightly before right side heart sounds
What effect does inspiration have on right heart filling time and heart sound?
It increases right heart filling time causing delayed closure of pulmonic valve, sometimes resulting in a split S2
What does a PMI greater than 2.5 cm indicate?
Left ventricular hypertrophy often seen in hypertension, aortic stenosis
Where on the chest are you most likely to hear a split S1?
The lower left sternal border where the tricuspid valve sound is heard (not at apex)
Where are you likely to hear the loudest S1 sound?
At the cardiac apex
What are the two main causes of heart murmurs?
Stenosis and regurgitation
Where can you best hear murmurs arising from the pulmonic valve?
Second left interspace close to the sternum
Where can you best hear murmurs arising from the aortic valve?
Second right interspace
Outline the pathway of electrical conduction
SA node – AV node – bundle of His – right and left bundle branch – Purkinje fibers – ventricular myocardium
Which three pressures is jugular venous pressure indicative of?
Right atrial pressure, central venous pressure, right ventricular end-diastolic pressure
Which vein is used to determine JVP?
Right internal jugular vein
What is considered an elevated JVP?
> 3cm above sternal angle
What bed angle should JVP be measured?
30°
How does bed adjustment differ when assessing JVP in hypovolemic and hypervolemic patients?
Hypovolemic – lower head of bed ( possibly to 0°)
Hypervolemic – raise head of bed (to 60°)
How far does the sternal angle lie above the right atrium?
4-5 cm
What landmark should be used if no pulsations in internal jugular vein can be found?
The point above which the external jugular vein appears to collapse
Which component of the cardiologic exam should be done in left lateral decubitus position?
PMI (apical impulse)
Contrast sounds and murmurs heard at the same time as carotid upstroke and murmurs heard after carotid upstroke
Murmurs heard during upstroke – systolic murmurs
Murmurs heard after upstroke – diastolic murmurs
Contrast sounds and murmurs heard at the same time as carotid upstroke and murmurs heard after carotid upstroke
Murmurs heard during upstroke – systolic murmurs
Murmurs heard after upstroke – diastolic murmurs
