Flashcards in Cardio Deck (51)
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1
Fever
> or equal to 100 deg. (often stated as 100.4)
2
Rectal temp
Higher than oral by 1 degree
3
Axillary Temp
Lower than oral by 1 degree
4
Tympanic Temp
Higher than oral by 1 degree
Measures core temperature
5
Base
R & L interspaces next to the sternum
Great vessels originate
6
Apex
Inferiolateral tip of left ventricle
Produces apical impulse which is normally the point of maximal impulse (PMI)
7
Tricuspid
4th or 5th ICS
8
Atrioventricular Valces
Mitral
Tricuspid
9
Semilunar Valves
Aoritic
Pulmonic
10
Murmur
Heart sounds that are produced as a result of turbulent blood flow
11
Thrill (or vibration)
-Palpable murmur
-May be caused by vigorous blood flow through any narrowed opening
-->aortic stenosis, ventricular septal defect
12
Lift (or heave)
-When cardiac impulse (apical impulse) feel more vigorous than normal and can be felt through the chest wall
-Causes: Ventricular hypertrophy, hyper dynamic ventricular activity
13
Precordium
-Front of chest wall that overlays the heart and epigastrium
-Examine w/ pt supine or in left lateral decubitus position
14
Apical Impulse
-Represents pulsation of the left ventricle
-Normall the PMI
-Located @ 5th ICS in MCL
-If lateral to MCL or larger than 2.5 cm diameter= Suggest left ventricular hypertrophy
15
Apex Beat
-Palpable in 25-50% of health adults in supine
-Palpable in 50% in left lateral decubitus position
16
Right Ventricular Hypertrophy
-Show as "parasternal lift" @ LSB
17
Diaphgragm of Stethoscope
-Best for high pitch sounds (S1, S2)
18
Bell of Stethoscope
-Best for low pitch sounds (S3 or S4, if present)
19
Auscultation of cardiac locations
Aortic- 2nd ICS, RSB
Pulmonic- 2nd ICS, LSB
2nd Pulmonic- 3rd ICS, LSB (Erb's Point)
Tricuspid- 45h and 5th ICS, LSB
Mitral (apex)- 5th ICS, MCL
20
Systole
-Contraction of ventricles
-Aortic and pulmonic valves forced open and blood is ejected into arteries
21
S1 heart sound
-Closure of AV valves: Mitral and tricuspid vlaves
-Produces "lub" sound
-Best heart @ Apex
-Carotid upstroke occurs just after S1
22
Diastole
-Relaxation of the heart
23
S2 Heart sound
- Produces "Dub" sound
-Closure of Aoritic and Pulmonic Valves
-Best heart @ base
-Carotid upstroke occurs just before S2
--S1-->Carotid upstroke-->S2
24
Normal split during inspiration
-A2 heard first, then P2
-"Physiological splitting of S2"
25
Expiration split
Suggest pathology due to delay in closure of pulmonic valves:
-Pulmonic stenosis
-Right ventricular heart failure
-RBBB
26
S3 Heart Sound (S3 Gallop)
-Low pitch sound (heard best w/ bell) @ apex
-Created in early diastole by early passive rapid ventricular filling by atria
-S1+S2+S3= Ventricular gallop rhythm
-->1 beat, followed by 2 beats
-Normal in children/young adults
->40 indicates pathologic changes in ventricular compliance (e.g. CHF)
27
S4 Heart Sound
-"Atrial Gallop" or "Atrial Sound"
-Low pitch, heard best @ apex with bell
-Created by 2nd phase of ventricular filling astroturfing the atria contract and eject blood into the ventricles
-S1+S2+S4=atrial gallop rhythm
-->2 beats followed by 1 beat
28
Causes of S4
-Uncommon in health adults
-Pathologic due to resistance in ventricular stiffing= stiffness of heart muscle, reduced compliance
Causes:
-HTN, CAD, Aortic Stenosis, Cardiomyopathy
-Right-sided S4 from pulmonary HTN or pulmonary stenosis
29
Cardiac dysrhythmias (or “arrhythmias)
Result from abnormal electrical activity of the heart
30
Rhythmically or sporadically irregular
-PAC's
-PVC's
31
Regularly irregular
Variation between two R-R intervals is > 0.04 with the appearance of a repeating pattern (second degree blocks)
32
Irregularly irregular
Variation between two R-R intervals is > 0.04 with no repeating pattern
E.g. atrial fibrillation
33
Valvular Stenosis
-Narrowing of heart valve, obstructing blood flow causing turbulence
-Most common stenosis
34
Valvular Regurgitation (insufficiency)
-occurs when the leaflets do not close completely, letting blood leak backward across the valve
-Hear the murmur of regurgitation when valves are??
35
Valvular Sclerosis
Hardening/thickening of a valve
-->e.g. aortic sclerosis
36
Mitral Valve Prolapse (MVP)
-Ballooning of the mitral leaflets into the left atrium during systole
-Mid-late systolic "click"
37
Septal Defect
Hole in the septum separating chambers the heart
38
Patent ductus arteriosus
-Neonoate's ductus arteriosus fails to close after birth
-Reults in abnormal connection between the aorta and pulmonary artery
39
Coarctation
-Narrowing of part of the aorta
-Congenital (present @ birth)
40
Hypertrophic Cardiomyopathy (HCM)
-Portion of the heart muscles become hypertrophied w/o any obvious cause
-Autosomal dominant inheritance
-Leading cause of sudden cardiac death in young athletes
41
Cardiac Auscultation Murmur Characteristics 101
"PQRST LI"
1. Pitch
2. Quality
3. Response to maneuvers
4. Shape
5. Timing
6. Location and Radiation
7. Intensity
42
Systolic Murmurs
-Occur between S1 & S2
-Associated with ventricular ejection
-->Aortic and Pulmonic Stenosis= valves are open during systole
-->Mitral and Tricuspid Regurgitation= Valves closed during systole
43
Mid-Systolic Murmurs
-crescendo-decrescendo character
-->start softly, become loudest near mid-systole, followed by decrease in sound amplitude
-Can result from Aortic and Pulmonic stenosis
44
Holosystolic (Pansystolic)
- Have a high amplitude throughout systole
-Result from: Mitral or Tricuspid Regurgitation, Ventricular septal defect
45
Innocent Systolic Murmurs
-Result from turbulent blood flow, BUT no valvular narrowing or obstruction
=no evidence of cardiac dz
-Usually grade 1-2
-Common in children and young adults
-Physiologic in pregnancy, anemia, fever, hyperthyroidism
46
Still's Murmur (Vibratory Murmur)
-Common benign pediatric heart murmur
-->children ages 2-5 – usu. Disappears with age
-Cause= Unknown
-Mid-systolic, low pitch, best heard at LSB, supine
47
Diastolic Murmurs
-Occur after S2
-Associated with Ventricular relaxation and filling
-->Aortic and Pulmonic regurgitation (valves closed)
-->Mitral and tricuspid stenosis (valves open)
-Indicate valvular dz
48
Majority of diastolic murmurs are due to?
Aortic Regurgitation
49
RRR
Regular Rate and Rhythm
50
MRG
Murmurs, Rubs, Gallops
51
