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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

4 sweep Technique palpating axillary lymph nodes

1. Anterior Axillary Line
2. Mid-Axillary Line
3. Posterior Axillary Line
4. Medial Upper Arm