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Flashcards in cardio Deck (42)
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1

where is aortic valve listened to

upper right sternal border at level of 2nd right intercostal space

2

where is pulmonary valve listened to

upper left sternal border at level of 2nd left intercostal space

3

where is tricuspid valve listened to

lower left sternal border at level of 4ths left intercostal space

4

where is mitral valve listened to

apex beat point - mid-clavicular line at level of 5th left IC spce

5

differences between JVP and carotid pulse

JVP is multiphasic
JVP not palpable
JVP is occludable
JVP varies with with head up tilt (HUT)
JVP varies with respiration - decreases with deep inspiration

6

what does JVP reflect

right atrial pressure

7

when we say JVP is multiphasic what do we mean

it beats twice in quick succession in the cardiac cycle

first is 'a' wave then second 'v' wave

8

when is JVP elevated

fluid overload + heart failure (esp right ventricular failure)
acute PE
COPD

9

what heart sound is heard same time carotid pulse

S1

10

what does S1 correlate with

beginning systole
when atrioventricular valves (mitral and tricuspid) close

11

what does S2 correlate with

closure of semilunar (aortic and pulmonary) valves

12

3rd heart sound

in diastole - after S2
can be physiological but >40yrs more likely pathological - left ventric failure, mitral regurg

13

4th heart sound

just before S1
left ventric hypertrophy

14

pericardial friction rub sound

coarse scratching sound

15

hands

colour
tar staining
cyanosis
clubbing
splinter haemorrhages
janeway lesions
osler's nodes
temp
cap refill

16

hand signs of infective endocarditis

splinter heamorrhages
Janeway lesions
osler's nodes

17

what do need to comment on when taking radial pusle

rate
rhythm: regular, irregularly irregular, regularly irregular
volume: normal, bounding, thready
character: normal, slow rising, collapsing

18

face

malar flush: mitral stenosis
anaemia eyes
corneal arcus
xanthelasmata
central cyanosis
red tongue (anaemia)
angular stomatitis

19

chest

back chest lung bases for crackles - left sided heart failure

sacral oedema if bes bound

20

lower limbs

pitting oedema (15 secs pressure)
temp
hair loss
cap refill
ulcers
varicose veins

21

measuring JVP

verticla distance between sternal angle and top of pulsation JVP

normally <4cm

22

inspection of precordium

chest deformities - pectus excavatum
scars
pacemaker
visible pulsation

23

palpation of precordium

tracheal position
cardiac pacemaker
apex beat
heaves
thrill

24

what is a heave and where do you feel for them

hand easily lifted with chest wall mocement - ventricular hypertrophy

L of sternum

25

what is a thrill and where do you feel for them

palpable murmur

both sides of sternum
apex point

26

auscultation of precodrium

4 valve areas with diaphragm and bell

left sided systolic murmurs
left sided diastolic murmurs

27

what are the left sided systolic murmurs

aortic stenosis
mitral regurgitation

28

what are the left sided diastolic murmurs

mitral stenosis
aortic regurgitation

29

listening for aortic stenosis

aortic valve area and carotid arteries

30

listening for mitral regurgitation

mitral valve area (apex) and L axilla for radiation