Cardiovascular Flashcards
(36 cards)
Heart valves names and surface markings
Aortic - right sternal border at 2nd ICS
Pulmonary - left sternal border at 2nd ICS
Tricuspid - left sternal border 4th ICS
Mitral - left MCL 5th ICS - APEX BEAT
Inspection
Scars, redness, bruising, swellings, chest wall deformities, SOB, cyanosis
What are the heart sounds and what do they signify?
S1 “lub” - AV valves closing
S2 “dub” - aortic + pulmonary valves closing
Causes of abnormal apex beat
Dextrocardia
Obesity
Pericardial effusion/TPT –> mediastinal shift
Emphysema (COPD)
Student incompetence/skeletal (pectus excavatum)
Causes of non-palpable apex beat
COPD (emphysema)
Obesity
Pericardial effusion
Dextrocardia
Shock
What type of murmur occurs in aortic stenosis? How is it accentuated?
ejection systolic
auscultate carotids
What type of murmur occurs in aortic regurgitation? How is it accentuated?
early diastolic
ask to lean forward
What type of murmur occurs in mitral stenosis? How is it accentuated?
mid-diastolic
left lateral decubitus
What type of murmur occurs in mitral regurgitation? How is it accentuated?
pansystolic
left lateral decubitus then move round to axilla
Lead placement in 12 lead ECG
Limb leads - R, Y, G, B
Chest leads
V1 - 4th ICS RSB
V2 - 4th ICS LSB
V3 - between V2 and V4
V4 - 5th ICS MCL
V5 - 5th ICS AAL
V6 - 5th ICS MAL
View and blood supply of lead I, aVL, V5, V6
lateral and left circumflex artery
View and blood supply of lead II, lead III, aVF
Inferior and right coronary artery
View and blood supply of V1, V2, V3, V4
V1/V2 - septal
V3/V4 - anterior
left anterior descending artery
Where can a central line be put?
IJV - between two SCM heads
Subclavian vein
Common femoral vein
Which arteries would you palpate to measure rate, rhythm, character and volume?
Pulse rate - right radial pulse (in bpm)
Rhythm - right radial pulse (reg/irreg)
Character and volume - RCC pulse
What is the apex beat and where is it palpated?
The most lateral and inferior point where a beat can be felt with each systole
5th ICS OR in children 5th rib
Always at MCL
What is a heave? Where can it be palpated?
LV hypertrophy can produce a forceful beat
Palpated by placing hand vertically parasternally
What is a thrill? Where can it be palpated?
Palpable heart murmurs due to volume overload in mitral/aortic regurgitation
–> hyperkinetic and sustained
Can be palpated at valve locations
Where does the common carotid artery divide?
The upper border of the thyroid cartilage into internal and external arteries
Common site used for phlebotomy?
Antebrachial (median cubital) vein in cubital fossa
Common site used for phlebotomy?
Antebrachial (median cubital) vein in cubital fossa
What is pericardiocentesis? When is it done? What are two locations?
Drainage of fluid from pericardium
In cardiac tamponade
Two points of needle entry:
- left 5th ICS near sternal border (needle perpendicular to chest wall)
- left sub-xiphesternal (needle facing leftf shoulder and going in posteriorly and superiorly)
Outline the symptoms of acute coronary syndrome (aka unstable angina MI)
Sudden onset chest pain
Central crushing chest pain
Radiate to arms or neck
Previous Hx of angina, MI
CV risk factors- diabetes, smoking, FH, anaemia, arrhythmias, hyperlipidaemia, obesity
Outline the symptoms of aortic dissection
Tearing pain
Radiates to back between scapulae