Cardiovascular Examination Flashcards Preview

1MB - Clinical Signs > Cardiovascular Examination > Flashcards

Flashcards in Cardiovascular Examination Deck (52):
1

risk factors for peripheral arterial disease

body habitus, age, smoking, etc

2

inspection of the upper arms may reveal?

skin colour changes (pink, pale, matted)
ischaemic changes (gangrene)
tar stains in fingers
tendon xanthomata

3

what does palpation involves of the upper limbs

check temperature, capillary refill, pulses

4

what is required in upper limb pulse checks?

radial pulse (including radio-radial delay and radio-femoral delay)
brachial pulse
blood pressure (>10 mmHg difference is significant)

5

inspection of face may reveal

eyes: corneal arcus, xantholasma
mouth: central cyanosis
check carotid pulse character and bruits

6

abdomen inspection is required - true or false?

true. check body habitus, scars, aortic pulse and femoral pulse

7

is it imporant to check for aortic pulse even in a focused exam of the legs?

yes. (will reveal if issues may be caused by a AAA)

8

what skin colour changes may be present on a lower limb inspection?

pink, pale, matted

9

true or flase, check for ischaemic changes between toes and at heels?

true

10

give examples of trophic changes

shiny skin, hair loss, thin skin, ulcers

11

why might scars be present on the lower leg?

previous surgeries - CABG venous grafting, femoral-popliteal bypass

12

palpation of lower limbs requires checking temperature, capillary refill and pulses?

yes

13

name the lower limb pulses and their anatomical location

dorsalis pedis - lateral to the extensor hallucis longus tendon
posterior tibial - halfway between the posterior border of the medial malleolus and the achilles tendon
popliteal - within the popliteal fossa

14

tenderness of calves may indicate critical ischaemia - true or false

true

15

describe Buerger's triangle

with the pateint lying supine, lift their leg until heel becomes pale and hold for 30s (if it does not become pale the test is normal; if it becomes pale, this is Buerger's angle)

16

pallor followed by reactive hyperaemia on dependancy is a positive test and implies significant peripheral aterial disease - true or false?

true

17

what is the ABPI of intermittent claudication?

ABPI <0.9

18

what is the ABPI of acute ischaemic limb? any other characteristics?

ABPI <0.6
6P's - pale, pulseless, parasthesia, paralysis, pain, perishingly cold

19

what is the equation for critical ischaemia?

= tissue loss + rest pain + ABPI <0.3

20

clubbing of the fingernails could be suggestive of what diseases?

cyanotic congenital heart disease
infective endocarditis

21

splinter haemorrhages could indicate what infection?

infective endocarditis

22

define Quincke's sign

visible pulsation of capillary bed
(aortic regurgitation)

23

extensor tendon xanthomata is due to hypolipidaemia - true or false?

false - indicative of hyperlipidaemia

24

Osler's nodes and Janeway lesions could indicate infective endocarditis. what are they?

O - painfull red lesions on palms and soles
J - nodular haemorrhaic lesions on palms and soles

25

anticoagulation issue could present as ___ on the skin

bruising

26

tachycardia is defined as a pulse rate <60 bpm, and bradycardia is defined as a pulse rate <100 bpm. true or false?

false
tachycardia is defined as a pulse rate >100 bpm, bradycardia is defined as a rate <60 bpm.

27

irregularly irregular pulse could be suggestive of what?

atrial fibrillation and ventricular ectopics

28

regularly irregular pulse could be suggestive of what?

2nd degree heart block

29

the radio-radial delay and radio-femoral delay may indicate aortic dissecion/coarctation of the aorta/aortic arch aneurysm. true or false

true

30

what conditions could a collapsing pulse indicate?

aortic regurgitation
patent ductus arteriosus
arteriovenous malformation

31

large pulse pressure is a sign of aortic stenosis. true or false

false.
large pulse pressure would indicate aortic regurgitation. aortic stenosis has a narrow pulse pressure.

32

name 4 facial signs which may be found on examination

pallor
malar flush
ruddy plethoric complexion
swollen cyanotic face

33

name 4 signs you would look for in the eyes

conjunctiva pallor
haemorrhages
corneal arcus
xantholasma

34

a high arched palate may be indicative of which condition?

Marfans

35

what could cause a raised JVP (hint: PQRST)

pulmonary hypertension/PE/PS/pericarditis/pericardial effusion
quality of fluid eg overload
right heart failure
SVC obstruction
tamponade/TR

36

carotid pulse pressure and volume of aortic stenosis

slow rising low volume

37

carotid pulse pressure and volume of aortic regurgitation

bounding/collapsing
(same as patent ductus arteriosus)

38

define Corrigan's sign

visible carotid pulsation (aortic regurgitation)

39

define de Musset's sign

heart bobbing in time with pulse (aortic regurgitation)

40

define pectus excavatum

congenital deformity producing a 'caved-in/hollowed' chest appearance

41

pigeon chest is an alternate name for pectus excavatum - true or false?

false. pectus carinatum may also be called pigeon chest

42

an impalpable apex beat may be due to

obesity, muscular or hyperinflated chest

43

a displaced apex beat may result from what conditions?

LV dilation eg from mitral/aortic regurgitation

44

what causes a heaving apex?

high pressure pulsation in LVH eg aortic stenosis or systemic hypertension

45

what causes a thrusting apex?

large area pulsation in volume overload eg MR or AR

46

mitral stenosis produces a tapping apex - true or false

true

47

what causes a parasternal heave?

RV hypertrophy in pulmonary hypertension

48

what is a thrill?

a palpable murmur

49

most common cause of a thrill

aortic stenosis

50

why must the lung bases be auscultated?

check from pulmonary oedema in heart failure - heard as fine crackles

51

peripheral oedema would indicate ___ and ___

hypoalbuminaemia and RVF

52

true or false - auscultation of the heart valves is done with the diaphragm of the stethoscope

true. unless stated otherwise