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Boards Prep- Cardiovascular > Cardiovascular System Physical Examination > Flashcards

Cardiovascular System Physical Examination Flashcards

(70 cards)

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1
Q

8 aspects of cardiovascular exam

A
  • Skin
  • Pulse
  • Heart Sounds
  • Heart Rhythm
  • Blood Pressure
  • Respiration
  • Oxygen Saturation
  • Pain
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2
Q

Signs of decreased cardiac output

A
  • Cyanosis: bluish color of skin, nail beds, lips, and tongue
  • Pallor: washed out, absence pf pink, rosy color
  • Diaphoresis: excess sweating and cool, clammy skin
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3
Q

What influences pulse?

A

force of contraction, volume and viscosity of blood, diameter and elasticity of vessels, emotions, exercise. blood temperature, and hormones

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4
Q

how long to palpate regular pulse?

A

30 seconds

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5
Q

how long to palpate irregular rhythm?

A

1-2 minutes

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6
Q

Apical Pulse (point of maximal impulse - PMI)

A
  • patient is supine
  • palpate at 5th interspace, midclavicular vertical line (apex of heart)
  • may be displaces upward by pregnancy or high diaphragm
  • may be displaced laterally by congestive heart failure, cardiomyopathy, ischemic heart disease
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7
Q

carotid pulse

A

patient is lying down with head of bed elevated; palpate over carotid artery; on either side of anterior neck between SCM and trachea

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8
Q

what should you do when assessing carotid pulse?

A

assess one side at a time to reduce the risk of bradycardia through stimulation of the carotid sinus baroreceptor, which produces a reflex drop in pulse rate or BP

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9
Q

Grading scale of pulses

A
  • 0: absent
  • 1+ pulse diminished, barely perceptible
  • 2+: easily palpable; normal
  • 3+: full pulse, increased strength
  • 4+ bounding pulse
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10
Q

Normal HR for adults and teens

A
  • 60-100 bpm
  • 40-60 bpm in aerobically trained
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11
Q

Children normal HR

A

60-140 bpm

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12
Q

newborn average HR

A

127 bpm
- range 90-164 bpm

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13
Q

what can cause compensatory tachycardia?

A

volume loss (surgery, dehydration)

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14
Q

Postural Tachycardia Syndrome

A
  • sustained HR increased > 30 bpm within 10 mins of standing (>40 in teens)
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15
Q

Irregular pulse

A

variations in force and frequency may be due to arrhythmias, myocarditis

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16
Q

What can cause weak, thready pulse

A

low stroke volume or cardiogenic shock

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17
Q

what can cause bounding, full pulse

A
  • may be due to shortened ventricular systole and decreased peripheral pressure
  • aortic insufficiency
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18
Q

Aortic valvue auscultation

A

located at second right intercostal space at sternal border

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19
Q

pulmonic valve auscultation

A

located at 2nd left intercostal space at sternal border

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20
Q

tricuspid valve auscultation

A

located at 4th left intercostal space at sternal boarder

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21
Q

mitral valve auscultation

A

located at the 5th left intercostal space at the midclavicular area

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22
Q

S1

A
  • lub
  • normal closure of mitral and tricuspid valves
  • marks beginning of systole
  • decreased in 1st degree heart block
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23
Q

S2

A
  • dub
  • normal closure of aortic and pulmonary valves
  • marks end of systole
  • decreased in aortic stenosis
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24
Q

Systolic murmur

A
  • falls between S1 and S2
  • may indicate valvular (mitral valve prolapse)
  • or may be normal
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25
Diastolic murmur
- Falls between S2 and S1 - Usually indicates valvular disease
26
Grades of heart murmurs
Grade 1 (softest audible) to grade 6 ( audible w/o stethoscope)
27
Thrill
- Abnormal tremor accompanying a vascular or cardiac murmur - Felt on palpation
28
Bruit
- An adventitious sound or murmur (blowing sound) of arterial or venous origin - Common in carotid or femoral arteries - indicative of atherosclerosis
29
Gallop rhythm
- abnormal heart rhythm with three sounds in each cycle - resembles gallop of horse
30
S3
- associated with ventricular filling - occurs soon after S2 - in older individuals, may be indicative of congestive (LV) heart failure
31
S4
- Associated with ventricular filling and arterial contraction - occurs just before S1 - Indicative of pathology including coronary heart disease (CAD), MI, aortic stenosis or chronic hypertension
32
ECG
See ECG section
33
Normal BP
<120/<80El
34
elevated BP
120-129/<80
35
Stage 1 Hypertension
130-139 or 80-89
36
Stage 2 Hypertension
at least 140 or at least 90
37
Hypertensive crisis
>180/>120
38
When are medications prescribed for stage 1 hypertension
when a patient has already had a heart attack or stroke or is at high risk of heart attack or stroke in the presence of diabetes, chronic kidney disease, or atherosclerotic risk
39
Neonate (96hr) BP
67-84/35-53
40
Infant (1-12mo) BP
72-104/37-56
41
Toddler (1-2 yo) BP
86-106/42-63
42
Preschooler (3-5yo) BP
89-112/46-72
43
School age (6-9yo) BP
97-115/57-76
44
Preadolescent (10-11yo) BP
102-120/61-80
45
Adolescent (12-15 yo) BP
110-131/64-83
46
Examining orthostatic hypotension
- first BP measured when pt supine for >5 min - moves to sitting, immediately take BP, again after 2 mins - moves to standing, immediately take BP, again after 2 mins
47
What is considered OH+
systolic drop > 20 mmHg or diastolic drop >10 mmHg
48
After what age are high BP levels the same as adults?
13 yo
49
What is MAP
Arterial pressure within large arteries over time; dependent upon mean blood flow and arterial compliance
50
how to calculate MAP
take the sum of systolic BP and twice the DBP and divide by 3
51
normal MAP
70-110 mmHg
52
normal newborn RR
30-40 breaths per min
53
normal child RR
20-30 breaths per min
54
tachypnea
RR >22 breaths per min
55
bradypnea
RR <10 breaths per min
56
hyperpnea
an increase in depth and rate of breathing
57
dyspnea on exertion (DOE)
brought on by exercise or activity
58
Orthopnea
inability to breathe when in a reclining or supine position
59
Paroxysmal nocturnal dyspnea (PND)
sudden inability to breathe occurring during sleep
60
Adventitious breath sounds
- crackles (rales): rattling, bubbling sounds, may be due to secretions in the lungs - wheezes (rhonchi): whistling sounds
61
Assessing cough
- productive or nonproductive - strong or weak - coordinated or uncoordinated - consistency and color of any secretions
62
What does pulse oximetry provide
- and estimate of PaO2 (partial pressure of oxygen) based on the oxyhemoglobin desaturation curve - normal: 98-100%
63
hypoxemia
SaO2 less than 90% which corresponds to PaO2 of 60mmHg
64
Anoxia
complete lack of oxygen
65
Ischemic cardiac pain (angina or MI)
- diffuse - Retrosternal - sensation of tightness, achiness in the chest - associated with dyspnea, sweating, indigestion, dizziness, syncope, anxiety
66
Symptoms more likely in women
- indigestion or gas like pain - dizziness or nausea - unexplained weakness or fatigue - discomfort or pain between shoulder blades - recurring chest discomfort - sense of impending doom
67
Referred pain
- cardiac pain can refer to shoulders, backs, arms, neck, or jaw - pain referred to back can occur from dissecting aortic aneurism
68
Review dyspnea scale
69
anginal scale
1+ light, barely noticeable 2+ moderate, bothersome 3+ severe, very uncomfortable 4+ most severe pain ever experienced
70

Boards Prep- Cardiovascular (21 decks)

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