Clinical examination Flashcards by Ellie Richardson

What is S1 in the cardiac cycle?

Caused by blood rebounding off closed AV valves and ventricular walls

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What is S2 caused by in the cardiac cycle?

The blood reverberating in the great vessels once the aortic and pulmonary valves have closed

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What is atrial fibrillation?

A very rapid irregular heartbeat

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What is the term for a high-pitched cardiac sound caused by turbulence of the blood?

Stenosis

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What kind of heart sound is caused by a narrowing of the aortic valve? Where is this sound loudest?

Sub-aortic stenosis

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What is pulmonic stenosis? Where is it loudest?

Usually a high-pitched sound induced by a narrowing of the pulmonic valve causing turbulence in the blood.
LHS

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List all systolic heart sounds

Atrial fibrillation
Sub-aortic stenosis
Pulmonary stenosis
Mitral regurgitation
Mitral valve click
Ventricular septal defect

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What are mitral regurgitation sounds caused by?

Inefficient closing of mitral valve permits backflow of blood, causing a mid-pitched sound

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What is a mitral valve click caused by? Where is it loudest?

Thickening of mitral valve

LHS

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What is a patent ductus arteriosus, and when is it of clinical significance?

A continuous murmur caused by the ductus arteriosus failing to close (therefore normal in puppies younger than 2do)
Abnormal sound if heard in animals older than 2d

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What is a patent ductus arteriosus, and when is it of clinical significance?

A continuous murmur caused by the ductus arteriosus failing to close (therefore normal in puppies younger than 2do)
Abnormal sound if herad in animals older than 2d

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What is a ventricular septal defect? Where is this sound loudest?

A low-pitched murmur caused by failure of ventricular septum to close
RHS

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What are ventricular premature contractions? And how is this affected by mitral regurgitation?

Extra heart sounds caused by extra, abnormal ventricular contractions due to turbulence of blood in the ventricle.
Mitral regurgitation exacerbates this with blood regurgitating back through the mitral valve

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What are ventricular premature contractions? And how is this affected by mitral regurgitation?

Extra heart sounds caused by extra, abnormal ventricular contractions due to turbulence of blood in the ventricle.
Mitral regurgitation exacerbates this with blood flowing back through the mitral valve

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What are ventricular premature contractions? And how is this affected by mitral regurgitation?

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With normal tracheal sounds, how do the inspiratory and expiratory sounds compare?

The expiratory sound is louder, and has both a higher pitch and longer duration than the inspiratory sound

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Which normal tracheal sound has the longer pause?

Expiratory pause

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How do vesicular and tracheal sounds compare normally?

For vesicular sounds the inspiratory sounds are louder, of higher pitch and longer duration; whereas tracheal sounds are loudest on expiration.
Both expiratory pauses are considerably longer than the inspiratory sounds

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When are vesicular lung sounds best heard?

When breathing is exaggerated

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Which lung sounds can also be heard alongside heart sounds?

Broncho-vesicular lung sounds

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What are broncho-vesicular lung sounds?

A combination of tracheal and vesicular sounds, with acoustic characteristics between the two

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Where would you auscultate for broncho-vesicular lung sounds?

Primarily over the central portions of the chest, on both front and back.

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What sounds are commonly detected in normal newborn puppies?

High respiratory rate, loud inspiratory phase, and irregular breathing patterns

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What sounds are commonly detected in normal newborn puppies?

High respiratory rate, loud inspiratory phase, and irregular breathing patterns

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Name the features of abnormal bronchial lung sounds.

Expiratory phase is louder and lasts longer than inspiratory phase High-pitched and harsh quality to expiratory phase Tachypnea is present Heart sounds are audible with occasional dysrhythmia

Where do abnormal bronchial lung sounds occur from?

From regions of pneumonia

Where do abnormal bronchial lung sounds occur from?

From regions of pneumonia

What is a polymorphic wheeze?

A 'musical' wheezing sound that is often heard in patients with asthma

Does the pitch of a polymorphic wheeze change, and if so when?

Yes - pitch is higher during inspiration than expiration

In asthmatics, when can a polymorphic wheeze be detected?

Often during either or both phases of respiration

What is the term for wheezing sounds that are presumed to originate from a single site?

Monophonic wheeze

What abnormal lung sounds are likely to originate from the friction of inflamed pleural surfaces moving against one another?

Pleural friction rub

What sound is pleural friction rub likened to?

Creaking of a gate

How does the sound of pleural friction rub alter if the patient's breathing pattern and body position remain the same?

The sound is monotonously repetitive; though this sound changes usually when the body position changes

What abnormal lung sound can crackles be likened to? How do they differ?

Crackles originating from the lung are similar in sound to a pleural friction rub; Pleural friction rub is lower in pitch.

What abnormal lung sound can crackles be likened to? How do they differ?

Crackles originating from the lung are similar in sound to a pleural friction rub Pleural friction rub is lower in pitch

What is stridor?

There is marked respiratory distress accompanied by a high-pitched tone during both inspiration and expiration, caused by a narrow aperture between the vocal chords

What happens towards the end of stridor lung sounds?

During the end of expiration there is an abrupt reduction in the pitch of the expiratory tone

Where might cavernous lung sounds be heard?

Over a lung cavity

What component of cavernous lung sounds is similar to tracheal lung sounds?

The loud exaggerated expiratory phase

What component of cavernous lung sounds is similar to tracheal lung sounds?

The loud exaggerated expiratory phase

State the features of cavernous lung sounds

Loud exaggerated expiratory phase Audible over a lung cavity Both phases of cavernous breathing have a higher pitch than normal tracheal sounds Heart sounds also audible

Describe the sounds produced by fine to medium crackles/rales

These sounds begin approximately mid-inspiration and intensify towards the end of expiration Coarse crackles are also audible in the early expiratory phase of some of the breaths

Describe the sounds produced by fine to medium crackles/rales

These sounds begin approximately mid-inspiration and intensify towards the end of expiration Coarse crackles are also audible in the early expiratory phase of some of the breaths

What are ronchi?

Very low-pitched repetitive sounds

When are coarse crackles present as lung sounds?

During inspiration and expiration

When do coarse crackles present as lung sounds?

During inspiration and expiration

What is heard with coarse crackles/rales with ronchi?

Coarse crackles occur during both inspiration and expiration Some ronchi are heard Some high-pitched squeaks can also be heard against the background of bronchial breath sounds

Describe the lung sounds made by coarse crackles/rales.

Coarse crackles that establish at the onset of inspiration, diminishing in intensity and prevalence towards its end

Which phase is not audible during coarse crackles/rales?

Expiration

Which phase is not audible during coarse crackles/rales?

Expiration

What is pulmonary oedema characterised by?

Medium and coarse crackles appearing towards the end of inspiration and continuing into expiration

What do the acoustics associated with pulmonary oedema mean?

All acoustics are consistent with respiratory distress and pulmonary congestion

What forms the subjective assessment of a patient?

Signalment, history, BCS, demeanour, posture, gait

What scales are used for assessing condition of domestic species? And what are the ideal scores?

BCS from 1-9 Dogs: 4/5 Cats: 5

What is stertor?

Inspiratory noise

What objective assessments of the head are made?

``` Musculature Submandibular lymph nodes Oral cavity - teeth, tongue, pharynx, mm, lips CRT, mm colour Nose and airflow Eyes - gross, ophthalmoscope Ears - gross, auroscope ```

What is examined in the nexk region?

``` Laryngeal cartilages and trachea Retropharyngeal and prescapular lymph nodes ROM Upper respiratory tract Jugular veins ```

How do you perform a tracheal pinch test?

Palpate laryngeal cartilages and trachea - if this elicits a cough, it is a + result

What does a + tracheal pinch test indicate?

This is suggestive of irritation or compression of the large airways

What different techniques are performed to assess the thorax?

Palpation Auscultation Percussion

At which ribspaces should the heart be auscultated?

3rd - pulmonary valve 4th - aortic and tricuspid valve 5th - mitral valve

Which valves can be auscultated on the LHS? And the RHS?

The pulmonic, aortic and mitral valves are heard on the LHS; tricuspid valve on RHS

In which species are gallop cardiac sounds normal?

Horse

What causes S3 in small animals?

Reduced ventricular compliance

What sound is generated by ventricular stiffening?

S4 cardiac sounds

Which organs should be palpable in the abdomen?

``` Caudal liver Spleen Kidneys Intestines Bladder ```

What is pleural effusion?

Excess fluid that accumulates in the pleural cavity surrounding the lungs

What is a pneumothorax?

The presence of air or gas in the cavity between the lungs and chest wall, causing collapse of the lung

What is a blepharospasm?

Involuntary tight closure of the eyelids

What is strabismus?

Abnormal alignment of the eyes

What is nystagmus?

Rapid involuntary movements of the eyes

Clinical examination Flashcards

(72 cards)