CV/PV/Pulm/ABD Flashcards
(99 cards)
1
Q
What is the angle of Louis?
A
Known at the sternal angle/notch (2nd ICS)
2
Q
Which valves are tricuspid valves?
A
Tricuspid, pulmonic, and aortic valves
3
Q
What valve is bicuspid?
A
Mitral valve
4
Q
What is preload?
A
Volumes of blood and stretch in the RV at the end of diastole
5
Q
What is afterload?
A
Pressure needed to overcome for ejection of blood from the LV
6
Q
When are coronary arteries perfused?
A
Diastole
6
Q
What is contractility?
A
Ability of cardiac muscle fibers to shorten; requires well-oxygenated cells
7
Q
What is the pacemaker of the heart?
A
SA Node (60-100)
8
Q
What is the backup pacemaker?
A
AV Node (40- 60 BPM)
9
Q
What is a conduction delay through the bundle of his to the ventricles?
A
Bundle Branch Block
9
Q
Inferior Leads
A
II, III, aVF
9
Q
Lateral Leads
A
I, aVL, V5, V6
10
Q
Septal Leads
A
V1, V2
10
Q
Anterior Leads
A
V3, V4
11
Q
Risk factors for CAD
A
Smoking, DM (metabolic syndrome), HTN, HLD, age, males, obesity, lifestyle choices (ETOH, diet, inactivity, family history (man <55 and women <65)
12
Q
Used in calculations to determine CV Risk
A
Framingham, Reynold’s Score
12
Q
What part of the stethoscope do you use for high-frequency sounds?
A
Diaphragm
13
Q
What is claudication?
A
Pain in the muscles of the legs while active, which is relieved by resting
14
Q
What part of the stethoscope do you use for low-frequency sounds?
A
Bell
14
Q
What is Levine’s Sign?
A
Gesture where a person clenches their fist and holds it over their chest to indicate ischemic chest pain
15
Q
Where do you auscultate the aortic valve?
A
2nd ICS, RSB
15
Q
Where do you auscultate the pulmonic valve?
A
2nd ICS, LSB
16
Q
Where do you auscultate the tricuspid valve?
A
4th/5th ICS LSB
17
Q
Where do you auscultate the mitral valve?
A
5th ICS, MCL
18
What are heaves?
Abnormally forceful and sustained systolic pulsation in the heart- signifies RV enlargement
18
Where is your PMI?
Same as Mitral Valve auscultation (5th MCL)
19
What does JVP estimate?
RA pressure and preload
20
PAD symptoms:
painful legs, claudication, pallor, cold extremities, weak pulses
20
What is a normal JVP?
<8 cm H20
21
PVD symptoms:
LLE swelling (DVT=unilateral), distended veins, poor wound healing, loss of hair, skin discoloration
22
What is ABI?
A non-invasive test that compares the BP in the ankle to the BP in the arm (This number should be equal in a healthy person)
23
Grading pulses
3+ bounding/not normal, 2+ brisk/expected, 1+ diminished/weaker than expected, 0 absent to palpation (need doppler)
24
What are the major veins of the legs?
Great saphenous and femoral
24
What is Allen's Test?
Ulnar patency- evaluates the collateral flow of the hand (Needed before ABG or cardiac cath)
25
What percent of venous return do the lower extremities provide?
90%
25
What is pectus excavatum?
a chest wall deformity that causes the sternum and ribs to grow abnormally, resulting in a caved-in or sunken appearance of the chest
26
Atherosclerosis anywhere=
Atherosclerosis everywhere
27
What is pectus carinatum?
a deformity of the chest wall in which the breastbone and ribs are pushed outward
28
What does tactile fremitus assess?
Presence of effusions, consolidation, or thickening
29
What does subcutaneous air indicate?
Presence of pneumothorax (rice krispy sensation)
30
Percussive lung sound for normal healthy lung tissue?
Resonance
31
Percussive lung sound in the presence of a pleural effusion or bone is?
Dull
32
Percussive lung sound produced with the presence of an air-filled bullous
Tymphany
33
Lung sounds that are soft and low pitched. They are heard throughout inspiration, continue without pause through expiration, and then fade away about one third of the way through expiration.
Vesicular
34
Inspiratory and expiratory sounds about equal in length, are at times separated by a silent interval. Detecting differences in pitch and intensity is often easier during expiration.
Bronchovesicular
35
Lung sounds that are louder, harsher and higher in pitch, with a short silence between inspiratory and expiratory sounds. Expiratory sounds last longer than inspiratory sounds.
Bronchial
36
What age group is more likely to have an NSTEMI?
Elderly
36
S1Q3T3 means?
Deep S wave in lead I, deep Q wave in lead III, and inverted T wave in lead III (PE on ECG w/ right axis deviation)
36
Lung sounds that are loud harsh sounds heard over the trachea in the neck.
Tracheal
37
What age group is more likely to have a STEMI?
Young adults
38
What type of coronary infarctions cause hypotension?
Right- decreases preload, decreases stroke volume
39
Who should you always screen for PVD?
Smokers
40
What does the peritoneum do?
Provides insulation, lubrication structure, blood/lymph/nerve supply, and immunity
41
What organs are in the RUQ?
Ascending colon, duodenum, gallbladder, right kidney, Liver, pancreas(head), transverse color and right ureter
42
What organs are in the RLQ?
Appendix, ascending colon, bladder, cecum, rectum, ovary/uterus/fallopian tube, prostate/spermatic cord, small intestine, right ureter
43
What organs are in the LLQ?
Bladder, ascending colon, ovary/uterus/fallopian tube, prostate/spermatic cord, small intestine, sigmoid colon, left ureter
44
What organs are in the LUQ?
Descending colon, left kidney, pancreas (body and tail), spleen, stomach, transverse colon, and left ureter
45
What are the 9 regions when a complaint doesn't fit in quadrants?
R/L hypochondrium, R/L lumbar, R/L illiac region, Epi/hypogastric, and umbilical region
46
How long is chronic abdominal pain classified?
>12 weeks
47
How short is acute abdominal pain classified?
<12 weeks
48
What is dysphagia?
Difficulty swallowing
49
What is odynophagia?
Painful swallowing
50
What is globus sensation?
Lump or something stuck in your throat
51
What are common middle age abdominal issues?
Colon cancer, hemorrhoids, uterine fibroids, AAA, hernias
51
New confusion in elderly needs?
UTI evaluation
52
What are common elderly abdominal issues?
Constipation, polypharmacy, appendicitis, incontinence, BPH, nocturia, UTI, POOP (pain out of proportion), SBO, weight loss (RED FLAG), epigastric pain (inf. MI)
52
What are common pregnancy-associated abdominal issues?
Issues with constipation, appendix, gallbladder, frequent urination
53
Pain that is difficult to localize, usually near midline, varies in quality
Visceral (organ)
54
Pain that indicates peritonitis, steady/aching, more precisely localized, aggravated by coughing/movement
Parietal (Somatic)
55
What is striae?
Stretch marks
56
In what illness would you see a protuberant abdominal contour?
Someone who has ascities (Pregnancy too)
57
What are the 9 Fs?
Fat, Fatal, Feces, Fetus, Fibroids, Flatus, Fluid
58
In what illness would you see a scaphoid abdominal contour?
Anorexia
59
What two signs can indicate hemorrhagic pancreatitis?
Cullen's Sign and Grey Turner Sign
60
What does positive CVA tenderness mean?
Inflamed kidney
60
What is a positive Carnett's sign?
Abdominal pain worsens when the abdominal wall is tensed, suggesting abdominal wall pain (somatic)
60
What does tympany assess the presence of?
Air
60
What disease process is a venous hum is associated with? (bowel sound)
Portal HTN
61
Hepatic friction rub is concerning for?
Cancer
62
What is a negative Carnett's sign?
Abdominal pain is caused by an intra-abdominal issue, suggesting visceral pain
63
How large is the liver?
6-10 cm (4-6 at tail)
63
What is the second largest organ?
Liver
64
What is a positive Murphy's sign?
Pain on inspiration (breathing stops short of full inspiration) liver essentially drops down during inspiration and makes contact with an infected gallbladder
65
What percent of the population will get an appendectomy?
7%
66
What are the classic signs of appendicitis?
No appetite (Pain starts periumbilical the pain localizes once inflammation extends to the peritoneum)
67
What happens when an appendix ruptures?
Relief of pain and sepsis
68
Where is McBurney's Point located?
One-third of the way from the navel to the right anterior superior iliac spine (ASIS), which is the bony projection of the right hip bone
69
What is the psoas sign?
Elicited by having the patient lie on his or her left side while the right thigh is flexed backward. Pain may indicate an inflamed appendix overlying the psoas muscle.
69
What is the Rovsing's Sign?
Press on LLQ and pain is elicited in RLQ
70
What is the iliopsoas sign?
Ask the patient to lift the right leg against the resistance of your hand. This motion causes friction of the psoas muscle over the inflamed appendix, causing pain
71
What is the obturator test?
Pain on passive internal rotation of the hip when the right knee is flexed. It is present when the inflamed appendix is in contact with the obturator internus muscle.
72
What are the three Fs for cholecystitis?
Fat, Fair, Forty
73
Results from gallstones (40-70%), ETOH abuse, pancreatic cancer, hypertriglyceridemia, medications (rare)
Acute Pancreatitis
74
Results from history of several acute episodes, chronic ETOH abuse (50%)/smokers, genetic disorder, idiopathic
Chronic Pancreatitis
75
What disease process has symptoms that include pain, clay-colored stools, diarrhea/oily stools, N/V, severe back pain, weight loss, or elevated glucose/new onset of DM
Pancreatitis
76
Tricks for reading axis deviation
77
Murmur Grading
78
Percussion Tones
79
Red Flag Signs
