CVS OSCE revision Flashcards
(35 cards)
What is the effect on BP reading if the cuff is too small?
Overestimates BP
What is the effect on BP reading if the cuff is too big?
Underestimates BP
What is the effect on BP if the arm is a) above the heart and b) below the heart?
a) Underestimate
b) Overestimate
What are Korotkoff sounds?
Turbulent blood flow
What is cyanosis?
Blue discolouration to the skin.
What is the difference between central and peripheral cyanosis?
Central cyanosis: Caused due to problems of the central pumping system – heart lungs. Blue discolouration to the tongue and lips due to presence of deoxygenated blood in the arteries i.e. respiratory problem
Peripheral cyanosis: Problems in vasculature and circulation. Blue discolouration to the peripheries due to inadequate supply of blood i.e. circulation problem.
Give some causes of peripheral and central cyanosis
- Peripheral – hypothermia, anaemia.
* Central – tetralogy of fallot, atrial stenosis, transposition of aorta and pulmonary valves, emphysema, asthma.
What are the layers of the pericardium?
Fibrous pericardium (most peripheral) Serous pericardium - parietal and visceral layers (fluid in-between)
What is an aortic aneurysm?
An aneurysm is a dilation (expansion) of an artery, which is greater than 50% of the normal diameter. An aortic aneurysm is due to a underlying weakness of the walls (such as Marfan’s syndrome), or a pathological process (such as aortic dissection).
The main concern with an aortic aneurysm is rupture of the aorta, which if not treated, will lead to death.
What are the borders of the heart?
- Right border – Right atrium
- Inferior border – Left ventricle and right ventricle
- Left border – Left ventricle (and some of the left atrium)
- Superior border – Right and left atrium and the great vessels
What is the oblique pericardial sinus?
A blind ending passageway (‘cul de sac’) located on the posterior surface of the heart.
Where is the transverse pericardial sinus found and what is its clinical significance?
Superiorly on the heart. It can be used in coronary artery bypass grafting.
What is the triangle of Koch and what are its borders?
The triangle of Koch is a triangle in the right atrium which is an important anatomical landmark to help find the location of the atrioventricular node.
The borders are:
•The opening of the coronary sinus.
•The anterior portion of the tricuspid valve annulus.
•The tendon of Todaro – a tendinous structure connecting the valve of the inferior vena cava to the central fibrous body posteriorly.
During BP measurement, we are listening to blood pressure as it is ejected from which ventricle?
Left
Heart sound :S1, LUBB
This is SYSTOLE of ventricles, DIASTOLE of atrium, closure of AV valves.
Heart Sound: S2 dupp
DIASTOLE of ventricles, SYSTOLE of atria, closure of semilunar valve
Why is S1 louder?
Ventricles are much stronger in contraction
Locations you can measure a persons pulse?
- temporal artery
- carotid artery
- axillary artery
- radial artery
- femoral artery
- popliteal artery
- post tibial artery
8 dorsalis predi artery
What is the first Korotkoff sound?
The first Korotkoff sound is the snapping sound first heard at the systolic pressure. Clear tapping, repetitive sounds for at least two consecutive beats is considered the systolic pressure.
What is the second Korotkoff sound?
The second sounds are the murmurs heard for most of the area between the systolic and diastolic pressures.
What is the third Korotkoff sound?
The third sound was described as a loud, crisp tapping sound.
What is the fourth Korotkoff sound?
The fourth sound, at pressures within 10 mmHg above the diastolic blood pressure, was described as “thumping” and “muting”.
What is the fifth Korotkoff sound?
The fifth Korotkoff sound is silent as the cuff pressure drops below the diastolic blood pressure. The disappearance of sound is considered diastolic blood pressure – 2 mmHg below the last sound heard.
What part of the heart does the left circumflex artery supply?
Left atrium & left ventricle
