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ECR 2012 > ECR Cardiovascular 12.5.12 > Flashcards

ECR Cardiovascular 12.5.12 Flashcards

(53 cards)

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1
Q

Where is the PMI (Point of maximum impulse)

A

5th intercostal space

Left Ventricle

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2
Q

What are common comlaints that would warrant a CV pathology?

A

Chest pain
Fatigue
Cough
Difficultly breathing (Dyspnea, Orthopenia, Paroxysal noctural dyspnea)

Loss of consiousness

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3
Q

What is orhopnea

A

lie down, positional breathing

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4
Q

What is Paroxysmal nocturnal dyspnea

A

lying down, aweaken by cough in the middle of night

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5
Q

4 steps of cardiac exam

A

Insection
Percussion
Palpation
Auscultation

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6
Q

Steps for vascular Exam

A

Pulses

Signs of arterior or venous insufficiency

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7
Q

What to look for in General Appearance

A

Level of concsiousness (aweake, alert, responsive to the environemnet

Signs of distress, labored breating, sweating, in pain, anxiety, cyanotic

Height and weight

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8
Q

What are four Vital Signs

A

BP
PUlse
RR
Temp

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9
Q

Cardiac Exam Components (3)

A

Inspect
Palpate
Ausculate

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10
Q

Pericardium

A

fibroserous sac surrounding heart and roots of great vessels (pericarditis if there is sac)

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11
Q

Myocardium

A

Chambers- Atria and Ventricles- supplies pumping energy

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12
Q

Endocardium

A

LINING OF HEART CHAMBERS and valves prevents thrombosis

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13
Q

What are the three chambers of the heart

A
  1. Right/Left Atria- Reservoirs
  2. Right/Left Ventricle- Pumps
  3. Interatriala nd Interventricular septa- divide right/left heart chambers
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14
Q

What are the 4 valves of the heart

A
  1. Tricuspid- separates Rt Atrium and Rt ventricle
  2. Mitral valve- left atrium and left ventricle
  3. Pulmonic valve- rt ventricle and pulmonary artery
  4. Aortic-Valve- left ventricle and aorta
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15
Q

Where is the PMI

A

Point of Maximal impulse

5th intercostal space (midclavicular line (apex)

Precordum, wehre you hear heart beat, medial clavicule–> Left ventricle, Mitral region

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16
Q

Palpation: Heaves and Thrills

A

Palpate with side of hand of MCP joints for thrilsl (grade 4 or greater murmur) and heaves

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17
Q

WHen are heaves visible or palpable?

A

when chamber enlargemetn or hypertrophy is present and impacts the chest wall with cardiac motion

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18
Q

What are normal heart sounds?

A

S1/S2- most distinct, splitting

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19
Q

What are extra heart sounds?

A

Gallops S3/S4- more difficult to hear

Murmurs (Grade I-VI)

Friction rubs

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20
Q

Bell vs Diaphragm

A

Bell - smaller (low pitched sounds)

Diaphragm- sensitive to high pitched sounds

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21
Q

What happens during Systole

A

period of ventricular contraction to eject blood
Aortic and pulmonic valvaes open.
Mitral and Tricuspid valves close

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22
Q

What happens during Diastole

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A

Period of Ventricular relaxation/ atria move blood to ventricle

Aortic and Pulmonic valves Closed.
Mitral and Tricuspid Valves Open

23
Q

S1- 1st heart sound

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A

Ass. with closure of mitral and tricuspid leaflets

(aortic and pulmonary open)

M1 an T1

24
Q

which is louder during S1, M1 or T1?

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A

M1 is louder and best heart at apex

T1 is best heard at lower LSB (lowe sternal border)

25
S2
Componnent of S2 include (arotic valve closure) and P3 (pulmonic alve closure)
26
Which is louder duing S2 (A2 or P2)?
A2 is louder than P2 A2 is heradn thorught the precordium 2 is heard best in 2nd and 3rd ICS on left close to sternum
27
What are the pulses tha tyou have to ausculate and palpate (5)
1. Carotid 2. Femoral 3. Popliteal 4. Posterior Tibila 5. Dorsalis Pedis
28
What are pulses and what do they mesure?
Measure of PERFUSION (blood flow oxygen) to a region Arteries carry blood form heart/ Pulses measure arterial Pressure
29
How can perfusion be impaired
cardiac problem/heart failture Arterial disease/ Atheriosclerosis Traumatic Injury
30
Which pulses are central pulses. When are they lost?
Carotid Femoral Loss at SBP (systolic baseal pressure?_ <50
31
Which pulses are peripheral?
Brachial, radial popliteal posterior tibial Dorsalis Pedis
32
What are the gradign for periphearl arteries?
3_= boudnign 2+ risk, expected (normal) 1+- diminished, weaker than expected 0- absent, unable to palpate indicate whether it is equal bilaterally
33
Where do you ausculate for Bruits?
Temporal Carotid Abdominal aorta Renal/iliac/femoral arteries Indicated Turbulent Flow- Transmitted murmurs Obstructed arterial disease Remember to HOLD BREATH
34
Other findings ass. with arterial insufficiency
Palor/cyanosis Poor hair growth/skin atrophy Impaired wound healting Regional uscle pain with exertion (claudification) - insufficiency Check the tem
35
venous insufficiency/edema
when examing lower extremeity, look for signs of venous insufficiency (problem returign BF to heart) Inspect for varicose veins and skin findings ass with poor blood return (statis dermatitis, swelling)
36
Edema
Note for pitting 1( slight) - 4 (marked) may indicate regional pathology (unilateral) or more significant cardiac patholgoy/heart failure (bilateral)
37
S3
heard after S2 Originates as blood hits the ventricular walls during ventricular filling (diastole)
38
When is S3 heard best? | What is cause for it
when listening over mitral area | Overload ofa non-compliant left ventricle LV hypertrophy
39
what is S4
heard after S3, prior to S1 Originates as blood hits ventricualr walls during late ventricular filling (atrial kick)
40
when is S4 best heard
low pitch (bell) best heard when listenign over mitral area Overlaod of a non-compliant left ventricule (LV hypertoprhy)
41
Which heart sounds are like Kentucky
S1, S2, S3
42
Which heart sounds are like Tennessee
S4 S1 S2 S3
43
How are murmurs different form S3 and S4
Cardiac murmurs are differentiated form ehart soudns by their longer duration S3/S4- blood hitting ventricualr walls Murmur- narrow valve orifice (stenosis)
44
What causes murmucs
forward flow thorugha narrowed valve orifice (stenosis) High flow rate through normal or abnormal orifices Backward flow through a valve that doesn't fully close (regurgitation or insufficiency)
45
When do you hear systolic murmuc?
between S1 and S2
46
When do you hear diastolic murmur
between S2 and S1
47
What is the gradign scale for murmurs
I-VI
48
Grade I1
faint, heard only by cardiologist
49
Grade II
quiet but heard immediately
50
III
moderately loud, no thrill
51
IV
loud, thrill present
52
V
very oud, heard with scope off of chest
53
VI
very oud, heard with /without scope

ECR 2012 (16 decks)

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