Lecture 1b: Clinical Evaluation of CV System & PE Flashcards Preview

Cardiopulmonary (Estrada-Fall 2014) > Lecture 1b: Clinical Evaluation of CV System & PE > Flashcards

Flashcards in Lecture 1b: Clinical Evaluation of CV System & PE Deck (46):
1

diaphragm side of stethoscope listens to:*

high frequency sounds

2

bell side of stethoscope listens to:*

low frequency sounds

3

differential cyanosis

the bluish coloration of the lower but not the upper extremity and the head. This is seen in patients with a patent ductus arteriosus (web)

4

normal jugular veins on PE should:*

not extend past thoracic inlet, should bounce back after being depressed

5

Hepatojugular reflex*

gentle pressure applied to cranial abd to increase venous return. If jugular pulsations seen, means there is a right-sided heart disease (such as diastolic dysfunction or volume overload)

6

When you are feeling a pulse, you are feeling the difference between:

systole and diastole

7

Thrill*

vibration caused by a murmur. The jet of a murmur "hits your hand"

8

PMI*

point of maximal intensity. Usually located over the LV apex. Web: the point on the chest wall at which the maximal cardiac impulse is seen and/or palpated

9

murmur is what kind of blood flow?*

turbulent

10

Regions of cardiac auscultation*

-left apex
-left base
-left, cranial
-R apex
-R base
-Sternum

11

left apex murmur assoc. with:*

mitral insufficiency, mitral stenosis Usually located at PMI

12

left base murmur assoc. with:*

(listen to aorta and pulmonary a.)
pulmonic stenosis
pulmonic insufficiency
aortic stenosis
aortic insufficiency

13

left cranial murmur assoc. with:*

PDA, arteriopulmonary window

14

right side murmur assoc. with:*

(listen to tricuspid valve)
tricuspid insufficiency --> heard best at R apex
ventricular septal defect --> heard best at R heart base

15

auscultate sternum for:*

murmur, especially in cats because they have a lazy aorta

16

What to listen for on L side of horse*

Heart base, apex, cranial region for pulmonic valve, aortic valve, mitral valve, PDA.

17

S1 in horse*

apex beat (listen over apex)
AV valve closure
start of systole
longer sound than S2

18

S2 in horse*

semilunar valve closure
listen over P and A valve area
represents end of systole

19

What to listen for on R side of horse*

same as right side. Also listen to tricuspid valve

20

S1 corresponds to:*

AV valves (mitral and tricuspid) closing

21

S2 corresponds to:*

semilunar (aortic and pulmonary) valves closing

22

S3 gallop often due to:*

diastolic volume overloading as in dilated cardiomyopathy, PDA, mitral insufficiency, and septal defects

23

S4 gallop often due to:*

increased ventricular concentric hypertrophy and stiffness

24

mid-systolic clicks often due to:*

sudden tensing of chordae tendina

25

possible cause of split heart sounds*

heart worms

26

atrial fibrillation sounds like*

some beats soft, others loud. Sounds like shoes in washing machine

27

sinus arrhythmia sounds like*

uneven beats

28

3rd degree AV block sounds like*

fast pulse then stop

29

sinus arrest sounds like*

long period of no beats

30

Murmurs are classified based on:*

-timing (i.e. is it systolic, diastolic?)
-locaiton
-intensity
-pitch
-shape

31

systolic murmur*

murmur that you hear between S1 and S2

32

diastolic murmur*

murmur heard after S2

33

continuous murmur*

murmur heard throughout S1 and S2

34

Heart mumur intensity:1*

only auscultable in a quiet room with calm dog

35

Intensity 2*

soft murmur

36

Intensity 3*

prominent, readily heard upon auscultation

37

Intensity 4*

loud murmur that isn't palpable

38

Intensity 5*

loud murmur that is palpable (thrill)

39

Intensity 6*

murmur auscultable with the stethoscope off the chest

40

Does intensity of murmur = severity?*

Not always. Intensity can vary depending on the "direction" of the murmur, or if a defect creates a small or large hole

41

High frequency pitch of murmur assoc. with:*

degenerative valve dz in EARLY stages

42

Low frequency pitch of murmur assoc. with:*

degen. valve dz in LATER stages

43

Diamond shaped ejection murmur assoc. with:*

Subvalvular aortic stenosis (SAS)
Pulmonary Stenosis (PS)
Ventricular Septal Defect (VSD)

44

Plateau Shaped Murmur assoc. with:*

Mitral/Tricuspid Insufficiency

45

Diastolic Decrescendo Murmur assoc. with:*

Aortic/Pulmonary Insufficiency. Begins at the end of systole

46

Pre-systolic murmur assoc. with:*

mitral stenosis. Diastolic, low-intensity murmur