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Flashcards in Midterm keys Deck (48)
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1

carotid pulse contour

>smooth rapid upstroke close to S1,
->brief round plateau,
->less rapid downstroke with dicrotic notch

->systole - upstroke
->diastole - plateau and downstroke

2

pulsus parvus

small amplitude

3

pulsus tardus

delayed upstroke

4

aortic stenosis

pulsus parvus
pulsus tardus
low delayed plateau
slow down stroke

5

aortic regurg

strong and bounding pulse
brisk upstroke
brief short plateau
rapid downstroke

6

amplitude of pulse

4 - bounding (aortic regurg)
3 - full and inc (hyperdynamic/hyperthyroid)
2 - normal
1 - diminished, barely palpable, thready (heart failure)
0 - absent, non-palpable (obstruction/shock)

7

pulsus alternans

alternating weak and strong beat with normal rhythm
assoc with left sided S3 - left vent failure

8

pulsus bisferiens

biphasic pulse
2 main systolic peaks separated by a mid systolic dip
aortic regurg or aortic stenosis + regurg

9

pulsus bigeminal

2 beats in rapid succession
normal + premature vent contraction
varied amplitude due to reduced SV in 2nd beat

10

pulsus paradoxus

exaggeration in normal fall in amp during inspiration
best det by change in systolic bp - 12-15 mmHg dip (norm 10)
severe obstructive lung disease, tamponade, constrictive pericarditis

11

Water Hammer/Corrigan/Collapsing pulse

->greater amplitude
->rapid upstroke,
->normal summit,
->sudden descent

*->aortic valve regurg,
->PDA*

12

pulse deficit

diff btwn heart rate by ausc at apex and peripheral pulse rate by palpation
rapid irreg rhythm - a fib

13

radio-femoral delay

increased transmission time of pulse wave to lower ext
norm: radial 75ms, femoral 70ms
Leriche's syndrome (aorto-iliac dis), post-subclavian coartaction
Measure supine BP in thigh and arm: LE < UE

14

Quincke's sign

nailbed capillary pulsation (flush/blanch)
aortic insufficiency

15

Durozie's sign

->femoral bruit/pistol shot
->hear in both systole and diastole over periph arteries
->rapid back and forth of flow in aortic insufficiency

16

De Mussett's sign

head nodding with carotid pulse

->aortic regurg

17

pulsus differens

->asymmetry due to vol differences

->local compression/stenosis

18

hypotension

<80 mm systolic
relative - past reading
absolute - signs and sx
orthostatic - fall of 20 systolic and/or 10 diastolic on standing for 3mins after recumbency

19

hypertension

pre 140

20

muscles of inspiration

diaphragm
intercostals
SCM
levator scapulae/serratus pos
scalenus anterior and medius
erector spinae

21

expiration

usually passive
abdominals
intercostals

22

respiration control

central (neurogenic)
->medullary rhythmicity center,
->apneustic center (depth),
->pneumotaxic center (rate)

peripheral (stretch)
->Hering-Breuer reflex,
->smooth muscles of bronchi and bronchioles (vagus med)

chemoreceptors
->central (outside of BBB, PCO2 and pH),
->peripheral
~carotid/aortic bodies,
~PO2,
~glossopharyngeal/vagus,
~not sig in normal resp

23

normal resp rates

adult: 12-20
kid: 15-20
infant: 25-50

24

bradypnea

<10
CNS, diabetic coma, inc ICP

25

tachypnea

>24 rapid shallow
restrictive lung dis, pleuritic chest pain, inc intra-abd pressure

26

hyperpnea

rapid deep
exercise, anxiety, metab acidosis, midbrain/pontine abnorm

27

Ataxic/Biot's

unpredictable irregularity - shallow, deep or cease
resp dep/medullary dmg

28

Cheyne-Stokes

deep-apnea alteration
brain dmg, heart failure, uremia, drug resp dep

29

prolonged expiration

obstructive lung disease - narrow airway
asthma, COPD

30

fever/pyrexia

core body temp over 99 in adults/101 in <3mo infants
increase in thermoreg set point
infection, trauma, drug rxn, hyperdynamic state