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Assessment > Module 3 > Flashcards

Module 3 Flashcards

1
Q

Signs of feeding intolerance in infants

A

Tires easily
Sweating while feeding
Cyanosis

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2
Q

apical impulse

A

visible at about the midclavicular line in the fifth left intercostal space

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3
Q

Left ventricular size- how to find

A

better judged by the location of the apical impulse

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4
Q

Right ventricle enlarges _______ diameter rather than _____

A

anteroposterior, laterally

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5
Q

aortic valve area

A

Second right intercostal space at the right sternal border

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6
Q

Pulmonic valve area

A

Second left intercostal space at the left sternal border

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7
Q

Second pulmonic area

A

Third left intercostal space at the left sternal border

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8
Q

Tricuspid area

A

Fourth left intercostal space along the lower left sternal border

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9
Q

Mitral (or apical) area

A

Apex of the heart in the fifth left intercostal space at the midclavicular line

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10
Q

Indicators of heart function in infants

A

vigor and quality are indicators of heart function

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11
Q

Innocent murmurs of childhood

A

Murmur changes with position or respiration
Usual occur during systole
No other abnormalities noted
Nonradiating to other parts of chest
Low amplitude
Still murmur: best heard at the lower left sternal border and changes with position.

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12
Q

Pathologic murmurs of childhood

A

Blowing, squeaky, or a whooshing sound
Louder, harsher sound
Holosystolic
Does not change with position change
May be accompanied by clicks or rubs
Sound transmits to other parts of the chest and back

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13
Q

Angina

A

Pain caused by myocardial ischemia

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14
Q

Bacterial endocarditis

A

Bacterial infection of the endothelial layer of the heart and valves

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15
Q

Congestive heart failure

A

Heart fails to propel blood forward with its usual force, resulting in congestion in the pulmonary or systemic circulation

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16
Q

Pericarditis

A

Inflammation of the pericardium

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17
Q

Cardiac tamponade

A

Excessive accumulation of effused fluids or blood between the pericardium and heart

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18
Q

Cor pulmonale

A

Enlargement of the right ventricle secondary to chronic lung disease

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19
Q

Myocardial infarction

A

Ischemic myocardial necrosis caused by abrupt decrease in coronary blood flow to a segment of the myocardium

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20
Q

Myocarditis

A

Focal or diffuse inflammation of the myocardium

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21
Q

Sick sinus syndrome

A

Arrhythmias caused by a malfunction of the sinus node

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22
Q

Conduction disturbances

A

Proximal to bundle of His or diffusely throughout conduction system

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23
Q

Ventricular septal defect

A

Opening between the left and right ventricles

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24
Q

Tetralogy of Fallot

A

Ventricular septal defect,
pulmonic stenosis,
dextroposition of the aorta,
right ventricle hypertrophy

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25
Q

Patent ductus arteriosus

A

Failure of the ductus arteriosus to close after birth

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26
Q

Atrial septal defect

A

Congenital defect in the septum dividing the left and right atria

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27
Q

Acute rheumatic fever

A

Systemic connective tissue disease occurring after streptococcal pharyngitis or skin infection

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28
Q

Atherosclerotic heart disease

A

Narrowing of small blood vessels that supply blood and oxygen to the heart

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29
Q

Senile cardiac amyloidosis

A

Amyloid, fibrillary protein produced by chronic inflammation or neoplastic disease, deposition in the heart

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30
Q

A third heart sound is created by:

A

Diastolic filling

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31
Q

Thrill

A

A palpable rushing vibration over the base of the heart

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32
Q

FRAIL

A

fatigue, resistance, ambulation, illness, and loss of weight

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33
Q

Peripheral clues may suggest pulmonary or cardiac difficulties

A

Fingers: clubbing
Breath: odor
Skin, nails, and lips: cyanosis or pallor
Lips: pursing
Nares: flaring

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34
Q

Tactile fremitus

A

Palpable vibration of the chest wall that results from speech or other verbalizations

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35
Q

Hyperresonance with pulmonary percussion

A

hyperinflation

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36
Q

Dullness with pulmonary percussion

A

diminished air exchange.

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37
Q

Vesicular

A

Low-pitched, low-intensity; heard over healthy lung tissue

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38
Q

Bronchovesicular

A

Heard over the major bronchi; moderate in pitch and intensity
Abnormal if heard over peripheral lung tissue

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39
Q

Bronchial

A

Highest in pitch and intensity
Ordinarily heard only over the trachea
Abnormal if heard over peripheral lung tissue

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40
Q

Crackles (formerly called rales)

A

Heard more often during inspiration and characterized by discrete discontinuous sounds
Fine: high pitched and relatively short in duration
Coarse: low pitched and relatively longer in duration

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41
Q

Rhonchi (sonorous wheezes)

A

Deeper, rumbling, pronounced during expiration, prolonged and continuous, less discrete than crackles
Caused by the passage of air through an airway obstructed by thick secretions, muscular spasm, tumor, or external pressure

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42
Q

Wheezes (sibilant wheeze)

A

Continuous, high-pitched, musical sound (almost a whistle) heard during inspiration or expiration
Caused by a relatively high-velocity airflow through a narrowed or obstructed airway
May be caused by the bronchospasm of asthma (reactive airway disease) or acute or chronic bronchitis

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43
Q

Friction rub

A

Occurs outside the respiratory tree
Dry, crackly, grating, low-pitched sound; heard in both expiration and inspiration
Caused by inflamed, roughened surfaces rubbing together

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44
Q

Mediastinal crunch (Hamman sign)

A

Found with mediastinal emphysema
Loud crackles, clicking and gurgling; synchronous with the heartbeat and not respiration

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45
Q

Stridor

A

high-pitched, piercing sound most often heard during inspiration
Due to obstruction high in the respiratory tree

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46
Q

Asthma

A

Small airway obstruction, airway inflammation, and excess mucus production

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47
Q

Atelectasis

A

Incomplete expansion of the lung at birth or the collapse of the lung at any age

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48
Q

Bronchitis

A

Inflammation of the large airways

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49
Q

Pleurisy

A

Inflammatory process involving the visceral and parietal pleura

50
Q

Pleural effusion

A

Excessive nonpurulent fluid in the pleural space

51
Q

Empyema

A

Purulent exudative fluid collected in the pleural space

52
Q

Lung abscess

A

Well-defined, circumscribed, inflammatory, purulent mass that can develop central necrosis

53
Q

Pneumonia

A

Inflammatory response of the bronchioles and alveoli to an infective agent (bacterial, fungal, or viral)

54
Q

Influenza

A

Viral infection of the lung; secondary bacterial infection

55
Q

Tuberculosis

A

Chronic infectious disease that most often begins in the lung but may then have widespread manifestations

56
Q

Pneumothorax

A

Presence of air or gas in the pleural cavity

57
Q

Hemothorax

A

Presence of blood in the pleural cavity

58
Q

Lung cancer

A

Bronchogenic carcinoma, a malignant tumor that evolves from bronchial epithelial structures

59
Q

Pulmonary embolism

A

Embolic occlusion of pulmonary arteries; common condition; difficult to diagnose

60
Q

Epiglottitis

A

Acute, life-threatening infection involving the epiglottis and surrounding tissue

61
Q

Tracheomalacia

A

Lack of rigidity/floppiness of the trachea or airway

62
Q

Cystic fibrosis

A

Autosomal recessive disorder of exocrine glands involving the lungs, pancreas, and sweat glands

63
Q

Bronchiolitis

A

Bronchiolar (small airway) inflammation leading to hyperinflation of the lungs occurring in infants younger than 6 months

64
Q

Croup (laryngotracheal bronchitis)

A

Syndrome that results in infection from viral agents occurring most often in children ≤3 years of age

65
Q

Chronic obstructive pulmonary disease (COPD)

A

Group of respiratory problems; cough, chronic/excessive sputum production; dyspnea
Smokers at greatest risk

66
Q

Emphysema

A

Lungs lose elasticity; alveoli enlarge.

67
Q

Bronchiectasis

A

Chronic dilation of bronchi/bronchioles caused by pulmonary infections/bronchial obstruction

68
Q

Chronic bronchitis

A

Large airway inflammation

69
Q

The “triangle of safety”

A

is an anatomical region in the midaxillary line formed by the lateral border of the pectoralis major muscle anteriorly, lateral border of the latissimus dorsi posteriorly, and the nipple line (4th or 5th intercostal space) inferiorly. This triangle represents a “safe position” for chest tube insertion.

70
Q

right lung lobes

A

upper, middle, lower

71
Q

left lung lobe

A

upper, lower

72
Q

right main bronchus is

A

wider, shorter, and more vertical than the left main bronchus and directly enters the hilum of the lung

73
Q

The left main bronchus

A

extends inferolaterally from below the aortic arch and anterior to the esophagus and thoracic aorta and then enters the lung hilum

74
Q

visceral pleura

A

covers the outer surface of the lungs.

75
Q

the parietal pleura

A

lines the pleural cavity along the inner rib cage and the upper surface of the diaphragm

76
Q

The principal muscle of inspiration

A

diaphragm

77
Q

tachypnea

A

> 25 breaths/min

78
Q

The ratio of the anteroposterior (AP) diameter to the lateral chest diameter is usually

A

0.7 to 0.75 up to 0.9 and increases with aging.

79
Q

Cheyne–Stokes Breathing

A

Periods of deep breathing alternate with periods of apnea (no breathing). This pattern is normal in children and older adults during sleep. Causes include heart failure, uremia, drug-induced respiratory depression, and brain injury (typically bihemispheric).

80
Q

Ataxic Breathing (Biot Breathing)

A

Breathing is irregular—periods of apnea alternate with regular deep breaths which stop suddenly for short intervals. Causes include meningitis, respiratory depression, and brain injury, typically at the medullary level.

81
Q

most anterior structure of the heart

A

right ventricle

82
Q

atrioventricular (AV) valves

A

the mitral and tricuspid valves

83
Q

semilunar valves

A

aortic and pulmonic valves

84
Q

systole

A

the period of ventricular contraction when the left ventricle ejects blood into the aorta

the aortic valve is open, allowing ejection of blood from the LV into the aorta. The mitral valve is closed, preventing blood from regurgitating back into the left atrium.

the pulmonic valve opens, and the tricuspid valve closes as blood is ejected from the RV into the pulmonary artery

85
Q

diastole

A

This period of ventricular relaxation

the aortic valve is closed, preventing regurgitation of blood from the aorta back into the LV. The mitral valve is open, allowing blood to flow from the left atrium into the relaxed LV

the pulmonic valve closes, and the tricuspid valve opens as blood flows into the relaxed right ventricle

86
Q

The second heart sound, S2, and its two components, A2 and P2, are caused by

A

primarily by closure of the aortic and pulmonic valves, respectively
during inspiration, two different sounds. expiration, one sound

87
Q

A2 is

A

normally louder, reflecting the high pressure in the aorta. It is heard throughout the precordium

88
Q

P2 is

A

relatively soft, reflecting the lower pressure in the pulmonary artery and as such is best auscultated near its anatomic location, the second and third left intercostal spaces close to the sternum. It is here that you should search for the splitting of S2.

89
Q

each electrical impulse originates in the

A

sinus node,

90
Q

Cardiac output

A

, the volume of blood ejected from each ventricle in 1 minute, is the product of heart rate and stroke volume

91
Q

Stroke volume is

A

the volume of blood ejected with each heartbeat,

92
Q

The ejection fraction (EF)

A

is the percentage of ventricular volume ejected during each heartbeat and is normally 60%

93
Q

Preload

A

refers to the load that stretches the cardiac muscle before contraction

94
Q

Myocardial contractility

A

refers to the ability of the cardiac muscle, when given a load, to shorten

95
Q

Afterload refers to

A

the degree of vascular resistance to ventricular contraction

96
Q

Factors Affecting Blood Pressure

A

Left ventricular stroke volume
Distensibility of the aorta and the large arteries
Peripheral vascular resistance, particularly at the arteriolar level
Volume of blood in the arterial system

97
Q

Jugular venous pressure (JVP) reflects

A

right atrial pressure, which, in turn, equals central venous pressure and right ventricular end-diastolic pressure.

98
Q

paroxysmal nocturnal dyspnea

A

“Do you experience any nighttime episodes of sudden dyspnea that awakens you usually 1 or 2 hours after falling sleep, prompting you to sit up and stand up?”

99
Q

Anasarca is

A

severe generalized edema extending to the sacrum and abdomen.

100
Q

Internal Jugular Pulsations

A

Rarely palpable
Soft biphasic undulating quality, usually with two elevations and characteristic inward deflection (x descent)
Pulsations eliminated by light pressure on the vein(s) just above the sternal end of the clavicle
Height of pulsations changes with position, normally dropping as the patient becomes more upright
Height of pulsations usually falls with inspiration

101
Q

Carotid pulsations

A

Palpable

A more vigorous thrust with a single outward component

Pulsations not eliminated by pressure on veins at sternal end of clavicle

Height of pulsations unchanged by position

Height of pulsations not affected by inspiration

102
Q

pulsus alternans

A

, the rhythm of the pulse remains regular, but the force of the arterial pulse alternates because of alternating strong and weak ventricular contractions. Pulsus alternans almost always indicates severe left ventricular dysfunction. It is usually best felt by applying light pressure on the radial or femoral arteries.

103
Q

Paradoxical pulse

A

or pulsus paradoxus is a greater-than-normal drop in systolic blood pressure during inspiration

104
Q

heaves

A

, use your palm and/or hold your fingerpads flat or obliquely against the chest. Heaves are sustained impulses that rhythmically lift your fingers, usually produced by an enlarged right or left ventricle (depending on the location of the heave) and occasionally by ventricular aneurysms.

105
Q

thrills

A

press the ball of your hand (the padded area of your palm near the wrist) firmly on the chest to check for a buzzing or vibratory sensation caused by underlying turbulent flow.

106
Q

systolic murmur

A

falling between S1 and S2
coincide with the carotid upstroke

107
Q

diastolic murmur

A

, falling between S2 and S1
usually represent valvular heart disease.

108
Q

A bisferiens pulse is

A

an increased arterial pulse with a double systolic peak, detected during moderate compression of the artery. Causes include pure aortic regurgitation, combined aortic stenosis and regurgitation, and hypertrophic cardiomyopathy.

109
Q

A bigeminal pulse is

A

caused by a normal beat alternating with a premature contraction.

110
Q

normal left ventricular PMI:

A

Location: in the fourth or fifth left intercostal space, at the midclavicular line
Diameter: discrete, or ≤2 cm
Amplitude: brisk and tappiing
Duration: ≤2/3 of systole

111
Q

Grade 1/6

A

Softer in volume than S1 and S2, very faint

112
Q

Grade 2/6

A

Equal in volume to S1 and S2, quiet, but heard immediately

113
Q

Grade 3/6

A

Louder in volume than S1 and S2, moderately loud

114
Q

Grade 4/6

A

Louder in volume than S1 and S2, with palpable thrill

115
Q

Grade 5/6

A

Louder in volume than S1 and S2, with thrill; may be heard when the stethoscope is partly off the chest

116
Q

Grade 6/6

A

Louder in volume than S1 and S2, with thrill; may be heard with stethoscope entirely off the chest

117
Q

Crackles sign of

A

pneumonia, chf

118
Q

Knife like pain

A

Pericarditis

119
Q

Wheezing

A

Asthma

120
Q

SOB

A

Asthma

121
Q

Characteristics of murmur

A

timing, shape, location, radiation, intensity, pitch and quality

122
Q

Normal cholesterol

A

<200

Assessment (7 decks)

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