Flashcards in Phys exam skills: Murmurs Deck (20)
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1
1. Slow rise of the carotid pulse
2. mid to late peak intensity murmur
3. decreased intensity of the 2nd heart sound
dx aortic stenosis
2
1. absence of murmur radiation to the R carotid artery
r/o aortic stenosis
3
Heart murmurs are produced when _____.
turbulent blood flow causes prolonged auditory vibrations of cardiac structures
4
1. max intensity at 2nd R intercostal space
2. radiates to the R carotid artery and R clavicle
typical for aortic stenosis
5
typical findings for aortic stenosis?
1. max intensity at 2nd R intercostal space
2. radiates to the R carotid artery and R clavicle
6
1. max intensity at 5/6th L intercostal space, midclavicular
2. radiates to the L anterior axilla line and L axilla
typical for mitral regurg
7
typical findings for mitral regurg?
1. max intensity at 5/6th L intercostal space, midclavicular
2. radiates to the L anterior axilla line and L axilla
8
1. max intensity at the lower L sternal border
2. radiates to the lower R sternal border, epigastrum, 5th intercostal space- mid L thorax
typical findings for tricuspid regurg
9
typical findings for tricuspid regurg?
1. max intensity at the lower L sternal border
2. radiates to the lower R sternal border, epigastrum, 5th intercostal space- mid L thorax
10
1. max intensity at the 5th L intercostal space, midclavicular
2. radiates to the lower L sternal border
typical for hypertrophic cardiomyopathy
11
typical findings for hypertrophic cardiomyopathy?
1. max intensity at the 5th L intercostal space, midclavicular
2. radiates to the lower L sternal border
12
What is apical-carotid delay? What does it mean?
assess the R carotid pulse and R brachial arterial pulse simultaneously with both hands. Delay btw the 2 = abnormal.
13
What signifies a grade 4 murmur?
a thrill (palpable precordial vibration)
14
How is the 4th heart sound best heard?
using the bell of the stethoscope in the L lateral decubitus position
15
____ are associated with MVP.
Systolic clicks
16
Systolic clicks are associated with ____.
MVP
17
What maneuvers increase the intensity of R sided murmurs? How do they do this?
1. quiet inspiration
2. sustained ab pressure
.... by increasing venous return
18
How are L sided heart murmurs intensified? How do they do this?
place an inflated BP cuff on each arm- murmur should intensify after 20 sec
.... by increasing systemic arterial resistance
19
What maneuvers increase venous return AND systemic arterial resistance?
standing to squatting, passive leg elevation
20
