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NPTE Cardio and Lymph > Physical Exam: Cardiovascular System > Flashcards

Physical Exam: Cardiovascular System Flashcards

1
Q

Grading scale for peripheral pulses

A 
0 absent, not palpable
1+ pulse diminished, barely perceptible
2+ easily palpable, normal
3+ full pulse, icn strength
4+ bounding pulse
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2
Q

Apical pulse or point of maximal impulse

A

pt is supine
palpate at 5th interspace, midclavicular vertical line
(apex of heart)

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3
Q

Other pulses

A 
Radial
Carotid
Brachial
Femoral
Popliteal
Pedal
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4
Q

Normal HR - adult and teen

A

60-100

40-60 if aerobically trained

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5
Q

Normal HR - child

A

60-140

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6
Q

Normal HR - newborn

A

avg is 127

90-164 is range

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7
Q

Tachycardia =

Bradycardia =

A

over 100

less than 60

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8
Q

Postural techycardia syndrome

A

sustained heart rate increase greater than or equal to 30 bpm within 10 minutes of standing

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9
Q

Irregular pulse

A

variations in force and frequency

may be due to arrhythmias, myocarditis

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10
Q

Weak, thready pulse - may be due to

A

may be due to low SV, cardiogenic shock

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11
Q

Bounding, full pulse - may be due to

A

shortened ventricular systole and decreased peripheral pressure or aortic insufficiency

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12
Q

Auscultation is what

A

Process of listening for sounds within the body

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13
Q

Auscultation landmarks - aortic valve

A

2nd R intercostal space at sternal border

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14
Q

Auscultation landmarks - pulmonic valve

A

2nd L intercostal space at sternal border

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15
Q

Auscultation landmarks - Tricuspid valve

A

4th L itnercostal space at sternal border

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16
Q

Auscultation landmarks - Mitral valve

A

5th L itnercostal space at midclavicle area

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17
Q

S1

A

lub

normal closure of mitral and tricuspid (AV valves)

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18
Q

S2

A

dub
normal closure of aortic and pulmonary valves (semilunar valves)
marks end of systole

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19
Q

S1 decreased in

A

first degree heart block

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20
Q

S2 decreased in

A

aortic stenosis

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21
Q

Systolic murmur

A

Falls between S1 and S2

Might indicate valvular disease or can be normal

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22
Q

Diastolic murmur

A

falls between S2 and S1

Usually indicates valvular disease

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23
Q

Grades of heart murmurs

A

Grade 1 (softest audible murmur) to Grade 6 (audible with stethoscope off chest)

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24
Q

Thrill murmur

A

an abnormal tremor accompanying a vascular or cardiac murmur
felt on palpation

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25
Q

Bruit is what

A

an adventitious sound or murmur (blowing sound) of arterial or venous origin
common in carotid and femoral arteries
indicative of atherosclerosis

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26
Q

Gallop rhythm is what

A

an abnormal heart rhythm with three sounds in each cycle, resembles a gallop of a horse

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27
Q

Gallop rhythm - S3 is what

A

associated with ventricular filling
occurs soon after S2
in older people can be indicative of LV congestive heart failure

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28
Q

Gallop rhythm - S4 is what

A

associated with ventricular filling and atrial kick/contraction
occurs just before S1
indicative of pathology like CAD MI aortic stenosis or chronic hypertension

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29
Q

ECG - P wave

A

atrial depolarization

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30
Q

ECG - PR interval

A

Time required for impulse to travel from atria to through conduction system to purkinje fibers

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31
Q

ECG - QRS wave

A

ventricular depolarization

32
Q

ECG - ST segment

A

beginning of ventricular repolarization

33
Q

ECG - T wave

A

ventricular repolarization

34
Q

ECG - QT interval

A

time for electrical systole

35
Q

ECG - PVC

A

premature beat arising from ventricle

No P wave, wide QRS that is premature

36
Q

ECG - ventricular tachycardia

A

run of 3 or more PVCs

150-200 bpm

37
Q

ECG - ventricular fibrillation

A

pulseless emergency sitation
no QRS
clinical death within 4 to 6 minutes

38
Q

ECG - atrial arrhythmias

A

P waves are abnormal

rate rapid - atrial tachycardia (140-250), atrial flutter (250-350), atrial fibrillation (more than 300)

39
Q

ECG - changes with acute MI

A

ST elevation

40
Q

Hyperkalemia does what to ECG

A

widens QRS
flattens P
T is peaked

41
Q

Hypokalemia does what to ECG

A 
flattens T (or inverts) 
produces U wave
42
Q

Hypercalcemia does what to ECG

A

widens QRS

short QT

43
Q

Hypocalcemia does what to ECG

A

prolong QT

44
Q

Hypothermia does what to ECG

A

elevate ST

slows rhythm

45
Q

Digitalis does what to ECG

A

depress ST
flattens T wave (or inverts)
QT shortens

46
Q

Quinidine does what to ECG

A

QT lengthens
T flattens (or inverts)
QRS lengthens

47
Q

Beta blockers do what to ECG

A

dec HR

blunt HR response to exercise

48
Q

Nitrates do what to ECG

A

Inc HR

49
Q

Antiarrythmic agents do what to ECG

A

might prolong QT interval

50
Q

Holter monitoring is what

A

Continuous ambulatory ECG monitoring via tape recording of cardiac rhythm for up to 24 hours

51
Q

BP - normal

A

less than 120/80

52
Q

Orthostatic Hypotension

A

systolic BO drops more than 20 mmHg OR diastolic drops more than 10 mmHg

53
Q

Pediatric BP - infants less than 2 yrs

A

106 - 110 for systolic

59-63 for diastolic

54
Q

Pediatric BP - children 3 to 5 yrs

A

113-116 systolic

67-74 diastolic

55
Q

Mean arterial pressure is what

A

the arterial pressure within the large arteries over time

dependent on mean blood flow and arterial compliance

56
Q

MAP - calculated how

A

sum of SBP and twice the DBP divided by 3

57
Q

MAP - normal

A

70-110 mmHg

58
Q

Normal adult RR

A

12-20

59
Q

Normal newborn RR

A

30-40

60
Q

Normal child RR

A

20-30

61
Q

Tachypnea

A

greater than or equal to 22

62
Q

Bradypnea

A

less than or equal to 10

63
Q

Hyperpnea is what

A

increase in depth and rate of breathing

64
Q

Dyspnea is what

A

shortness of breath

65
Q

Orthopnea

A

inability to breathe when in a reclining or supine position

66
Q

Paroxysmal nocturnal dyspnea

A

sudden inability to breathe occuring during sleep

67
Q

Modified borg dyspnea scale

A

0 to 10
0 nothing at all
10 maximal

68
Q

Adventitious sounds - crackles (rales) =

A

rattling, bubbling sounds

might be due to secretions in the lungs

69
Q

Adventitious sounds - wheezes (ronchi)

A

whistling sounds

70
Q

Hypoxemia

A

abnormally low amount of oxygen in blood (saturation below 90% meaning PaO2 of 60 mmHg)

71
Q

Hypoxia

A

low oxygen level in tissues

72
Q

Anoxia

A

complete lack of oxygen

73
Q

Angina scale

A 
1+ = light, barely noticeable
4+ = most severe pain ever experienced
74
Q

Cardiac pain can refer to

A

shoulders, back, arms, neck, or jaw

75
Q

Pain referred to back can occur from

A

dissecting aortic aneurysm

NPTE Cardio and Lymph (9 decks)

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