PRACTICAL: SA cardio-respiratory exam

Question 1

What is S2?

Answer 1

end of systole and closure of AV valves.

Question 2

What might you hear on right side thoracic auscultation?

Answer 2

tricuspid valve sounds and murmurs associated with congenital defects such as VSDs

Question 3

Where should you listen for lung sounds?

Answer 3

o Place over caudodorsal lung fields and cranioventral lung fields. Both sides.

Question 4

What are the 2 surfaces to a stethoscope?

Answer 4

Flat = diaphragm surface. 
Concave = bell surface.

Question 5

What do you listen to with the diaphragm side of the stethoscope?

Answer 5

high frequency sounds (S1 and S2) and systolic heart murmurs

Question 6

What do you listen to with the bell side of the stethoscope?

Answer 6

use for lower frequency sounds, abnormal sounds in S3 and S4, diastolic heart murmurs.

Question 7

How do you differentiate high and low frequency heart sounds with a single surface stethoscope?

Answer 7

o Apply different pressures to body surface in order to distinguish low and high frequency sounds
o High frequency sounds – medium pressure
o Low frequency sounds – reduced pressure

Question 8

What is increased respiratory effort associated with?

Answer 8

URT disease (e.g. laryngeal paralysis, laryngeal tumour)

Question 9

What is paradoxical breathing? What are the Ddx for this?

Answer 9

abdomen moves inwards, diaphragm moves cranially. Can be a subtle finding. DDx: URT disease, stiff lungs (congestion or fibrosis), significant chronic pleural effusion or diaphragmatic disease.

Question 10

What should you palpate the cervical trachea for?

Answer 10

for shape. Yorkshire terriers may have an abnormal shape associated with tracheal collapse. Gentle pressing may cause coughing – known as ‘tracheal pinch’.

Question 11

When are jugular veins significantly distended?

Answer 11

RA increased pressure and therefore the possibility of right-sided CHF

Question 12

Why palpate the abdomen on a CVS exam?

Answer 12

any evidence of hepatic congestion or obvious ascites (both present with marked right-sided CHF).

Question 13

What clinical sign might you see in giant dogs with HF?

Answer 13

dependent oedema in distal limbs in animals with HF

Question 14

What might absence of an apex beat indicate?

Answer 14

a SOL between the heart and body wall.

Question 15

T/F: most murmurs in SAs are systolic

Answer 15

True

Question 16

What does a phonogram do?

Answer 16

shows intensity of heart murmur in relation to points on an ECG when the two are run simultaneously.

Question 17

Where is a PDA murmur heard?

Answer 17

heard beyond heart base, high into the axilla (since the duct lies outside the heart), continuous (i.e. in systole and diastole). Commonly a cow-teat shape of the ductus.

Question 18

Define ‘gallop rhythm’. Cause?

Answer 18

= ‘du lub dup’. S1 and S2 heard but also additional sounds: S3 passive ventricular filling, S4 active ventricular filling or occasionally both. Endocarditis may cause this.

Question 19

T/F: a rising pulse is normally palpable in small animals

Answer 19

True

Question 20

Why should you listen to the lungs over ribs 12 or 13?

Answer 20

lungs don’t extend this far caudally - you will be auscultating the liver instead. Remember to do both sides of the thorax!

Question 21

How can you distinguish URT and LRT noises?

Answer 21

URT get louder as you move cranially to the URT from the LRT (i.e. you may first detect them as referred noises from the URT in the LRT).

Question 22

What may an absence of heart sounds indicate? 2

Answer 22

SOL or pleural fluid

Question 23

What do crackles indicate?

Answer 23

primary lung disease or secondary to CHF. Be careful with wirey haired breeds!