Review V Flashcards
(69 cards)
spinal facilitation
nociceptive input
- CNS has decreased firing threshold
- these neurons fire more quickly
pathologic murmur
holosystolic or diastolic grade 3 or higher harsh increased intensity with standing max intensity ULSB
echo - definitive diagnosis
feeding difficulty with infant
first sign of CHF
liver enlargement/ascites
CHF
wide fixed split S2
atrial septal defect
URSB
aortic valve clicks
ULSB
pulmonary valve clicks
LLSB
ventricular septal defects
apex
aortic and mitral valve clicks
venous hum
grade 1 to 6 continuous murmur
accentuated in diastole
whining, roaring, or whirring quality
heard over low anterior neck lateral to SCM
louder on right
resolves or changes when patient is supine
still murmur
grade 1 to 3 early systolic murmur
low to medium pitch - vibratory/musical
best heart lower left sternal border
loudest with patient supine
decreases with patient supine
ventricular septal defect
loud holosystolic murmur at LLSB for small defect
thrill at LLSB, split S2, grade 2-5, grade 1 or 2 mid-diastolic rumble - for medium or large defects
atrial septal defect
grade 2 or 3 systolic ejection murmur
-best heart ULSB
wide flixed split S2
absent thrill
may have grade 1 or 2 diatolic flow rumble at LLSB
patent ductus arteriosus
continuous grade 1 to 5 in ULSB
- crescendo in systole and decrescendo into diastole
- normal S1 - buried S2
- thrill or hyperdynamic left ventricular impulse may be present
tetralogy of fallot
central cyanosis, clubbing nail beds grade 3 or 4 long systolc ejection murmur at ULSB -may have holosytolic murmur at LLSB -systolic thrill at ULSB -increased S1 and single S2
coarctation of aorta
systolic ejection murmur best heard over interscapular region
=normal S1 and S2
-decreased or delayed femoral pulse
-increased left ventricular impulse
seven S’s
of innocent murmurs
- sensitive - changes with childs position
- short duration
- single
- small
- soft
- sweet - not harsh
- systolic
most common innocent murmur
still murmur
- characteristic to LLSB - musical or vibratory quality
- vibrations of left outflow tract
chest radiography and ECG
rarely assist diagnosis of heart murmur
phonocardiography
good for distinguishing between innocent and pathologic murmurs
diagnosis of innocent murmur
1 absence of abnormal physical exam findings
2 negative ROS
3 history negative for features that increase risk of structural heart disease
4 auscultatory features of innocent murmurs
criteria for children older than 1 year
newborns
higher risk of having serious structural heart disease that presents as asymptomatic murmur
cardiac viscerosomatics
Sympathetics - T1-5
Parasympathetics - OA
pulmonary viscerosomatics
sympathetics T2-6
parasympathetics OA
