Flashcards in Vitals Deck (70)
Why get vitals
Reflects body basic fucntions
Detects abnormal functioning
What is the 5th vital
What type of sound is the Bell of the stethoscope used for?
Low frequency sound (with light pressure)
What types of sound is the Diaphragm of the stethoscope used for?
High pitched sounds (i.e. 300hz)
What is a normal heart rate?
60-100 bpm (140 in infants)
What is tachycardia?
> 100 bpm
What is bradycardia?
< 60 bpm
What does an EKG measure?
What is a regular pulse rhythm?
What is a regular irregularity pulse?
Repetitive irregular pattern
Seen in premature atrial or ventricular contraction
What is an irregular irregularity pulse?
Random irregular pattern
Seen in atrial dysthytmia (i.e. atrial fibrillation)
Explain pulsus differens
Volume differences between two different pulses
Seen in local stenosis or compression of the paths of the vessel with the weaker pulse
What is the scale for amplitude of pulse?
4 - bounding
3 - full and increased
2 - normal
1 - diminished, barely palpable, thready
0 - absent, not palpable
What can cause a pulse amplitude of 4?
What can cause a pulse amplitude of 3?
Hyperdynamic circulation (hyperthyroidism)
What can cause a pulse amplitude of 1?
What can cause a pulse amplitude of 0?
Obstruction or shock
Describe a Pulsus alterans. What can cause it?
Alternating weak and strong beat with ah normal rhythm.
Usually associated with a left-sided S3.
Seen in left ventricular failure
Describe a Pulsus Bisferiens. What can cause it?
Has 2 main peaks
2 strong systolic beats separated by a mid systolic dip
Seen in aortic regurgitation with or w/o stenosis
Describe a Pulsus Bigeminal. What can cause it?
2 beats in rapid succession
Normal beat plus premature beat
The two beast vary in amplitude due to the reduced stroke volume of the second beat
Seen in premature ventricular contraction
Describe a Pulsus Paradoxus. What can cause it?
Exaggeration of the normal fall in amplitude of the pulse during inspiration
Decreased is determined by changes in the systolic blood pressure
Normal - 10mmHg fall during inspiration
If a fall is greater than 12-15mmHg, indicative of Pulsus Paradoxus
Seen in severe obstructive lung disease, pericadial tamponande, constrictive pericarditis
Describe a Water Hammer Pulse. What can cause it?
AKA Corrigan pulse, Collapsing pulse
Greater amplitude, rapid rise/upstroke, normal summit, sudden descent
Due to a blackflow through the aortic valve
Seen in aortic regurgitation and patent ductus arteriosus
Describe a large, bounding pulse. What can cause it?
Defined as 3+
Does not fade out with pressure - not easily obliterated
Seen in hyperdynamic circulation (i.e. hyperthyroidism)
What is a pulse deficit? What can cause it?
Difference between the heart rate by auscultation at the apex and the peripheral pulse rate by palpation
Seen in atrial fibrillation, rapid irregular rhythms
What is a radio-femoral delay? What can cause it to be abnormal?
Normal transmission of a pulse wave is 75ms (radial artery) and 70ms (femoral artery)
Longer when there is obstruction to the flow of blood
Seen in Leriche's syndrome (isolated aortic-iliac disease), post-subclavian coarctation of the aorta
What is Quinke's sign? What does it indicate?
Capillary pulsation in the nail bed
Manifests as alternating flushing and blanching of the nail bed due to pulsations in the subpapillary arteriolar and venous plexuses
Seen in aortic insufficiency
What is Durozie's sign? What does it indicate?
Femoral bruit ("pistol shot")
Normally a bruit is only heard in systole.
Durozie's is seen in both systole and diastole (two phase bruit), heard over the peripheral arteries (i.e. femoral).
Rapid "back and forth" flow of blood - as seen in aortic insufficiency
What is de Mussett's sign? What does it indicate?
Head nodding coinciding with the carotid pulse
Seen in aortic regurgitation
What does a positive Osler maneuver mean?
Rigid wall is indicative of atherosclerotic disease of the blood vessel