Week 6, Cardiovascular Flashcards
(52 cards)
Blood flow through the heart
Superior + Inferior vena cava–> Right atrium–> through tricuspid valve–> right ventricle–> though pulmonary valve –> lungs–>pulmonary vein–>(oxygenated) –> left atrium–> through mitral valve–> left ventricle–>aortic valve–> aorta–> body
Relevant Personal Hx.
Smoking, alcohol, diet, exercise, etc.
Relevant Family history
Diabetes, HTN, CAD, hyperlipidemia
S&S
angina, fatigue, dizziness, syncope, diaphoresis, palpitations
Paroxysmal nocturnal dypsnea
sudden waking at night due to dyspnea (hallmark sign- if someone can’t sleep more than 2 hours)
Orthopnea
Can’t breathe laying down, need to elevate HOB
S1- systole
“lub”- tricuspid and mitral valves closing, CONTRACTION, loudest at apex (bottom)
S2- diastole
“dup”- pulmonary and aortic valves closing, RELAXATION, loudest at base (top)
CV assessment order
- Inspect
- Palpation
- Auscultate
Angle of louis
2nd rib
Inspection:
-semi fowlers
skin? scars? color? lift/heaviness? deformities?
Palpate
temp of skin and PMI (point of maximal impulse) at 5th intercostal space
Erb’s Point
3rd IC space, where you can hear everything roughly the same
Rub sound
high-pitched scratchy sound (r/t friction from pericardial inflammation), best heard @ lower left sternal border
Murmur
turbulent blood flow WITHIN HEART (narrowing or obstruction)
Graded 1-6, higher- more severe
S3
ventricular regurgitation, hear
S1–S2-S3
Ken—tuc-ky
S4
diastolic heart failure, hear
S4-S1–S2
Ten-nes—see
Male presentation of MI
chest pressure
Female presentation of MI
nausea, sweating, vomiting, pain in neck, jaw, throat, abdomen, back (referred pain)
Peripheral pulses
Bilateral equality, radial, brachial, femoral, popliteal, dorsalis pedis (top of foot), posterior tibialis 2+ normal 0- absent 3+/4+ - bounding 1- thready
Edema: depress for 5 seconds.
Pitting:
1+ (disappears rapidly, 2mm)
2+ (10-15 seconds, 4mm)
3+ (deeper, 1 min, 6mm)
4+ (severe, 2min +, 8mm)
DVT:
unilateral edema; pain, aches, cramps ; erythema; Warmth; URGENT: DO NOT MOVE
Arterial disorder
pain AFTER exercise -sharp, stabbing -worse with activity -lower extremity reduces pain (blood can flow there) -Skin cool and cool -hairless, smooth pulse absent -pallor with elevation -don't see edema
Venous disorder
- pain with standing
- achy, heavy
- pain alleviated with activity
- raise foot above heart level
- skin warm, mottled, stasis dermatitis
- pulse bounding
- edema frequent
