Term
| What are some s/s of CHF? |
|
Definition
symptoms:
-DOE
-swollen ankles
-fatigue
-SOB at night
signs:
-JVD at 45 degrees
-tachycardia
-hypotension
-S3 heart sound
-pulmonary edema
-hepatomegaly
-CXR- left ventricular hypertrophy
-ECG- conduction abnormalities |
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Term
| What grade of murmur is loud, but heard with stethoscope only, and has a prominent thrill? |
|
Definition
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|
Term
| What type of murmur is associated with mitral valve stenosis? |
|
Definition
| mid-diastolic murmur with opening snap heard loudest at apex |
|
|
Term
| What are symptoms of intermittent claudication? |
|
Definition
| pain on walking, relieved by sitting down |
|
|
Term
| What are s/s of aortic dissection? |
|
Definition
symptoms:
-sudden, severe, tearing pain
signs:
-decreased peripheral pulses |
|
|
Term
| What is the S3 heart sound caused by? |
|
Definition
| rapid ventricular filling after the mitral valve opens |
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|
Term
| What signs indicate left ventricular enlargement? |
|
Definition
-PMI palpated at 6th intercostal space to the left of the MCL
-heave
-h/o HTN
-h/o MI |
|
|
Term
| What causes the inspiratory physiologic splitting of S2? |
|
Definition
| closure of the aortic then pulmonic valves |
|
|
Term
| What valve is involved in a murmur heard only at the cardiac apex? |
|
Definition
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|
Term
| What stage is an ulcer with exposed dermis and pink tissue? |
|
Definition
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|
Term
| What structures are found near the mediastinum? |
|
Definition
|
|
Term
| What other systems might be assessed with cardiac symptoms? |
|
Definition
-GI
-neuro
-musculoskeletal
-respiratory |
|
|
Term
| What is an important reason to rank the severity of pain? |
|
Definition
| in order to monitor progress, e.g. relief with nitroglycerin |
|
|
Term
| What factors are included in the Framingham risk score? What isn't included for? |
|
Definition
included:
-age
-gender
-DM
-BP
-total and HDL cholesterol
-smoking
not included:
-ethnicity
- <34 yo, >74 yo
-PMH |
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|
Term
| What are some pt positions that should be included in the cardio exam? |
|
Definition
-seated, leaned forward
-supine
-left lateral recumbent |
|
|
Term
|
Definition
| clenched fist over chest to describe ischemic pain |
|
|
Term
| What techniques are used to assess JVD? |
|
Definition
-supine, 45 degree HOB, head turned to left
-oblique lighting
-valsalva |
|
|
Term
| What is an abnormal JVD finding? |
|
Definition
| >5 cm above sternal angle |
|
|
Term
| What does leg pallor or pain on elevation indicate? |
|
Definition
|
|
Term
|
Definition
-dependent rubor
-decreased hair growth
-shiny, atrophic skin
-cool skin
-thickened toenails
-gangrene |
|
|
Term
|
Definition
-edema, weeping
-hyperpigmentation
-stasis dermatitis with scarring and contraction
-thickened skin
-fibrotic, malleolar ulcers |
|
|
Term
|
Definition
-non-painful
-palms and soles of feet |
|
|
Term
|
Definition
-painful
-raised, red
-fingertips |
|
|
Term
| What is the grade of a normal pulse? |
|
Definition
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|
Term
| What is the grade of a pulse that is diminished and can be obliterated with too strong a grasp? |
|
Definition
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|
Term
| What can percussion be used for in the cardiac examination? |
|
Definition
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|
Term
| Where can the aortic area be auscultated? |
|
Definition
-2nd ICS, R sternal border
-radiates to carotid |
|
|
Term
| Where can the tricuspid area be auscultated? |
|
Definition
| -5th ICS, L sternal border |
|
|
Term
| Where can the mitral area be auscultated? |
|
Definition
-5th ICS, MCL
-radiates to armpit |
|
|
Term
| Where can Erb's point be auscultated? |
|
Definition
| -3rd ICS, L sternal border |
|
|
Term
| Where can the pulmonic area be auscultated? |
|
Definition
| -2nd ICS, L sternal border |
|
|
Term
|
Definition
-location where S2 best auscultated
-3rd ICS, L sternal border |
|
|
Term
| What is a strategy to distinguish S1 from S2? |
|
Definition
| palpate carotid while auscultating |
|
|
Term
| Where is S1 heard loudest? |
|
Definition
|
|
Term
| Where is S2 heard loudest? |
|
Definition
|
|
Term
| What do S1 and S2 sound like at the apex? |
|
Definition
|
|
Term
| What do S1 and S2 sound like at the base? |
|
Definition
|
|
Term
| What does S1 and an S2 split sound like on inspiration? |
|
Definition
|
|
Term
| A rub sounds constant with each heartbeat. T/F |
|
Definition
|
|
Term
|
Definition
| abnormal heart sound due to prolonged, disrupted blood flow |
|
|
Term
| What are potential causes of a murmur? |
|
Definition
-valve defect
-septal defect
-great vessel dilation
-high blood flow
-cerebral vessels stenosis |
|
|
Term
| What are types of gallops? |
|
Definition
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|
Term
|
Definition
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|
Term
|
Definition
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|
Term
| What are reasons for an audible S3? |
|
Definition
-young child
-CHF
-anemia
-impaired left ventricular function |
|
|
Term
| What causes the S3 sound? |
|
Definition
-mitral valve opens
-left ventricle fills rapidly, passively |
|
|
Term
| What causes the S4 sound? |
|
Definition
| atria contracting against a non-compliant ventricle |
|
|
Term
| What are reasons for an audible S4 sound? |
|
Definition
-trained athlete
-hypertrophied left atria
-stiffened left ventricle
-HTN |
|
|
Term
| What are aspects of murmurs that must be assessed? |
|
Definition
-timing- systolic, diastolic
-location- where heard best
-quality- harsh, blowing, musical, soft
-pattern- crescendo, decrescendo, pansystolic
-intensity- Grade I-VI
-radiation- to carotid or left axilla
-effect of position- increase with maneuvers |
|
|
Term
| What grade is a murmur that is heard with stethoscope off chest, has a prominent thrill and a visible heave? |
|
Definition
|
|
Term
| What grade is a murmur that is barely audible in a quiet room? |
|
Definition
|
|
Term
| What grade is a murmur that is loud and with a thrill? |
|
Definition
|
|
Term
| What grade is a murmur that is very loud and with a prominent thrill? |
|
Definition
|
|
Term
| What grade is a murmur that is quiet but easily audible? |
|
Definition
|
|
Term
| What grade is a murmur that is loud and with a thrill? |
|
Definition
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