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WVSOM -- CS1
Cardiovascular Tips for Success
| Question | Answer |
|---|---|
| What is the base of the heart? | broader upper portion of the heart |
| What is the apex of the heart? | Narrow lower tip of the heart |
| What is the primary muscle mass of the heart? | ventricles |
| What is the anterior surface? | right ventricle |
| What is posterior surface? | left ventricle |
| What is the left border of the heart? | left ventricle |
| What is responsible for the apical impulse? | the left ventricle |
| What is the right border? | the right atrium |
| What is preload | pressure stretching the ventricles of the heart cause by venous return |
| What is afterload? | pressure that the left ventricle must squeeze against to eject blood into the aorta |
| What is systole? | The ventricles contracting and ejecting blood from the left ventricle into the aorta and from the right ventricle into the pulmonary artery |
| What is diastole? | The atria contract and the ventricle dilate (blood moves from the atria to the ventricles) |
| Where do electrical impulses originate? | SA node |
| Where is the SA node located? | Right atrium |
| What is the path of the electrial impulses in the heart? | SA Node -> AV Node -> Bundle of His -> Purkinje Fibers |
| Where is the AV node located? | atrial septum |
| Where is the bundle of His and the purkinje fibers | Ventricles |
| How do ventricles contract? | At apex and spread to base |
| How does the fetus compensate for nonfunctional lungs? | umbilical vessels |
| Where does the right ventricle pump blood in the fetus? | ductus arteriosus |
| When does teh ductus arteriosus close? | after birth in approximately 24-48 hours |
| When does the foramen ovale close? | As pressure rises in the left atrium at birth |
| How much does blood increase in pregnant women? | 40-50% |
| Why does blood increase in pregnant women? | increased plasma volume |
| How does the heart compensate during pregnancy? | The left ventricle increases in wall thickness and mass? |
| Why does the heart compensate during pregnancy? | to allow for increased work load |
| What happens to the heart in older adults | The left ventricle wall thickens and valves tend to fibrose and calcify |
| What causes changes to the heart in older adult? | stress on the heart due to HTN, heart disease, etc. |
| One finger to chest pain indicates? | non-cardiac pain |
| N/Vomiting/Diaphoresis with chest pain is? | cardiac till proven otherwise |
| What does jaw pain indicate? | ischemia and pericarditis |
| What does sharp chest pain and hemoptysis indicate? | pulmonary embolism or tumor |
| What does pain with swallowing indicate? | esophageal spasm or pericarditis |
| What does fever with chest pain indicate? | pneumonia |
| What does sighing and mood issues with chest pain indicate? | anxiety and depression |
| What are cardiac risk factors? | age hyperlipidemia family Hx obesity sedentary lifestyle tobacco diabetes personality hypertension gender |
| If a person has hyperlipidemia, tobacco use or diabetes, the odds on having cardiac issues are what? | 8x more likely |
| What are the 5 points of auscultation? | Aortic Pulmonic Erbs Point Tricuspid Mitral |
| Where is the aortic auscultation point? | 2nd intercostal space on the RIGHT side |
| Where is the pulmonic auscultation point? | 2nd intercostal space on the LEFT side |
| Where is the Erbs point? | 3rd intercostal space on the left side |
| Where is the tricustpid auscultation point? | 4th intercostal space on the left side |
| Where is the mitral valve auscultation point? | 5th intercostal space on the left side |
| What is Erbs Point? | where S2 is best auscultated |
| What is the point of maximal impulse? | 5th intercostal space, left mid-clavicular line |
| Where does PMI shift in left ventricular hypertrophy? | downward and laterally |
| what is S1? | during ventricle systole when the mitral and tricuspid valves are closing |
| What is S2? | During ventricular diastole when the aortic and pulmonic valves close. |
| What is S3? | rapid filling of left ventricle in diastole. |
| When is an S3 sound normal? | normal into 3rd decade |
| What does S3 indicate in an older adult? | sign of heart failure |
| What does S4 heart sound? | Atrial diastolic gallop caused by vibration of valves and ventricular walls |
| What causes an S4 heart sound? | aortic stenosis |
| What is a grade I murmur? | barely audible in quiet room |
| What is a grade II murmur? | quiet but clearly audible |
| What is a grade III murmur | moderately loud |
| What is a grade IV murmur? | Loud with thrill |
| What is a grade V murmur? | Very loud with thrill and easily palpable |
| What is a grade VI murmur? | very loud, audible without a stethoscpe not in contact with chest, thrill palpable and visible. |
| What is a thrill? | fine palpable rushing vibration. Innocent murmurs do NOT have thrills |
| What are the two systolic murmurs? | Aortic stenosis and mitral regurgitation |
| Where is aortic stenosis heard? | 2nd intercoastal space and radiating to carotids |
| Where is mitral regurgitation heard? | best at teh apex and radiating to the left axilla |
| What are the two diastolic murmurs? | Aortic regurgitation and mitral stenosis |
| Where is aortic regurgiation heard? | right 2nd intercostal space with teh patient leaning forward using the diaphragm of the stethoscope |
| Where is mitral stenosis heard? | Left mid-clavicular line, 5th intercostal space with the patient lying in the left lateral recumbent position using the bell of the stethoscope |
| What murmurs are always pathological? | Diastolic Murmurs (Aortic regurg and mitral stenosis) |
| What needs to be inspected and palpated for the peripheral vascular system? | skin temperature, color, texture, pulses, any pain/tenderness, presence of edema, varicosities, hair distribution, muscle tone |
| How do you grade a normal pulse? | +2 |
| What is the scale to grade pulses? | 0 - +4 |
| What is Homan's Sign | calf pain with dorsiflexion of ankle indicating DVT |
| What is JVD? | Jugular Vein Distension Asymmetry of the jugular veins seen on inspection of patient sitting at 45 degrees |
| What does JVD indicate? | Right sided heart failure |
| What is the hepato-jugular reflex? | press lightly for 30 seconds on the right upper quadrant. If you see an increase in JVD then there could be right ventricular dysfunction. |
| What are bruits? | heard over renal arteries, carotids, abodminal aorta, iliac arteries, temporal arteries, and orbital arteries |
| How do you hear bruits? | With the bell of the stethoscope |
| What do bruits sound like? | "whooshing" |
| What do bruits indicate? | a build up of plaque |
| What does pitting edema indicate? | right sided heart failure |
| What is +1 pitting edema? | 1-2mm |
| What is +2 pitting edema? | 2-4mm |
| What is +3 pitting edema? | 4-6mm |
| What is +4 pitting edema? | 6-8 mm |
| What are the 5 P's of arterial occusion? | Pain Pallor Paralysis Paresthesia Pulselessness |
Created by:
tjamrose
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