Midterm Exam
Quiz yourself by thinking what should be in
each of the black spaces below before clicking
on it to display the answer.
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| Where is the PMI (apical impulse)? | Left ventricule at 5th inter-space, 7-9 cm from mid-sternal line (mid-clavicular)
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| What closes at the S1? | Mitral and Tricuspid Valve
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| When is systolic? | Between S1 and S2
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| What are four systolic extra heart sounds? | Aortic stenosis, pulmonic stenosis, HTN, and MVP Click
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| What are four diastolic extra heart sounds? | Mitral stenosis, physiologic S3, pathologic S3 or gallup, S4 or atrial gallop
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| What could cause an S3 or gallop? | Myocaridal failure, tricuspid or mitral regurg.
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| What could cause an S4 or atrial gallop? | HTN, CAD, Atrial Stenosis, Cardiomyopathy, delayed AV conduction
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| Where is physiologic splitting of S2 best heard? | 2nd or 3rd left interspace
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| What indicated pathologic splitting? | No change with respiration; should normally only be heard on inspiration
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| Where is the place to hear a pericardial friction rub? | 3rd space at left sternal border
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| Where is the place to hear a patent ductus arteriorsus? | 2nd Left space (congenital opening between aorta and pumonary artery
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| What are common sites for bruits? | Temporal, Subclavian, Carotid, Abdominal aorta, Femoral aorta
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| What are the three P's of occlusion? | Pain, Pallor, Pulselessness
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| What are types of venous obstruction or insufficiency? | Thrombosis, Edema, Varicose Veins
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| What is evidence of thrombosis? | Redness, thickening and tenderness along superficial vein... Homan's sign positive for DVT
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| What are general sx of vascular problems? | Leg pain/cramps, dizziness, headaches, swollen ankles
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| What does sternal angle mark? | Bifurcation of trachea
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| Name inspiratory muscles? | External intercostals, Scalenes
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| Name expiratory muscles? | Internal Intercostals, Rectus Abdominus
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| What is a normal respiratory rate? | 12-20
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| What is Stridor? | Upper airway, high pitched, mostly inspiratory
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| What is Wheezing? | Lower airway, high pitched, mostly expiratory
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| What are causes of Stridor? | Croup, FB, trauma, COPD
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| What are the causes of Wheeze? | Asthma, pulmonary edema, COPD, infection, FB
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| Where should you place your thumbs to test expansion? | 10th rib level
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| What does decrecreased fremitus indicate? | Pulmonary edema, emphysema
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| What does increased fremitus indicate? | Consolodation, solid mass
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| What is normal length for diagphramatic excursion? | 3-5cm
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| What kind of breathing is heard over most lung fields? | Vesicular, inspiration > expiration
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| What kind of breath is heard only over the trachea? | Bronchotracheal, expiration > inspiration
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| Describe crackles | discontinuous, heard with inspiration, not cleared by coughing
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| Describe rhonchii | Continuous, fog horn, usually clears with coughing, can be due to secretions or a tumor
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| What do increased transmission of sound on special lung tests indicate? | Airless lung
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| What is normal JVD? | normal is no more than 4 cm if measured from sternal angle
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| Flat, circumstrcibed change in color of skin that is less than 1 cm and examples | Macule, freckles, nevi
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| Flat, circumscribed change in color of skin that is greater than 1 CM | Patch, mongolian spots
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| Elevated, firm, circumscribed, less than 1CM | Papule, wart, elevated nevi, seborrheic keratosis
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| Elevated, firm, circumscribed, over 1 CM | Plaque
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| Elevated, irregular shaped, area of cutaneous edema | Wheal; Hives, insect bites
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| Elevated, firm, circumscribed, deeper in dermis | Nodule; Lipoma
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| Elevated, solid, deep in dermis, >2cm | Tumor
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| Elevated, circumsribed, not in dermous, filled with clear fluid, less than 1cm | Vesicle; Varicella, Herpes Simplex
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| Elevated, circumscribed, superficial, filled with clear fluid, greater than 1cm | Bulla, blister
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| Elevated superficial with purulent material | Pustule, impetigo, acne
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| Cyst | Elevated, circumscribed, encapsulated, fluid or semi-solid
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| Fine, irregular, capillary dilation | Telangiectasia; rosacea
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Created by:
adhass
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