Term
| What should you ask about during cardiac history? |
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Definition
Chest pain
Palpitations
Dizzy
Syncope
Dyspnea
Orthopnea - How many pillows?
+/- cough
+/- sweats
+/- nausea
Peripheral edema
SMOKING |
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Term
| How would you know that edema is related to cardiac system? |
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Definition
| If swelling is bilateral and worse in evening |
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Term
| What are 5 major risk factors of heart disease? |
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Definition
1. Smoking history
2. Diabetes Mellitus
3. Hypertension
4. Obesity (BMI >30 kg/m2)
5. High Cholesterol levels |
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Term
| How do you measure for JVD? |
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Definition
-Position bed at 30-45 degree angle and look for pulsations and fullness
-A normal reading the vein goes down as the head goes up = not stressed |
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Term
| What would central cyanosis indicate? |
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Definition
| Poor arterial circulation |
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Term
| What would periperal cyanosis indicate? |
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Definition
| Peripheral vasoconstriction |
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Term
| What are you hearing during the "Lub (S1)" part of the heart sound? |
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Definition
| The closure of the tricuspid and mitral vavle (AV valves) |
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Term
| What are you hearing during the "Dub" (S2) part of the heart sound? |
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Definition
| Closure of aortic and pulmonary valves (SL valves) |
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Term
| What is a Split S2 (physiologic split)? |
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Definition
| Aortic valve closes earlier than pulmonic valve during inspiration |
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Term
| What is normal for Split S2? |
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Definition
-It is normal to hear in athletes < 40 y.o.
-Best heard at base of heart (Mitral, Pulmonic)
-Louder on reclining and disappears during slow breathing or holding breath |
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Term
| What is normal for Split S2? |
|
Definition
-It is normal to hear in athletes < 40 y.o.
-Best heard at base of heart (Mitral, Pulmonic)
-Louder on reclining and disappears during slow breathing or holding breath |
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Term
| What is an abnormal split? |
|
Definition
-Occurs in expiration
-Stays when sitting up |
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Term
|
Definition
-S3 occurs when ventricles are resistant in early rapid filling phase = protodiastole
-Not varying with respiration; persists when sitting upright, increases with isotonic exercise |
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Term
| Who would you expect to have an S3 sound? |
|
Definition
-Young adults, children
-Increased heart rate
-Late pregnancy |
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Term
| What would indicate an abnormal S3 sound? |
|
Definition
-Older adult
-Hypertension
-Volume overload (CHF)
-Mitral Regurg
-High output states (thyroid, anemia) |
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|
Term
|
Definition
| Occurs from resistance to filling at end of disatole (at prestole) |
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Term
| List the heart murmur grades: |
|
Definition
I - Very hard to hear
II - Quiet but heard with stethoscope
III - Moderately loud, without a thrill
IV - Loud, may have thrill
V - Very loud, definite thrill, can be heard with stethoscope partly off chest
VI - Heard without stethoscope on chest, obvious thrill |
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Term
| What is intermittent claudication? |
|
Definition
| Pain in leg aggravated by walking or activity |
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Term
| What does Homen's test look for? |
|
Definition
| DVT (but is only 35% accurate) |
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Term
| What would be worrisome findings during inspection and palpation of lymph nodes? |
|
Definition
-Prolonged swelling over 1.5 cm
-widespread adenopathy
-multiple positive history points |
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Term
| What does an orthostatic reading show? |
|
Definition
| How the heard accommodates when the patient changes position |
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Term
|
Definition
| Problem with blood oxygen going to the muscle |
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|
Term
|
Definition
| Problem with blood going back to the heart |
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|
Term
| What are the symptoms of PAD? |
|
Definition
-Pain upon limb elevation (arterial blood cannot get to muscle)
-Pain increased with walking (intermittent claudication)
-Can tell how bad PAD is by how far they can walk
-Increase of pain at at night
-Increase of pain with cool temperature |
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Term
| What would hair loss on a patient's legs be indicative of? |
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Definition
| Loss of oxygen to the area (can happen with PAD or PVD) |
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Term
| What are the anterior landmarks for location of the normal adult heart? |
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Definition
| From the 2nd to 5th intercostal space and from the right border of the sternum to the left mid-clavicular line |
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|
Term
| Where is the anatomical location of the apical impulse? |
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Definition
| 5th intercostal space, mid-clavicular line |
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Term
| In which of the 4 auscultatory will the S1 sound be loudest? |
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Definition
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|
Term
| In which of the 4 auscultatory areas will the S2 sound be the loudest? |
|
Definition
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|
Term
| List the 4 precordial areas for ascultation and their anatomical landmarks. |
|
Definition
1. Aortic: Right 2nd intercostal space
2. Pulmonic: Left 2nd intercostal space
3. Tricuspid: Left 5th intercostal space
4. Mitral (PMI): Left 5th intercostal space at midclavicular line |
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Term
| When checking the different peripheral pulses of the arm, what 3 arteries are we feeling? |
|
Definition
1. Brachial
2. Radial
3. Ulnar |
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Term
| When we are feeling the different peripheral pulses of the leg, which 4 arteries are we feeling? |
|
Definition
1. Femoral
2. Popliteal
3. Dorsalis Pedis
4. Posterior tibial |
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|
Term
| Which pulse do we feel to check peripheral pulses on the neck? |
|
Definition
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Term
| What are the functions of the lymphatic system? |
|
Definition
1. Recycle and conserve fluids and plasma proteins
2. Part of immune system pathway: lymph nodes
3. Absorb lipids from the intestinal tract |
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|
Term
| List the superficial lymph nodes available for direct examination. |
|
Definition
-Cervical
-Axillary
-Inguinal: upper and lower |
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Term
| What would be worrisome findings during a lymphatic assessment? |
|
Definition
-Prolonged swelling over 1.5cm wide
-Widespread adenopathy
-Multiple positive history points |
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|
Term
|
Definition
| fatty thickening in walls of arteries |
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Term
|
Definition
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Term
|
Definition
| Alternating force of pulse; almost always indicates severe left-sided heart failure and is usually best felt by applying light pressure on radial or femoral arteries |
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Term
|
Definition
| Greater than normal drop in systolic pressure during inhalation |
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|
Term
|
Definition
3 factors that set stage for venous thrombosis
1. Venous stasis
2. Hypercoaguability
3. Vessel wall damage |
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|
Term
|
Definition
| Develops when lymph channes are obstructed by tumor, fibrosis, or inflammation, and in cases of axillary node dissection and radiation. |
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Term
|
Definition
| Edema is soft in early stages, then becomes hard and nonpitting. Skin is thickened, ulceration is rare, no pirgmentation and is usually found bilaterally on extremities. |
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Term
| Why might the PMI be felt in the xiphoid process or epigastric area? |
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Definition
| Results from right ventricular hypertrophy, usually as a result of obstructive pulmonary disease |
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Term
| False high blood pressure |
|
Definition
Cuff too small
Cuff too loose or uneven
Arm below heart
Inflating or deflating too slow
Deflating cuff too quickly |
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Term
|
Definition
Cuff too large
Repeating BP too quickly
Inaccurate level of inflation
Pressing stethoscope too tightly |
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|
Term
|
Definition
- Normal <120, <80
- Prehypertension: S: 120-139, D: 80-89
- Stage 1: hypertension: S: 140-159, D: 90-99
- Stage 2: hypertension: S: 160+, D: 100+ |
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