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16 Cards in this Set
- Front
- Back
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HPI
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Location
Quality Quantity or Severity Radiation see slide - OPQRSTi |
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Pulse
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Regularity
Quality Rate |
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Taking the BP
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Extend Pts arm with palm upward, arm at heart level
Center of cuff over Brachial A. Diaphragm of scope over Brachial A. under edge of cuff Take systolic (first Korotkoff sound), diastolic, etc... |
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Point of Maximal Impulse (PMI)
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Below nipple line, midclavicular, 5th intercostal space
Where the apex of the heart is closest to wall of heart when the patient is sitting up, leaning forward |
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Thrill
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Sensation of sound/vibration in the hand
Felt by skin at base of fingers |
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Heaves/Lifts
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Heart is swinging heavily against wall, can be palpated by "heel" of hand
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Heart Sounds
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S1 Lub - closing of mitral, tricuspid v's
S2 Dub - closing of aortic, pulmonic v's S3 - sound after S2 - ventricular refill during diastole S4 - sound before S1 |
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S1
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Closure of mitral valve
Left ventricle contracting Aortic valve open Beginning of systole |
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systole
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time between S1 and S2
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diastole
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time between S2 and S1
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S2
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Closure of aortic valve, mitral valve open
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S3
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Rapid Ventricular Filling into a Dilated Ventricle
Blood moving into the ventricle "Mis-sissippi" Based on the elasticity of the ventricle-- blood "slapping" against the dilated ventricle Typically abnormal S1 S2 S3 |
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S4
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Atrial contraction
At the end of diastole Contraction against a stiff/non-compliant ventricle Could be hypertensive heart disease S4 S1 S2 |
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Description of Cardiac Murmurs
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Timing
-systolic (AS, MR, MVP) -diastolic Location Intensity Quality Radiation |
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Palpating for Edema
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Hold down skin for 3 seconds, see refill
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Auscultation
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Done in a Z pattern
2nd ICS right sternal border 2nd ICS left sternal border left lower sternal border 5th IC space What do each test? |
