Bates Physical Exam Chapter 9 Techniques To Assess Cardiovascular System

Front 1

Should let the patient rest for this long before taking BP

Back 1

5 minutes

Front 2

True or False You can evaluate the JVP in children under 12

Back 2

False

Front 3

True or False You may need to lower the bed to evaluate JVP in hypovolemic patietns

Back 3

True

Front 4

True or False Carotid pulsations are affected by inspirations or position

Back 4

False

Front 5

An increase in JVP may indicate these risks

Back 5

left ventricular end diastolic pressure, low LV ejection fraction

Front 6

Prominent a waves in evaluating JVP may be associated with ?

Back 6

increased resistance such as tricuspid stenosis, 1st degree AV block, SVT, junctional rhythms, pulmonary hypertension and pulmonic stenosis

Front 7

This rhythm may have absent a waves

Back 7

Atrial fibrillation

Front 8

Pressing on the carotid sinus causes...

Back 8

syncope

Front 9

bounding carotid pulse

Back 9

aortic insufficiency

Front 10

weak, thready carotid pulse

Back 10

cardiogenic shock

Front 11

Having patient turn to left lateral decubitus, allows you to better auscultate an S3 which may indicate...?

Back 11

mitral stenosis

Front 12

S2 heard louder here

Back 12

apex

Front 13

S1 heard louder here

Back 13

base

Front 14

True or False The carotid upstroke and apical impulse occur in systole

Back 14

True

Front 15

Accompany loud harsh murmurs such as aortic stenosis, pda, ventricular septal defects, mitral stenosis

Back 15

thrills

Front 16

Situs inversus

Back 16

Liver, stomach and heart on right side

Front 17

apical impulse may be displaced upward and to the left

Back 17

in pregnancy

Front 18

lateral displacement of apical impulse

Back 18

chf, cardiomyopathy, ischemic heart disease

Front 19

PMI > 3 cm suggests...

Back 19

left ventricular enlargement

Front 20

True or False A normal PMI is bounding and slow

Back 20

False, it is brisk and tapping

Front 21

Causes of increased amplitude of PMI

Back 21

hyperthyroidism, severe anemia, pressure overload of left ventricle

Front 22

May be able to assess PMI in COPD patients here

Back 22

epigastrium

Front 23

True or False A palpable S2 at the left 2nd interspace suggests systemic hypertension

Back 23

False suggests pulmonary hypertension, the right 2nd interspace with palpable S2 indicates systemic hypertension and possibly aortic aneurysm

Front 24

Picks up high pitched sounds of S1 and S2, aortic and mitral regurgitation and pericardial friction rubs

Back 24

The diaphragm

Front 25

Picks up low pitched sounds of S3 and S4 and murmur of mitral stenosis

Back 25

The bell

Front 26

This position accentuates aortic murmurs

Back 26

Sitting and leaning forward

Front 27

falls between S1 and S2

Back 27

systolic murmur

Front 28

falls between S2 and S1

Back 28

diastolic murmur

Front 29

This murmur is loud and often radiates to right side of neck

Back 29

aortic stenosis

Front 30

grade of murmur heard without stethoscope

Back 30

grade 6

Front 31

Usually indicates severe left sided heart failure and felt best by applying pressure on the radial or femoral arteries. Alternately loud/soft sounds or sudden doubling of heart rate as cuff declines

Back 31

Pulsus alternans

Front 32

large drop in systolic pressure during inspiration

Back 32

Paradoxical pulse

Front 33

Most common reason for paradoxical pulse

Back 33

obstructive airway disease

Front 34

True or False Normal pulse pressure is 20-30mm Hg

Back 34

False Pulse pressure is normally 30-40mmHg

Front 35

Cause of bisferiens pulse

Back 35

aortic regurgitation

Front 36

varying S1

Back 36

found in complete heart block and irregular rhythms

Front 37

True or False Systolic clicks are caused by mitral valve prolapse

Back 37

True; squatting delays click/murmur and standing moves them closer to S1

Front 38

True or False S3 is commonly heard in 2nd trimester of pregnancy

Back 38

False, the 3rd trimester

Front 39

True or False A pathologic S3 sounds like "Tennessee"

Back 39

False; sounds like "Kentucky"; the left sided S4 sounds like "Tennessee"

Front 40

To hear tricuspid regurgitation murmur, listen here

Back 40

left lower sternal border