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25 Cards in this Set
- Front
- Back
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Rhythm: EKG
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Premature atrial/ventr contraction
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Rhythm EKG
Irregular irregularity |
atrial fibrillation
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Amplitude
Rate 4 [Hyperdynamic circulation] |
Increased stroke volume [e.g. aortic regurgitation, aretriovenous fistulas, or patent ductus areteriosis]
Decreased peripheral resistance, Decreased compliance [arteriosclerosis] |
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Contour
Pulsus alternans: Alternating weak & strong beat |
[Left ventricular failure that is usually accompanied by left sided S3]
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Contour
Pulsus bisferiens: Biphasic pulse, 2 Strong systolic beats separated by mid systolic dip, AS+AR |
Pure aortic regurgitation,
Aortic stenosis combined w/ regurgitation, palpable hypertrophic cardiomyopathy |
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Contour
Pulsus bigeminal: May masquerade as pulsus alternans |
Normal beat alternating w/ premature contraction
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Contour
Pulsus paradoxus [misnomer]: Exaggeration of normal fall in amplitude during inspiration, Systolic BP drop >12-15mmHg, |
Severe airway obstruction [e.g. severe asthma, emphysema]
Precardial tamponade, [Constrictive pericarditis] |
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Water Hammer Pulse/Corrigon pulse [collapsing pulse]:
Greater amplitude, Rapid rise [upstroke], Normal summit, Sudden descent [due to backflow through aortic valve], A pulse that suddenly collapses |
[Aortic regurgitation, or Patent ductus arteriosis]
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Pulse deficit assessment
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It is the difference between the heart rate by auscultation & peripheral rate by palpitation or radial pulse
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Radio-femoral delay:
Is a delay between the time it takes for a pulse wave to reach the radial artery & femoral artery & is assessed by palpating the radial & femoral arteries at the same time Normal transmission of pulse wave to radial is 75ms & 70ms to femoral If a delay exists measure upper & lower extremity blood pressure in supine position |
Radio femoral delay indicates Leriche’s syndrome:
Aorta or iliac atherosclerosis Coarctation of aorta after the subclavian artery |
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Symmetry assessment:
If there are differences in pulses between sides |
local stenosis
compression in the path of the weaker pulse |
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Check for orthostatic hypotension or autonomic insufficiency
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diabetes, adrenal insufficiency
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i) While palpating radial or brachial artery inflate cuff until pulse is no longer palpable [note this reading] & add 30mmHg
(1) Note whether the artery is still palpable [Osler’s maneuver], if it is that is called a positive Osler’s |
arteriosclerosis
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Bradypnea: <10 breaths per minute,
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Diseases affecting the CNS
Metabolic disorders such as diabetic coma Raised ICP |
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Tachypnea: >24 BPM, Rapid shallow
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Restrictive lung diseases,
pleuritic chest pain, elevated diaphragm e.g. intra abdominal pressure (bowel obstruction) |
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Hyperpnea: Rapid deep hyperventilation
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[Exercise, Anxiety]
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Ataxic: Biot’s breathing that can have unpredictable irregularity or regular irregular pattern, May be shallow or deep for a short period
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[Lesion in lower pons or upper medulla]
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Cheyne-Stokes: Shallow or deep, Rapid shallow [tachypnea], Rapid deep [hyperpnea], Deep alternating with periods of apnea
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[Damage to cerebral hemispheres (forebrain), Heart failure, Uremia, Drug induced respiratory depression]
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Prolonged expiration:
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Obstructive lung disease [Narrowed airway, resistance, to air flow, e.g. asthma, COPD]
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Kussmaul breathing [labored breathing]: Is the very deep and labored breathing with normal or reduced frequency
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[Found among people with severe acidosis; it is a form of hyperventilation, Hyperventilation can also be seen in midbrain damage.]
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Inspiratory cramps
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[Lesion to the upper pons]
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Impaired or lagging respiratory movement:
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[Disease of the underlying lung or pleura, phrenic nerve palsy]
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4. Temperature: Tachycardia is observed during fever
a) Ranges: i) Normal: 37C or 98.6F w/ diurnal variation of 0.5C between 4:00PM & 8:00PM ii) Fever or pyrexia: >99F iii) Hyperpyrexia: >41.1C or 106F iv) Hypothermia: <35C or <95F |
ii)Infection, Trauma, Hyperdynamic state
iii) Septicemia iv) Exposure to cold, Hypothyroidisim |
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Variations: Temperature
Intermittent: Diurnal variation, Temp fluctuates between normal & elevated over 24hr |
Malaria
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↓BP w/ ↑HR
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Hypovolemia
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