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41 Cards in this Set

  • Front
  • Back
S1
S2
S3
S4
S1: AV close
S2: Semilinar close
S3: Initial vent filling
S4: atrial Kick
on what side of the heart is the cardiac cycle a bit slower?
right
Name three changes that occur in the heart after birth
1. Ductus arteriosus and foramen ovale close
2. R heart takes over pulm circut
3. L vent takes systemic circulation
what cardiovascular changes occur in pregnancy
add the placenta so
1. overall resistance decreases
2. BV increases
3. BP should decrease
what changes in the heart are seen in older folks?
1. heart size decreases
2. left vent hypertrophy
3. valves fibrise and calcify
4. endocardium thickens
5. myocardium becomes less elastic
Dx of orthostatic hypotension
Must have 1 of the following:
1, 20 mm drop in systolic
2. 10 mm drop in diastolic
3. cerebral hypofrofusion

**sympt must be seen within 2 to 5 min of standing
where is PMI of heart
left sternal border
apex
5th intercostal space
MCL
shouldnt be more than 2.5 cm
what happens to PMI with L vent enlargement
it is lateral to MCL
larger than 2.5 cm
whats a thrill
palpable mummur (murmmur, you can HEAR it)

**can be due to turbulent flow through any narrowed opening. valvular stenosis, vent septal defect
whats a lift of heave
when cardiac impulse can be felt (its NOT heard, NOT a murmmur)

**can be caused by vent hypertrophy or hyperdynamic vent activity
what is the diff btwn a thrill and a lift or heave
thrill: hear and feel, palpable murmur
Lift/Heave: cardiac impulse is felt (more vigirous) but NOT heard
what part of stethascope is used for low pitch sounds, high pitch
low: bell
high: diaphragm
what happens to PMI for preggers or fatso
shifts up and lateral
where shpuld you listen to hear:
S1
S2
S1: AV close (take medicine), best heard at APEX (bottom)

S2: semilunar close, best heard at base
when is there non path splitting of S2
inspiration

*physiological, inspiration will delay closure of pulmonic valve
when is there pathological splitting of S2
Pulmonic valve may close later due to...
1. atrial septal defect (fixed)
2. pulmonic stenosis (wide)
3. R vent heart failure (fixed)
4. r bundle block (wide)
what is wide slpitting of S2
delayed closeure of pulmonic
due to RBBB or Pulm stenosis
what is fixed splittin of S2
doesnt vary with inspiration
atria septal defevt
r vent failure
what arhythemia is a gallop?
S3 present, low pitch, heard with bell at apex, when initial filling of vent is heard. decreased compliance of vent

S1+S2+S3 gallop
what happens to babies at birth
they breath, this will decrease pressure in R heart and increase Pressure in L heart, foramen ovale closes, ductus arteriosus closes and the R heart sends things to lungs
what are some characteristics of babies that clue you in they may have heart failure
1. tire when eating
2. breathing changes
3. cyanosis
4. weight gain (go by their smooth curve, not the percents)
5. knee chest position (increase venous return)
6. Moms health during preggo
what does the body do when you stand up fast and blood pools in lower extremities
1. decreased venous return, decrease CO, decrease BP
2. baroreceptors will see this and send SNS to increase RESISTANCE, increase venous return, increase CO

**this NORMAL response causes:
SP to fall 5-10
DP to raise 5-10
increase in pulse 10-25
what is an S3 look like
what does an S4 look like
S1 S2 S3 S1

S4 S1 S2 S4 S1 S2
what pathology elicits S3
Kids: usually no biggie

Adults over 40: heart failure, anemia, volume overload, decreased contractility
what pathloogy elicits S4
uncommon: heard bc of resistnace to filling/decreased compliance

In traind athletes may be present, no heart disease
is it ok for a babe to have a mummur
yep, after 48 hours the holes should all close up and no mummur should be heard
Children with heart disease will present with...
1. weight gain/loss
2. development delays
3. cyanosis
4. clubbing of fingers/toes
NSR
Brady
Tachy
60-100
<60
>100
what is a systolic mummur
what is a diastolic mummur
S1 shh S2
S1 S2 shh
systolic mumur occurs after what heart sound, diatsolit
systolic: S1

Diastolic: S2
how are mummurs graded
severity out of 6

1/6
5/6 etc
what kind of mummur is barely audible in a quiet room
1/6
what kind of mummur is quiet but clearly audible
2/6
wht kind of mumur is moderatly loud
3/6
what kind of murmur is loud and has a thrill
4/6

**thrill, palpable murmur
what kind of murmus is LOUD and can be heard with murmur partly off chest, it has an obvious thrill
5/6
what kind of murmur is LOUD and is heard with scope entirely off chest, it has an obvious thrill
6/6
whats the dif btwn 5/6 and 6/6
5/6 heard with scope partly off chect
6/6 heard with scope entirely off chest
what the diff btwn 3/6 and 4/6
3/6 moderatly loud
4/6 loud with thrill
what murmur is 'innocent'
systolic (S1 sss S2)

*associated more with turbulence than stenosis
what is seen with R atrial failure
JVD