Icm Winter

Front 1

S1
S2
S3
S4

Back 1

S1: AV close
S2: Semilinar close
S3: Initial vent filling
S4: atrial Kick

Front 2

on what side of the heart is the cardiac cycle a bit slower?

Back 2

right

Front 3

Name three changes that occur in the heart after birth

Back 3

1. Ductus arteriosus and foramen ovale close
2. R heart takes over pulm circut
3. L vent takes systemic circulation

Front 4

what cardiovascular changes occur in pregnancy

Back 4

add the placenta so
1. overall resistance decreases
2. BV increases
3. BP should decrease

Front 5

what changes in the heart are seen in older folks?

Back 5

1. heart size decreases
2. left vent hypertrophy
3. valves fibrise and calcify
4. endocardium thickens
5. myocardium becomes less elastic

Front 6

Dx of orthostatic hypotension

Back 6

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

Front 7

where is PMI of heart

Back 7

left sternal border
apex
5th intercostal space
MCL
shouldnt be more than 2.5 cm

Front 8

what happens to PMI with L vent enlargement

Back 8

it is lateral to MCL
larger than 2.5 cm

Front 9

whats a thrill

Back 9

palpable mummur (murmmur, you can HEAR it)

**can be due to turbulent flow through any narrowed opening. valvular stenosis, vent septal defect

Front 10

whats a lift of heave

Back 10

when cardiac impulse can be felt (its NOT heard, NOT a murmmur)

**can be caused by vent hypertrophy or hyperdynamic vent activity

Front 11

what is the diff btwn a thrill and a lift or heave

Back 11

thrill: hear and feel, palpable murmur
Lift/Heave: cardiac impulse is felt (more vigirous) but NOT heard

Front 12

what part of stethascope is used for low pitch sounds, high pitch

Back 12

low: bell
high: diaphragm

Front 13

what happens to PMI for preggers or fatso

Back 13

shifts up and lateral

Front 14

where shpuld you listen to hear:
S1
S2

Back 14

S1: AV close (take medicine), best heard at APEX (bottom)

S2: semilunar close, best heard at base

Front 15

when is there non path splitting of S2

Back 15

inspiration

*physiological, inspiration will delay closure of pulmonic valve

Front 16

when is there pathological splitting of S2

Back 16

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)

Front 17

what is wide slpitting of S2

Back 17

delayed closeure of pulmonic
due to RBBB or Pulm stenosis

Front 18

what is fixed splittin of S2

Back 18

doesnt vary with inspiration
atria septal defevt
r vent failure

Front 19

what arhythemia is a gallop?

Back 19

S3 present, low pitch, heard with bell at apex, when initial filling of vent is heard. decreased compliance of vent

S1+S2+S3 gallop

Front 20

what happens to babies at birth

Back 20

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

Front 21

what are some characteristics of babies that clue you in they may have heart failure

Back 21

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

Front 22

what does the body do when you stand up fast and blood pools in lower extremities

Back 22

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

Front 23

what is an S3 look like
what does an S4 look like

Back 23

S1 S2 S3 S1

S4 S1 S2 S4 S1 S2

Front 24

what pathology elicits S3

Back 24

Kids: usually no biggie

Adults over 40: heart failure, anemia, volume overload, decreased contractility

Front 25

what pathloogy elicits S4

Back 25

uncommon: heard bc of resistnace to filling/decreased compliance

In traind athletes may be present, no heart disease

Front 26

is it ok for a babe to have a mummur

Back 26

yep, after 48 hours the holes should all close up and no mummur should be heard

Front 27

Children with heart disease will present with...

Back 27

1. weight gain/loss
2. development delays
3. cyanosis
4. clubbing of fingers/toes

Front 28

NSR
Brady
Tachy

Back 28

60-100
<60
>100

Front 29

what is a systolic mummur
what is a diastolic mummur

Back 29

S1 shh S2
S1 S2 shh

Front 30

systolic mumur occurs after what heart sound, diatsolit

Back 30

systolic: S1

Diastolic: S2

Front 31

how are mummurs graded

Back 31

severity out of 6

1/6
5/6 etc

Front 32

what kind of mummur is barely audible in a quiet room

Back 32

1/6

Front 33

what kind of mummur is quiet but clearly audible

Back 33

2/6

Front 34

wht kind of mumur is moderatly loud

Back 34

3/6

Front 35

what kind of murmur is loud and has a thrill

Back 35

4/6

**thrill, palpable murmur

Front 36

what kind of murmus is LOUD and can be heard with murmur partly off chest, it has an obvious thrill

Back 36

5/6

Front 37

what kind of murmur is LOUD and is heard with scope entirely off chest, it has an obvious thrill

Back 37

6/6

Front 38

whats the dif btwn 5/6 and 6/6

Back 38

5/6 heard with scope partly off chect
6/6 heard with scope entirely off chest

Front 39

what the diff btwn 3/6 and 4/6

Back 39

3/6 moderatly loud
4/6 loud with thrill

Front 40

what murmur is 'innocent'

Back 40

systolic (S1 sss S2)

*associated more with turbulence than stenosis

Front 41

what is seen with R atrial failure

Back 41

JVD