Pcs - Physical Exam Of The Great Vessels

Front 1

JVP depends on ____

Back 1

blood volume and right heart function

Front 2

how do you measure the JVP

Back 2

measure height (cm) of pulsation in IJV from strernal angle and add 5cm

Front 3

what is abnormal JVP

Back 3

>4cm above sternal angle (>9cm above right atrium)

Front 4

How do you measure AJR?

Back 4

push on belly, neck veins go up: pos: if viens stay up with normal breathing
neg: if veins go normal once breathing returns to normal.

Front 5

What does positive AJR mean?

Back 5

Positive AJR indicates elevated left sided filling pressures (CHF)*

Front 6

"waves" of JVP

Back 6

a - right atrial contraction,
c - artifact caused by carotid upstroke,
v - increased right atrial pressure with closure of the tricuspid valve

Front 7

increased JVP a-waves?

Back 7

increase right atrial force (RV hypertrophy due to pulmonary hypertension)

Front 8

cannon a-waves of JVP?

Back 8

PVCs with pulmonary hypertension

Front 9

prominent x-descent of JVP?

Back 9

(cardiac tamponade, atrial septal defect (ASD), RV overload)

Front 10

prominent JVP v-wave?

Back 10

tricuspid regurgitation

Front 11

what is the innominate artery?

Back 11

brachial artery off of aortic arch.

Front 12

info gathered from exam of carotid artery (3)

Back 12

1- Amplitude of the pulse
2- Contour of the pulse
3- Presence or absence of bruits

Front 13

Tf, T1, T2, Ti, and Tt of the Carotid pulse

Back 13

foot, first shoulder, secnond shoulder, incisura, duration (time)

Front 14

condition causing:
Increased magnitude of carotid pulse excursion

Back 14

Aortic regurgitation

Front 15

condition causing:
Prolongation of the ejection period with delayed propagation and slower upstroke

Back 15

Aortic stenosis

Front 16

condition causing:
- LV ejects most of the blood during the 1st ½ of systole
- Rapid upstroke

Back 16

Hypertrophic Cardiomyopathy

Front 17

? pulsation of the left ventricle as it moves anteriorly during contraction and touches the chest wall ?

Back 17

PMI

Front 18

what parameters of PMI should you note?

Back 18

location, diameter, amplitude and duration

Front 19

normal location of PMI

Back 19

mid clavicular line at 4-6 rib space

Front 20

normal diameter of PMI

Back 20

2.5cm

Front 21

normal amplitude of PMI

Back 21

brisk and tapping

Front 22

normal duration of PMI

Back 22

1/2 -2/3 of systole

Front 23

PMI displaced laterally correlates with _________

Back 23

cardiomegaly

Front 24

PMI displaced medially can indicate _________

Back 24

chronic lung disease

Front 25

Increased amplitude may reflect hyperthyroidism, anemia, aortic stenosis or ____________

Back 25

mitral regurgitation

Front 26

Sustained impulse indicates possible _____________

Back 26

ventricular hypertrophy

Front 27

hyperthyroidism may cause what PMI anomaly?

Back 27

Increased amplitude

Front 28

anemia may cause what PMI anomaly?

Back 28

Increased amplitude

Front 29

chronic lung disease may cause what PMI anomaly?

Back 29

PMI displaced medially

Front 30

Generally, the aorta should be no larger than _____ wide.

Back 30

3 cm
(test question)

Front 31

Most common cause of AAA is ___________

Back 31

atherosclerosis

Front 32

Most common site of AAA is _________________

Back 32

below the renals and above the common iliacs

Front 33

Gender most likely with AAA

Back 33

male

Front 34

AAA:
Usually asymptomatic
Unexplained hypotension
Sudden onset of abdominal or back pain
Pulsatile tender mass
Decreased _____________

Back 34

or absent distal pulses

Front 35

test ordered for suspicion of acute AAA

Back 35

Abdominal ultrasound

Front 36

test ordered to follow a chronic AAA

Back 36

abdominal CT

Front 37

Most common site of abdominal bruits is _________

Back 37

over the renal arteries

Front 38

Renal artery bruits in the setting of hypertension warrants an evaluation for possible ________

Back 38

stenosis