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40 Cards in this Set

  • Front
  • Back
Should let the patient rest for this long before taking BP
5 minutes
True or False You can evaluate the JVP in children under 12
True or False You may need to lower the bed to evaluate JVP in hypovolemic patietns
True or False Carotid pulsations are affected by inspirations or position
An increase in JVP may indicate these risks
left ventricular end diastolic pressure, low LV ejection fraction
Prominent a waves in evaluating JVP may be associated with ?
increased resistance such as tricuspid stenosis, 1st degree AV block, SVT, junctional rhythms, pulmonary hypertension and pulmonic stenosis
This rhythm may have absent a waves
Atrial fibrillation
Pressing on the carotid sinus causes...
bounding carotid pulse
aortic insufficiency
weak, thready carotid pulse
cardiogenic shock
Having patient turn to left lateral decubitus, allows you to better auscultate an S3 which may indicate...?
mitral stenosis
S2 heard louder here
S1 heard louder here
True or False The carotid upstroke and apical impulse occur in systole
Accompany loud harsh murmurs such as aortic stenosis, pda, ventricular septal defects, mitral stenosis
Situs inversus
Liver, stomach and heart on right side
apical impulse may be displaced upward and to the left
in pregnancy
lateral displacement of apical impulse
chf, cardiomyopathy, ischemic heart disease
PMI > 3 cm suggests...
left ventricular enlargement
True or False A normal PMI is bounding and slow
False, it is brisk and tapping
Causes of increased amplitude of PMI
hyperthyroidism, severe anemia, pressure overload of left ventricle
May be able to assess PMI in COPD patients here
True or False A palpable S2 at the left 2nd interspace suggests systemic hypertension
False suggests pulmonary hypertension, the right 2nd interspace with palpable S2 indicates systemic hypertension and possibly aortic aneurysm
Picks up high pitched sounds of S1 and S2, aortic and mitral regurgitation and pericardial friction rubs
The diaphragm
Picks up low pitched sounds of S3 and S4 and murmur of mitral stenosis
The bell
This position accentuates aortic murmurs
Sitting and leaning forward
falls between S1 and S2
systolic murmur
falls between S2 and S1
diastolic murmur
This murmur is loud and often radiates to right side of neck
aortic stenosis
grade of murmur heard without stethoscope
grade 6
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
Pulsus alternans
large drop in systolic pressure during inspiration
Paradoxical pulse
Most common reason for paradoxical pulse
obstructive airway disease
True or False Normal pulse pressure is 20-30mm Hg
False Pulse pressure is normally 30-40mmHg
Cause of bisferiens pulse
aortic regurgitation
varying S1
found in complete heart block and irregular rhythms
True or False Systolic clicks are caused by mitral valve prolapse
True; squatting delays click/murmur and standing moves them closer to S1
True or False S3 is commonly heard in 2nd trimester of pregnancy
False, the 3rd trimester
True or False A pathologic S3 sounds like "Tennessee"
False; sounds like "Kentucky"; the left sided S4 sounds like "Tennessee"
To hear tricuspid regurgitation murmur, listen here
left lower sternal border