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38 Cards in this Set
- Front
- Back
S1
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-First normal heart sound
-Beginning of systole -Tricuspid and Mitral valves close |
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S2
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-Signifies end of systole
-Second normal heart sound -Aortic and Pulmonic valves close |
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S3
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-Sometimes occurs after S2
-Not necessarily pathological for those under 30yo |
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S4
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-Heard before S1
-Signifies ventricular hypertrophy |
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In order, cardiac auscultation locations
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Aortic
Pulmonic Erb's Pointe Tricuspid Mitral |
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Aortic Auscultation Location
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-2nd intercostal space, right sternal border
-Best location to hear aortic valve -S2 should be louder |
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Pulmonic Auscultation Location
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-2nd intercostal space, left sternal border
-Best location to hear pulmonic valve -S2 should be louder |
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Erb's Pointe
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-3rd intercostal space, left sternal border
-S1 and S2 typically have same volume at this location |
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Tricuspid Auscultation Location
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-4th intercostal space, left sternal border
-Best location to hear tricuspid valve -S1 should be louder |
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Mitral Auscultation Location
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-5th intercostal space, midclavicular line
-Best location to hear mitral valve -Also location to begin searching for apical pulse -S1 should be louder |
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How should the heart be auscultated?
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-All five cardiac auscultation points, in order (APETM)
-Once with diaphragm and once with bell side of stethoscope |
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Murmur
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-Sound heard due turbulence caused by leaky valve or abnormal blood flow through heart chambers
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Bruit
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-Sound heard due to turbulence caused by abnormal blood flow due to plaque on artery walls
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Tangential Lighting
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-Penlight used at 90* angle to skin
-Used to see depth on skins surface -Used on neck to check for jugular vein distention -Used on precordial area to check for abnormalities |
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Precordial
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-Body surface directly over the heart
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Continuous Murmur
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-A murmur that continues through both systole and diastole
-Potentially very serious, notify healthcare provider |
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Diastolic Murmur
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-A murmur present only during diastole
-Potentially very serious, inform healthcare provider |
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Systolic Murmur
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-A murmur present only during systole
-More common and less likely to be a serious issue |
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Pansystolic or pandiastolic murmur
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-A murmur heard throughout the respective phase
-As opposed to early, mid or late murmurs present during the described period of the phase |
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What arteries may be auscultated?
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Temporal (checked for bruit)
Carotid (checked for bruit) -Checked in three locations -High -Middle -Lower Brachial (used for BP) Femoral (checked for bruit) |
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Heaving
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-Palpable feeling of heart solidly hitting chest wall
|
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Commonly Examined Lymph Node Locations
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Preauricular
Postauricular Submandibular Submental Anterior Cervical Chain Posterior Cervical Chain Deep Cervical Chain Superficial Cervical Chain Supraclavicular Axillary Epitrochlear Femoral |
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Normal Lymph Node Response
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-Palpable when 1-2cm
-Rubbery -Movable -Swelling typically bilateral -Well defined edges |
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Modified Allen's Test
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-Used to test quality of blood supply to hand, especially prior to procedures involving the radial artery
-Radial and ulnar arteries are occluded stopping blood flow -Client clinches hand several times -One artery is released to evaluate how quickly color and blood supply perfuses the palm -Repeated for other artery |
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Pitting
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-Depression left when pressure is applied to edema
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Pitting
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-Depression left when pressure is applied to edema
|
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Brawny
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-Edema does not pit
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Pitting
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-Depression left when pressure is applied to edema
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Brawny
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-Edema does not pit
|
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Edema Pitting Scale
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1+ 2mm
2+ 4mm 3+ 6mm 4+ 8mm |
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Pitting
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-Depression left when pressure is applied to edema
|
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Brawny
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-Edema does not pit
|
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Edema Pitting Scale
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1+ 2mm
2+ 4mm 3+ 6mm 4+ 8mm |
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Apical Pulse Width
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-1-2 finger widths is normal
-3-4 finger widths is indicative of enlarged heart |
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Lift
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-Feel pulsation of heart over precordial area
-Not term used for apical pulse -Indicative of enlarged heart |
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Thrill
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-Feeling as though a car is purring when palpating precordial area
-Always related to a murmur |
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Pulse Locations
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Temporal
Carotid Apical Brachial Radial Ulnar Femoral Popliteal Dorsalis Pedis Posterior Tibial |
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What is the normal sound when auscultating a peripheral artery?
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-Nothing or faint S1, S2 sounds
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