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46 Cards in this Set
- Front
- Back
What structure is located directly behind and below the sternum
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right ventricle
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What forms the left lateral margin of the heart and where is this structure located?
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The left ventricle and it is located behind the right ventricle and to the left.
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What forms the right heart border?
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The right atrium.
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What produces the sound that forms S1?
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Closure of the mitral valve.
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What normally corresponds to the systolic blood pressure?
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Maximal left ventricular pressure.
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What produces the sound that forms S2?
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Closure of the aortic valve.
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What is thought to cause a S3 sound and what can it indicate?
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The sudden deceleration of blood against the left ventricular wall causes S3 and it is thought to be due to decreased ventricular compliance.
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What occurs at the same time as S4 and what is it thought to be caused by?
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Atrial contraction is thought to cause S4 and it is also associated with decreased ventricular compliance.
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What do the P, QRS, and T waves correspond to?
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P=atrial depol, QRS=ventricular depol., T=ventricular repol.
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What is referred to as the ability of the heart muscle, when given a load, to shorten
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contractility
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Why are the pulses in the arms and legs unsuitable for timing things in the cardiac cycle?
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There is a palpable delay between ventricular contraction and peripheral pulses.
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What are the main factors that influence arterial pressure?
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left ventricular stroke volume, distensibility of the aorta, PVR, volume of blood in the arterial system
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Where is the internal jugular vein located and what an it be used to estimate?
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It is deep to the sternomastoid muscles in the neck and its pulsations can be used to estimate the right atrial pressure
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What measurement for JVP separates normal from abnormal?
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A measurement of 4cm above the sternal angle (total of 9cm above right atrium) is abnormal
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What does the "a" wave represent?
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the slight rise in atrial pressure that accompanies atrial contraction -- occurs just before the first heart sound and before the carotid pulse
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What does the "x" descent reflect?
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atrial relaxation.
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What does the "v" wave reflect?
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during systole blood is flowing into the right atrium from teh vena cavae and this fills the atrium and increases the pressure as the tricuspid valve is closed
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What is the "y" descent?
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Early in diastole blood from the right atrium flows passively into the right ventricle and right atrial pressure falls
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When do the "x" and "y" descents happen?
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The "x" descent is more prominent and occurs just before the second heart sound, "y" descent follows the second heart sound, early in diastole
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What does a flow murmur usually denote?
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Often found in children this is thought to denote pulmonic blood flow
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What is a mammary souffle?
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This is a mirmur seen in women who are lactating that is due to increased blood flow in the breasts. Usually systolic and diastolic.
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How is aortic sclerosis different from aortic stenosis?
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aortic sclerosis is just the thickening of the bases of teh aortic cusps with calcification with no obstruction of blood flow while stenosis impedes blood
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Is the systolic murmur of mitral stenosis ever considered innocent?
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no
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Who is a jugular venous hum seen in?
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children through young adults
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What happens to systolic and diastolic blood pressure as one ages?
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Systolic blood pressure rises as one ages and diastolic also rises until about the 6th decade when it begins to remain constant.
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What does sharp pain from the chest that radiates into the back or neck imply?
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aortic dissection
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What arrhythmia can be readily identified at the bedside?
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atrial fibrillation, irregularly irregular.
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What are some pathologic processes indicated by orthopnea?
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left ventricular heart failure, mitral stenosis, and obstructive lung disease.
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What is periorbital puffiness indicate? What about enlarged waistline?
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periorbital puffiness = nephrotic syndrome, enlarged waistline = ascites and/or liver failure
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What are teh optimal levels for LDL, HDL, and total cholesterol?
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LDL<100, total cholesterol<200, and HDL between 40 and 60.
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What is the starvation response and what can be done to counteract this?
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It is the drop in metabolic rate in response to a decrease in caloric intake and exercise can help offset this
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What do prominent "a" waves indicate?
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increased resistance to right atrial contraction as in tricuspid stenosis or the decreased compliance of the right ventricle
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What is indicated by the disappearance of the "a" waves?
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atrial fibrillation
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What do larger "v" waves indicate?
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tricuspid regurgitation.
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What can pressure on the carotid sinus do?
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cause a reflex drop in the pulse rate of blood pressure
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What are bounding pulses usually associated with?
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aortic insufficiency
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What is the normal upstroke of the carotid pulse like and what is associated with a delayed upstroke
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normal is a brisk upstroke and delayed upstroke is seen in aortic stenosis.
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What is the left lateral decubitus position good to listen for?
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good for hearing low-pitched extra sounds like S3, opening snaps, and diastolic rumble of mitral stenosis.
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What is the sitting, leaning forward after full exhalation position good for listening for?
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good for hearing the soft decrescendo diastolic murmur of aortic insufficiency
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When is S1 decreased and when is S2 decreased?
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S1 is decreased in 1st degree heart block, S2 is decreased in aortic stenosis
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What is the bell of the stethoscope good for listening to, both generally and specifically?
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generally it is good for low-pitched sounds, specifically for things like S3, S4, and the murmur of mitral stenosis
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What does the murmur of a patent ductus arteriosus sound like?
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it starts in systole and continues without pause through S2 and into but not necessarily through diastole, it is called a continuous murmur
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What kind of murmur is often heard in mitral stenosis?
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a presystolic murmur
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What kind of murmur is heard in aortic regurgitation?
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an early diastolic murmur
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What kind of murmur is heard in aortic stenosis and innocent flow murmurs
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a midsystolic murmur
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What kind of murmur is heard in mitral regurgitation?
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a pansystolic (holosystolic) murmur
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