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ChiroBoards3:Heart

ChiroBoards3: Heart

QuestionAnswer
Measures the pressure of the right side of the heart and can be more pronounced with CHF Jugular venous pulsations
Jugular venous pulsations become more pronounced with CHF when performing this liver reflex test = hepatojugular reflex
What part of HIPPIRONEL are jugular venous pulsations discovered on? Inspection
Peripheral Pulses: Pulsus magnus "bounding"; increased cardiac output; exercise, anxiety, fever, hyperthyroidism
Peripheral Pulses: Pulsus Parvus weak or thready; decreased stroke volume; hypovolemia, aortic stenosis, CHF
Peripheral Pulses: Pulsus Alterans alternates in amplitude: **left ventricular failure**
Peripheral Pulses: Pulsus Bisferiens two strong systolic peaks separated by mid systolic dip; aortic regurgitatio and aortic stenosis
Where is Pulsus Bisferiens best felt at? at the carotid artery
Peripheral Pulses: Pulsus Paradoxus (seen in 4 conditions) decreased amplitude on inspiration, increased with expiration (>10mmHg amplitude change); COPD, bronchial asthma, emphysema, pericardial effusion.
Peripheral Pulses: Water Hammer Pulse A jerky pulse that is rapidly increasing and then collapses because of aortic insufficiency.
Vibration produced by turbulent blood flow within the heart (murmurs) = Thrills
Systole occurs when ... ventricles contract
Diastole occurs when the ventricles are..... at rest and filling
S1 = closure of AV (mitral and tricuspid) valves
S2 = closure of semilunar (pulmonary and aortic) valves
S3, aka... Ventricular gallop
S3 = normal in; and abnormally seen with = normal in children, young adults, and athletes >40 y.o = earliest sign of CHF
S4, aka... Atrial gallop
S4 = similar to S3 and is related to stiffness of the ventricular myocardium to rapid filling
S4 is always.... pathological
The aortic valve auscultation point (2nd IC space of right sternal border) is best auscultated with patient in what position? Seated, leaning forward, and exhaling
Where is the mitral valve auscultation point? mid-clavicular line at the 5th intercostal space
Best patient position for performing the mitral valve auscultation point? Left lateral decubitus positon
Valve has trouble opening and the blood swirls through a narrow opening = murmur
Murmurs are best heard with bell or diaphram? bell
Murmur = high or low pitch? low pitch
Valve is insufficient and blood seeps or squirts back into the chamber regurgitation
regurgitation has high or low pitch? high pitch
Regurgitation = bell or diaphragm? diaphragm
The mnemonic ARMS and PRTS occurs in which phase? Diastole (opposite occurs in systole)
ARMS and PRTS are written horizontally or vertically when matching the mnemonic? vertically; two columns, one for ARMS, and one for PRTS
What is the mnemonic for remembering heart murmur patterns? ARMS and PRTS
Failure to shunt to close between the aorta and left pulmonary artery, creating continuous/machinery like murmurs = Patent Ductus Arteriosus
Explain the 4 things seen with Tetralogy of Fallot = Dextraposition of the aorta, Right ventricular hypertrophy, Interventricular septal defect, and Pulmonic stenosis (DRIP)
What serious congenital defect creates a loud ejection murmur during systole and severe cyanosis? Tetralogy of Fallot
Constriction of the descending aorta (usually distal to the left subclavian) Coarctation of the Aorta
Causes higher blood pressure in the upper extremity by 20 mmHg when compared to the lower extremity. Coarctation of the Aorta
Coarctation of the Aorta is commonly associated with this condition = Marfans Syndrome
Narrowed proximal to the vertebral artery. Seen in younger women who faint while exercising Subclavian Steal Syndrome (subclavian steals from the vertebral)
Most common cause of left sided heart failure is Systemic Hypertension
2nd most common cause of left sided falure is aortic stenosis
Early signs of Left sided Heart Failure (3) Pulmonary Edema (fluid in lungs); Shortness of breath (exertional dyspnea) and Orthopnea
First sign of heart failure exertional dyspnea
Left sided heart failure: fluid collects here first costophrenic angles
Most common cause of mitral stenosis is = Rheumatic fever
Most common cause of right sided heart failure is = Left sided heart failure
When the right side fails by itself (lung condition that causes right sided heart failure) Cor Pulmonale
Which gallop is seen in right sided heart failure? S3
Blood pressure increases or decreases in right sided heart failure? decreases
Stasis dermatitis (late or early sign of CHF?) late
Tearing pain in chest; acute medical emergency = Aortic Dissection
Associated with hypertension/arteriosclerosis (descending aorta) and Marfan's (Ascending aorta) = Aortic Dissection
People with Marfan's have ventricular weakness and enlargement, spider-like fingers, tall stature, and subluxation of what structure? the lense
DDx between Angina Pectoris and Printzmetal Angina? Printzmetal typically comes on with rest; Angina Pectoris comes on with exertion
aka for angina pectoris = coronary vasospasm
what vasodilator helps treat angina pectoris? Nitroglycerine
3 lab values for diagnosing MI = Increased CK-MB; increased SGOT, and increased LDH
cause of MI = Atherosclerosis
Abnormal widening that involves all 3 layers; defect in elastic-media tissues Aneurysm
ECG = Increased PR interval (causing prolonged AV nodal delay) = condition? Primary Heart Block
ECG = Two P waves before QRS = condition? Secondary heart block
Secondary heart block, aka = Weinkbochs- block of bundle of HIS
ECG = No QRS = seen with = Complete heart block
No ______________ contraction with complete heart block ventricular
Where is atrial repolarization hidden on an ECG? under the QRS complex
ECG = Inverted or enlarged ST segment = Acute heart failure (MI)
Echocardigrams are used to detect what? murmurs
Created by: bglasman on 2012-03-11



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