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Flashcards in Cardiac Exam Deck (13)
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1
Q

The sternal angle is ___ cm above the right atrium.

A

The sternal angle is 5 cm above the right atrium.

2
Q

To better examine the left ventricular impulse. . .

A

have the patient roll slightly to the left.

3
Q

S1

A

First heart sound. Closing of the mitral and tricuspid valves.

4
Q

S2

A

Second heart sound. Closing of the pulmonic and aortic valves.

5
Q

S1 to S2

A

Systole

6
Q

S2 to S1

A

Diastole.

7
Q

When should you be able to feel the pulse?

A

During systole (in between S1 and S2)

8
Q

S2 may occasionally be heard as. . .

A

Two distinct sounds: A2 and P2 (Aortic2 and Pulmonic2)

This is not necessarily pathological. This happens in many perfectly healthy people. It can be heard particularly in the aortic/pulmonic upper sternal areas.

9
Q

S3

A

A sound heard almost exclusively in cases of congestive heart failure.

S3 is heard in the ventricular areas in the T5 interspace.

10
Q

Normal jugular venous pressure

A

5-7 cm

11
Q

Pulses may be reported as

A

2+ : very apparent

1+ : you can find it, but it’s not obvious

12
Q

Pitting Edema

A

swelling, often bilateral with a depression or indentation in the skin called “pitting” after 1-2 sec of thumb pressure on the anterior tibiae and feet. Commonly occurs in the “dependent” (areas of the body most affected by gravity, such as lower legs and feet). It is caused by several conditions including prolonged “dependent” position of the legs, heart failure, nephrotic syndrome, cirrhosis, and malnutrition.

13
Q

Writeup of normal cardiac exam

A

Cardiac: Chest is symmetric, no scars. No cardiac heaves or lifts. No thrills appreciated. Point of maximal impulse (PMI) noted at midclavicular line, in fifth intercostal space. Normal S1 and S2, with regular rate and rhythm. S2 > S1 at the base, S1 > S2 at apex. No splitting of the heart sounds heard. No murmur. No S3 or S4, no friction rub.

Neck: No jugular venous distention or pulsations. No carotid bruits, or transmitted murmur. Carotid pulses 2/4 bilaterally.

Extremities: No rashes, swelling, color change, or cyanosis in arms or legs. No signs of venous stasis or arterial insufficiency in legs, with normal hair distribution, and no pigmentation around ankles. No clubbing in fingernails. Capillary refill is brink (<1 sec). No pitting or non-pitting edema in feet. 2+ radial and 2+ dorsalis pedis pulses bilaterally.