Health assessment Cardiac

Card Set Information

Author:
CateQ
ID:
222408
Filename:
Health assessment Cardiac
Updated:
2013-06-04 13:36:48
Tags:
CRNA
Folders:

Description:
CRNA
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  1. ¨Loud S1
    • ¨Short PR
    • interval (<160 msec)

    • ¨Tachycardia or hyperkinetic
    • states

    • ¨"Stiff"
    • left ventricle

    ¨Mitral stenosis

    ¨Left atrial myxoma

    • ¨Holosystolic mitral
    •  valve prolapse
  2. ¨Soft S1
    • ¤Long PR
    • interval (>200 msec)

    • ¤Depressed left
    • ventricular contractility

    • ¤Premature closure
    • of mitral valve ( e.g., acute aortic regurgiation)

    • ¨Left bundle
    • branch block

    • ¨Extracardiac factors
    • (e.g., obesity, muscular chest,
    • chronic obstructive
    • pulmonary disease, large breasts)

    • ¨Flail mitral
    • leaflet
  3. Mid‐diastolic
    sounds
    • ¨are, for all practical purposes, either normal or abnormal S3 sounds, and most,
    • if not all, late diastolic or presystolic sounds
    • are S4 sounds

    • ¨Each sound
    • coincides with its relevant diastolic filling
    • phase

    • ¨In sinus
    • rhythm, the ventricles receive blood during
    • two filling phases
  4. The
    third heart sound: S3
    • ¨Low‐pitched sound produced in the ventricle 0.14 to
    • 0.16 s after A2, at
    • the termination of rapid filling

    • ¨Frequent in
    • normal children and in patients with high cardiac output

    • ¨In older
    • patients an S3 is abnormal

    • ¤Impairment of
    • ventricular function

    • ¤AV valve
    • regurgitation

    • ¤Other conditions
    • that increase the rate or volume of ventricular filling

    • ¨Left sided
    • S3

    • ¤Bell piece
    • of the stethoscope

    • ¤Left ventricular
    • apex during expiration

    • ¤Left lateral
    • position

    ¨Right‐sided S3

    • ¤Left sternal
    • border or just beneath the xiphoid

    • ¤Louder with
    • inspiration
  5. S4
    • ¨Low‐pitched,
    • presystolic sound

    • ¤Associated with
    • an effective atrial contraction

    • ¤Best heard
    • with the bell piece of the stethoscope

    • ¤Loudest at
    • apex

    • ¤Left lateral
    • decubitus position

    • ¨Diminished ventricular
    • compliance

    • ¨Frequently accompanied
    • by visible and palpable presystolic
    • distention of
    • the left ventricle








    • ¨S4 is
    • generated during the atrial filling phase

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