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Which artery is the only one with O2?
What are the landmarks of the heart?
- 2nd and 5th intercostal
- base vs apex
- apical pulse (apex)
- PMI, L ventricle
What occurs during systole
- heart pumps blood out
- Closing of AV valves ( Tricuspid, Mitral)
- R Ventricle pumps blood to pulmonary artery (pulmonic valve-open)
- L ventricle pumps blood to aorta (aortic valve is open)
- Heart fills with blood
- Semilunar valves close (aortic and pulmonic)
- R. atrium fills-Tricuspid valve open
- L. Atrium fills- Mitral Valve is open
What are the semilunar valves?
Aortic and Pulmonic
What is the equation for CO?
CO= Stroke volume x HR
What is the equation for BP?
Co x SVR
What is preload?
- Ventricles stretch to capacity
- Volume overload
What is afterload?
- Ventricles contract to capacity
- Pressure overload
How much blood is pumped per min?
Where to men tend to experience MI?
Left arm, jaw, chest
Where to women tend to experience MI?
What are the two main categories for cardiac causes of chest pain?
What are the ischemia causes of chest pain?
MI, stable, unstable, varies
What are non-ischemia causes of chest pain?
- Mitral Valve Prolapse**: one/both valve leaflets prolapse back into atrial during systole
- Dissecting aneuryms
What are pulmonary causes of chest pain?
- Pulmonary Embolism: dyspnea more common, could be asymptomatic
- Pleurisy: inflammation around lung
- Pulmonary HTN: dyspnea is more common, non radiating
- Mediastinum Emphysema: air in the mediastinum
What is Hammer's sign?
- sounds like someone walking through snow
- sign of mediastinum emphysema
What is an embolism?
blood clot that travels to lung
What are GI causes of chest pain?
- Esophageal Reflux
- Gallstone colic
What is orthopnea?
dyspnea when lying down
What is paroxysmal nocturnal dyspnea?
difficulty breathing after lying down for several mins/hours
What is pulmonary edema and the signs?
- pulmonary congestion (L-sided heart failure)
- Pink Frothy Sputum
What is pink frothy sputum an indication of?
What is valvular heart disease?
- involving one or more of the heart valves
- Principal symptom: dyspnea
When does valvular heart disease occur?
- Late mitral regurg
- Aortic stenosis/regurg
What are the two types of palpitations?
- Sudden onset
- Gradual Acceleration
What is syncope?
What is the most common reason for syncope?
Vasovagal, mediated by vagus nerve CN 10
What are cardiovascular causes of syncope generally?
Anything that affects blood flow to the brain
What is ascites?
What is the most common cause of edema?
R sided heart failure (CHF)
What is anasarca?
- edema everywhere
- Caused by heart failure, liver failure, nephrotic failure
What is nocturia?
peeing a lot at nighttime
What is general cyanosis and indication of?
decreased pulmonary venous saturation
What is peripheral cyanosis
Decreased CO (CHF or Shock)
If fatigue is worse in evening, it's a sign of __
What is hemoptysis?
coughing up blood
What is the most common cause of hemoptysis?
mitral valve stenosis (MVS)
What is infarction?
local tissue death due to obstruction of tissue's blood supply
What is orthostatic hypotension?
Systolic drops > 15 mmHg, HR increases > 10 beats per min
What are some causes of hypotension?
- vascular volume loss (diarrhea, vomiting)
- Prolonged Bed Rest
- ANS dysfunction
- Parkinson's Disease
How would you describe the carotid arteries?
- Brisk- Normal
- Diminished- Decreased
What is the jugular venous pressure?
- The distance between the jugular pulse and the angle of louis
- Generally 8 cm
What is the precoridium?
portion of body over the chest
What do you inspect the precordium for?
lifts or heaves
What do you palpate for the cardiovascular system?
- PMI (5th intercostal, midclavicular)
- looking for a thrill
What if the PMI is in a different spot?
Then LV has dilation
What are the signs of ventricular hypertrophy?
increased force and duration, but no change in location
What does S3 usually mean?
Where does S1=S2?
What is a split S2?
When the Aortic valve closes before the pulmonic
What is S3 called?
- Ventricular Gallop (kentucky)
- During Diastole
What is S4 called?
- Atrial Gallop/Kick (Tennesse)
- During Diastole
What is S3 the first sign of?
How do you tell if murmur is aortic regurg?
Heard at Base, during S2 (Diastole)
How do you tell if a murmur is aortic stenosis?
Apex during S1 (Systolic)
How do you tell if a murmur is Tricuspid regurg?
Apex, during S1 (Systolic)
How do you tell if a murmur is tricupsid stenosis?
Base, S2 (Diastole)
How do you describe a murmur?
- When does it happen: systole/diastole
- Duration: early/mid/late diastole/systole
- Quality: harsh, soft, blowing, rumbling
- Pitch: high, medium, low
What is the foramen Ovale?
- Opening between R and L atrium in a fetus
- Closes when O2 hits
What is patent duct arteriosus
bypasses lungs in fetus because they aren't working in the lung
What should you expect about RR and HR in a baby?
Increased RR and Increased HR