Bates ch9.txt

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Bates ch9.txt
2011-08-05 02:09:54

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  1. Factors influencing arterial pressure
    • LVSV
    • aorta distensibility & lrg arteries
    • PVR=arterial level
    • vol blood art sys
  2. jvp reflects what
    R atrial pr=CVP & RV end dia pr
  3. JVP best estimated at
  4. when does JVP fall
    loss of blood
  5. when does JVP increase
    • RLHF
    • pulm HT
    • TS
    • pericardial tamponade/compr
  6. estimate level of jvp
    highest pt oscillation IJV
  7. how is JVP measured
    vertical distance=sternal angle
  8. when is JVP considered to be abnormal
    • greater than 4cm above stern angle
    • greater than 9 cm above RA
  9. what reflects changing pressures in RA
  10. when can you access the apical impulse
    children & young adults typically but when AP dia increase it gets harder to find
  11. what are the common or concerning symptoms for the CV sys
    • CP
    • palpitations
    • dyspnea
    • orthopnea
    • PND
    • edema
  12. Unpleasant awareness of the heartbeat described as skipping or fluttering
  13. uncomfortable awareness of breathing that is inappropriate to a given level of exertion
  14. dyspnea that occurs when the patient is lying down & improves when the patient sits up
  15. Orthopnea can often be seen in what
    • LVHF
    • MS
  16. PND can often be seen in what
    • LVHF
    • MS
    • mimicked=nocturnal asthma attacks
  17. Episodes of sudden dyspnea & orthopnea that awaken the patient from sleep
  18. What are the common health promotion & counseling topics for CV
    • hypertension screen
    • CHD & stroke screen
    • dyslipidemias screen
    • promoting lifestyle modification & RF reduction
  19. what are some gen Rf's for HT
    • inactive
    • high sodium
    • low K
    • excess alcohol consumption
  20. What defines metabolic syndrome
  21. Metabolic syndrome is linked to what disorder
    insulin resistance
  22. JVP will be low with what type of patients
    hypovolemic=lower bed
  23. JVP will be high with what type of patients
  24. When does the a wave precede
    b4 s1 & carotid pulse
  25. when does the x descent happen
    systolic collapse
  26. when does the v wave happen
    with S2
  27. when does the y descent happen
    early diastole
  28. what pulse provides valuable info about cardiac fx & important for detecting stenosis or insufficiency of aortic valve
    carotid pulse
  29. what to look for when doing carotid pulse
    • amplitude
    • contour
    • variations in amplitude
  30. when does a normal carotid upstroke happen in reference to s1 & s2
    • follows s1
    • precedes s2
  31. murmur like sound of vascular rather than cardiac origin
  32. where is S1 usually louder than S2 at
  33. where is S2 usually louder than S1 at
  34. when will S1 be decreased
    1st degree heart block
  35. when will S2 be decreased
  36. A heart situated on the right side
  37. what does a sustained high amplitude impulse that is normally located suggests
  38. what does a sustained low amplitude (hypokinetic) impulse result from
    dilated cardiomyopathy
  39. in patients with an increased AP diameter palpation of what may be useful
    RV=epigastric or subxiphoid area
  40. A palpable S2 over the pulmonic area may suggests
    pulmonary HT
  41. A palpable S2 over the aortic area may suggests
    systemic hypertension
  42. what to use to listen to the high pitch sounds of S1 & S2; aortic murmurs, mitral regurg & pericardial friction rubs
  43. what to use to listen to the low pitch sounds of S3 & S4 & the murmur of MS
  44. The rhythm of the pulse remains regular but force of arterial pulse alternates b/c of alternating strong & weak ventricular contractions. It typically occurs with L sided HF & best felt by applying light pressure on radial or femoral arteries.
    pulsus alternans
  45. what is the greater than normal drop in sys pr during inspiration
    paradoxical pulse