Bates Chapter 16 Cardiovascular Questions And Answers Graded A+
A brief early to middiastolic impulse represents a palpable? - S3 A difference between these levels constitutes a paradoxical pulse? - >= 10mm Hg to 12 mm Hg a large pericardial effusion may make the apical impulse? - Undetectable A medium pitched, grade 2/4, blowing decrescendo diastolic murmur, best heard in the fourth left intercostal space with radiation to the Apex may indicate? - Aortic Regurgitation A middiastolic murmur and PreSystolic murmur would reflect? - Turbulent flow across the Atrioventricular valves (mitral et tricuspid valves A midsystolic ejection murmur may be? - 1. Innocent-w/o any detectable physiologic or structural abnormality 2. Physiologic-from physiologic changes in body metabolism 3. Pathologic-arising from structural abnormalities in the heart or great vessels --Tend to peak near midsystole et usually stop before the S2. The crescendo-decrescendo or "diamond shape" may not always be audible -usually disappears on sitting A palpable S2 in the pulmonary artery area points to? - Known as pulmonary artery tap; points to increased pulmonary artery pressure from pulmonary HTN A PMI >2.5 cm is evidence of? - Left ventricular hypertrophy (LVH), often seen in hypertension or dilated cardiomyopathy A pulsation in the Aortic outflow tract area suggests? - Dilated or aneurysmal aortaA shape of the murmur is described as ? - Crescendo, Decresendo, or Holosytolic A simplified way to remember the three peaks is: - A: Atrial contraction C:Carotid transmission (although this may represent closure of the tricuspid valve V: Venous filling A Sustained ventricular Impulse is? - ventricular hypertrophy from chronic pressure load (increased afterload) A tortuous et kinked carotid artery may produce a? - Unilateral pulsatile bulge Abnormally prominent cannon a waves occur in? - Increased resistance to right atrial contraction, as in tricuspid stenosis -Severe 1st, 2nd, 3rd AV block -Supraventricular tachycardia -Junctional tachycardia -Pulmonary HTN -Pulmonic stenosis absent a waves signal what? - atrial fibrillation Afib in women increases? - stroke risk fivefold; often asymptomatic et undetected Afterload refers to? - The degree of vascular resistance to ventricular contraction. Sources of resistance to contraction include the tone in the walls of the aorta, the large arteries, et peripheral vascular tree (primarily small arteries et arterioles), et volume of blood already in aorta Alternately loud et soft kortokoff sounds or sudden doubling of the apparent heart rate as the cuff pressure declines signals what? - Pulsus AlternansAlthough JVP accurately predicts elevations in fluid volume in heart failure, its prognostic value for heart failure outcomes and mortality is? - Unclear Although not often heard in normal adults, a fourth heart sounds S4, marks? - Atrial contraction. It immediately precedes S1 of the next beat et can also reflect a pathologic ventricular stiffness, as seen in HTN, or Myocardial Infarction an elevated JVP is 98% specific for what? - an increased left ventricular end diastolic pressure and low ventricular ejection fraction, An identical degree of turbulence would cause a _____ murmur in a thin person than in a very muscular or obese person. - louder An outward movement just before S1 signifies a palpable? - S4 An S3 corresponds to? - An abrupt deceleration of inflow across the mitral valve
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