PD 2
Terms
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- Point of Maximal impulse
-
- at the apex of the heart
- usually found in the 5th intercostal space just lateral to midclavicular line - S1
-
- closure of the mitral and tricuspid valve
- begining of systole - Bronchophony
- - louder, clearer voice sounds
- Egophony
-
- E to A change
- present in lobar consolidation=pneumonia - Whispered Pectoriloquy
-
- louder, clearer whispered sounds
- should not be heard this way - S2
-
- Aortic and pulmonary valves close
- then another diastole begins - S3
-
- rapid deceleration of the column of blood against the ventricular wall.
- occurs after S2 - S4
-
- marks atrial contraction
- not normally heard
- just before S1 - Bruit
-
- sound heard when stethoscope placed over artery
- ex. over carotid
- heard when there are atery problems - Palpitations
-
- unpleasant awarenss of the heartbeat
- - Atrial fibrillation
- - "irregularly irregular"
- Orthopnea
-
- dyspnea that occurs when pt lying down and improves when they sit up
- left ventricular heart failure, mitral stenosis - Thrills
-
- humming vibrations
- different from bruit which are murmur like sound of a vascular origin -
Stethoscope
-diaphragm -
- high pitched sounds
- S1 and S2 -
Stethoscope
- bell -
- low pitched sounds
- S3 and S4
- press it very lightly on skin - Intermittent claudication
- - exercise induced pain that is absent at rest, makes a pt stop exertion and remits wihtin about 10 min.
- Raynaud's Disease
- - digital ishemci changes of blanching, followed by cyanosis then rubor with cold exposure and rewarming
- Atherosclerosis
- - most commonly obstructs arterial circulation in the thigh
- Varicose Veins
-
- dilated and tortuous
- walls may feel somewhat thickened