TERM 1
12. What does afterload have to do with
circulating volume?
DEFINITION 1
- Cardiac output is the product of hea rt rate and stroke volume -
Stroke volume is a factor of preload, m yocardial contractility, and
afterload - Afterload - degree of vascu lar resistance to ventricular
contraction o Source of resistance to left ventricular contraction
include: Tone in the walls of the aort a, large arteries, and the
peripheral vascular tree (primarily sm all arteries and arterioles),
and the volume of blood already in th e aorta
TERM 2
where is the normal PMI? What is its normal
size What may make it undetectable? How do
you estimate its location?
DEFINITION 2
Location: just medial to the mid-clavi cular line, 5th interspace may
be normal - max 50% are palpable, pa thologic reasons: - COPD -
moves to xiphoid or epigastric due to R VH - pregnancy or high left
diaphragm - displaces up and to left - c ardiomyopathy or IHD -
lateral displacement - dilated pulomn ary artery or AA will displace
(somewhere) Look lateral to the xiph oid Normallhy 2.5 cm
TERM 3
why put fingers on the carotid artery while
auscultating the heart? Where, exactly,
should those fingers be
DEFINITION 3
S1 should occur before carotid upstroke, S2 follows upstroke
Keep fingers in lower third of neck to avoid the carotid sinus
TERM 4
Which normal and pathologic heart sounds
are heard with the diaphragm/bell
DEFINITION 4
diaphragm: (high pitch) - S1, S2, - aortic murmurs and mitral
regurg - pericardial rubs bell: (low pitch) - S3, S4 - mitral
stenosis
TERM 5
18. In what position is it likely as S3 or S4
would be heard?
DEFINITION 5
- S3 and S4 are easier to hear in the left lateral decubitus
brings the left ventricle close to the chest wall - Will also
accentuate mitral stenosis - May miss these sounds if you
dont try this position
