Exam (elaborations)
Advanced Health Assessment - Exam #2 2023/2024
Advanced Health Assessment - Exam #2 2023/2024
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Advanced Health Assessment - Exam #2Holosystolic murmur heard best at Apex, may transmit to axilla and sternum. - ANSMitral
Regurgitation
Symptoms of Mitral regurgitation - ANSmay be asymptomatic for decades, then SOB, Fatigue,
HF
What increases the murmur of Mitral regurgitation, what decreases the murmur? -
ANSDecrease murmur = stand up
Increase murmur = clench fist
Common causes of mitral regurgitation - ANSCongenital abnormality, Rheumatic Heart disease,
acute endocarditis, Chordae tendinae dysfunction...
Mid-systolic grade II-III/VI, best heard between L. sternal border and apex. - ANSphysiologic
murmur - specifically "Still's Murmur" (usually ages 3-6)
Harsh, crescendo-decrescendo systolic murmur best heard at right sternal border. Can radiate
to the neck - ANSAortic Stenosis
What are the common symptoms of Aortic Stenosis - ANSChest pain, syncope, exercise
intolerance, dyspnea, CHF. May have a long latent period before sx.
what are patients at risk for with severe aortic stenosis - ANSSudden Death!
What am I associated with .... Medium pitched CONTINUOUS murmur in both systole/diastole.
Usually harsh, machinery like noise. Loud, sometimes a thrill is present. (heard best L
infraclavicular fossa and pulmonic area) - ANSpatent ductus arteriosus
Mid-to late systolic murmur, may have a mid-systolic click best heard over the lower left sternal
border. - ANSMitral Valve Prolapse
what are the symptoms associated with MVP? - ANSMost people are asymptomatic. May have
chest pain, palpitation, mild dyspnea, fatigue, anxiety.
Loud, blowing, high pitched diastolic murmur best heard Lower Left Sternal Border.. - ANSAortic
insufficiency / Aortic regurgitation
What are symptoms associated with severe aortic regurgitation? - ANSDyspnea, fatigue, CHF,
widened pulse pressure. Water-hammer pulse
, Low pitched, mid-diastolic rumble best heard at the apex in the Left Lateral position. May also
hear an "opening Snap" - ANSMitral Stenosis
What is the most common cause for mitral stenosis - ANSRheumatic Heart Disease
What are the sx associated with Mitral stenosis? - ANSDYSPNEA, fatigue, palpitations,
hemoptysis, angina-like chest pain. A-fib is common
What are patients with Mitral Stenosis at risk for? (2 things) - ANSThromboembolization &
pulmonary hypertension
Which murmurs are louder during inspiration? (left or right) - ANSRight
Which murmurs are louder during expiration? (left or right) - ANSLeft
Early, mid, or late systolic OR pansystolic Medium pitched murmur best heard at the lower left
sternal border. Can radiate to the right sternal border? - ANSTricuspid
Regurgitation/Insufficiency
What is associated with a Pansystolic, louder in midsystole. best heard at LSB with radiation to
the RSB. May have systolic THRILL at LLSB. Increased murmur with Valsalva. - ANSVentricular
Septal Defect
In a fetus, blood flows from the right atrium to the left atrium through the __________. -
ANSForamen ovale
In a fetus, the connection between the pulmonary artery and aorta is the ___________. -
ANSDuctus arteriosus
_________ brings blood back from the fetus to the placenta - ANSumbilical artery
________ brings blood from the placenta to the fetus - ANSumbilical vein
Which 3 CHD are associated with INCREASED pulmonary blood flow - ANSPDA, ASD, VSD
What are symptoms associated with Patent Ductus arteriosus? - ANSmay be asymptomatic, or
CHF, bounding peripheral pulses, WIDE pulse pressure, II-V Harsh machinery like
CONTINUOUS murmur best heard left clavicle, 1st/2nd L ICS.
What is the treatment for PDA? - ANSIndomethacin to effect closure
Blood flows from Left to Right Atrium through an opening. Can result in R atrium and ventricle
distention, and increased pulmonary blood flow. - ANSAtrial Septal Defect
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