Quiz 4 Blueprint Review Guide: Chapters 12, 20, 21, and 22

Comprehensive vocabulary flashcard review set covering the cardiovascular, peripheral vascular, nutritional, and abdominal assessment topics from Quiz 4 blueprint chapters.

Pericardium

Tough, fibrous, double-walled sac that surrounds and protects the heart.

Myocardium

Muscular wall of the heart responsible for pumping action.

Endocardium

Endothelial tissue lining the inner surface of the heart chambers and valves.

S1 (First Heart Sound)

Heart sound caused by the closure of the Atrioventricular (AV) valves (tricuspid and mitral), heard loudest at the apex of the heart (5th intercostal space at the left midclavicular line).

S2 (Second Heart Sound)

Heart sound caused by the closure of the Semilunar (SL) valves (pulmonic and aortic), heard loudest at the base of the heart (2nd intercostal space).

Carotid Bruit

A blowing, swooshing sound indicating turbulent blood flow through a narrowed artery, audible when an artery is approximately $\frac{1}{2}$ occluded.

Heart Murmur

Gentle, blowing, swooshing sound caused by turbulent blood flow through heart valves due to increased blood velocity, decreased blood viscosity, or structural valve defects.

Lift / Heave

A sustained forceful thrusting of the ventricle during systole, observed or felt at the left sternal border in right ventricular hypertrophy.

Thrill

A palpable vibration (feels like a purring cat) felt at the base of the heart that indicates aortic stenosis or pulmonary hypertension.

Apical Impulse

A short, localized tap normally occupying only one intercostal space at the 5th intercostal space at or inside the left midclavicular line.

S3 (Ventricular Gallop)

An extra heart sound occurring in early diastole immediately after S2 ('lub-dup-pa') caused by ventricles resistant to filling due to volume overload, best heard at the apex with the bell.

S4 (Atrial Gallop)

An extra heart sound occurring in late diastole just before S1 ('da-lub-dup') caused by the atria pushing blood into stiff, non-compliant ventricles, best heard at the apex with the bell.

Pericardial Friction Rub

High-pitched, scratchy sound caused by inflammation of the pericardial sac, common post-MI or post-CABG surgery.

Pulse Deficit

A difference between the auscultated apical heart rate and the palpated radial pulse rate, indicating weak or uncoordinated ventricular contractions.

Preload

The volume of blood in the ventricles at the end of diastole (venous return / filling pressure according to Frank-Starling's law).

Afterload

The opposing resistance or pressure the ventricle must generate to open the aortic valve and pump blood out.

Precordium

The area on the anterior chest directly overlying the heart and great vessels.

Deep Veins of the Legs

The femoral and popliteal veins, which conduct the vast majority of venous return from the lower extremities.

Deep Vein Thrombosis (DVT)

Blood clot formation in a deep vein, presenting with unilateral leg edema, warmth, redness, and tenderness, with a primary risk of dislodgement leading to a pulmonary embolism.

Epitrochlear Nodes

Lymph nodes located in the depression above and behind the medial epicondyle of the elbow that drain the hand and lower arm.

Inguinal Nodes

Lymph nodes located in the groin that drain the lower extremities, external genitalia, and anterior abdominal wall.

Intermittent Claudication

Muscle ischemia and cramping pain in the legs during walking or exercise that is promptly relieved by rest, serving as a classic sign of Peripheral Artery Disease (PAD).

Allen’s Test

An assessment that evaluates collateral arterial circulation in the hand prior to radial artery cannulation or blood gas sampling by compressing both radial and ulnar arteries and releasing the ulnar artery.

Chronic Venous Stasis

Condition resulting from incompetent venous valves that leads to lower leg edema, brown hemosiderin skin discoloration, and thickened skin.

Lymphedema

Non-pitting swelling of an extremity caused by obstructed lymphatic drainage, commonly occurring post-mastectomy or lymph node dissection.

Doppler Ultrasound

A diagnostic tool used to detect weak, non-palpable peripheral pulses or to measure low arterial blood pressures.

Raynaud’s Disease

Condition marked by episodic arterial vasospasms causing a triphasic color change in fingers and toes: pallor (white) to cyanosis (blue) to rubor (red) upon exposure to cold or stress.

Arterial Ulcers

Painful ulcers with a pale, yellow base, clean 'punched-out' edges, and minimal bleeding, located on toes, metatarsal heads, or lateral malleolus.

Venous Ulcers

Aching and exudative with a red or granulating base and irregular borders, located on the medial malleolus amid brown pigmented skin.

Pellagra

Niacin deficiency characterized by pigmented, scaling lesions on skin exposed to light.

Scorbutic Gums

Condition caused by Vitamin C deficiency, characterized by swollen, ulcerated, and bleeding gums.

Follicular Hyperkeratosis

Skin condition caused by Vitamin A or linoleic acid deficiency, characterized by dry, bumpy papules.

Bitot’s Spots

Foamy plaques on the cornea caused by Vitamin A deficiency.

Rickets

Bone softening and bowing caused by Vitamin D and calcium deficiency.

Magenta Tongue

Purplish tongue discoloration caused by Riboflavin (Vitamin B2) deficiency.

Sequence of Abdominal Physical Assessment

Inspection, Auscultation, Percussion, and Palpation (light then deep), designed to avoid manually stimulating peristalsis before auscultation.

Ascites

Abdominal fluid distention presenting as a single curve with bulging flanks, taut skin, a protruding umbilicus, tympany on top with dullness over lateral fluid, and positive fluid wave and shifting dullness tests.

Hematemesis

Vomiting bright red blood or dark 'coffee-ground' emesis, indicating an upper gastrointestinal bleed.

Melena

Black, tarry, sticky stool with a foul odor, indicative of an upper gastrointestinal bleed.

Hematochezia

Bright red blood passed per rectum, indicating a lower gastrointestinal bleed.

Costovertebral Angle (CVA) Tenderness

Sharp pain elicited by indirect fist percussion over the 12th rib, indicating pyelonephritis (kidney infection).

Light Palpation (Abdomen)

Depressing the abdominal skin $1\,\text{cm}$ using a gentle rotary motion to evaluate overall muscle tone, skin surface characteristics, and superficial tenderness.

Deep Palpation (Abdomen)

Depressing the abdominal skin $5\text{ to }8\,\text{cm}$ to evaluate organ location, size, consistency, and deep abnormal masses.

Scaphoid Abdomen

A caved-in, contour seen in thinness or malnutrition.

Protuberant Abdomen

Pronounced abdominal distention caused by ascites, heavy obesity, gas, pregnancy, or tumor.