Cardiac And Peripheral Health Assessment Exam 3

Front 1

What is the Pericardium?

Back 1

Pericardium outer most layer of the heart Tough fibrous, double walled sac that surrounds the heart

Front 2

What is the myocardium?

Back 2

Myocardium the middle layer
Muscular wall of the heart

Front 3

What is the Endocardium?

Back 3

Endocardium The inner most layer
Thin layer of endothelial tissue that lines the inner surface of the heart chambers and valves

Front 4

What are the four valves of the heart?

Back 4

Pulmonary, aortic, tricuspid, and mitral

Front 5

What are the two semi lunar valves?

Back 5

Pulmonary and Aoritic

Front 6

What are the two Atrial and ventricle valves (AV)?

Back 6

Mitral and tricuspid

Front 7

What is the first sequence that the heart goes through to pump in and out blood, when the deoxigenated blood first goes in?

Back 7

deoxygenated blood flows back to the heart via the sup. and inf. vena cava and enters the Rt. Atrium

Front 8

What is the 2nd step the heart goes through?

Back 8

From right atrium through tricuspid valve to right ventricle

Front 9

What is the 3rd step the heart goes through?

Back 9

From RV through pulmonic valve to pulmonary artery

Front 10

What is the 4 step the heart goes through?

Back 10

Oxygenated blood to lungs for O2
Pulmonary vein returns fresh O2 blood to Lt. Atrium

Front 11

What is the 6th step the heart goes through?

Back 11

Lt Atrium through mitral valve to Lt. ventricle

Front 12

What is the 7th and final step the heart goes through?

Back 12

Through aortic valve to Aorta to all parts of body

Front 13

What happens when listing to the heart at S1?

Back 13

S1:occurs with closure of the AV valves and signals beginning of systole
Systole is contraction
The Mitral and Tricuspid fuse as one sound and is loudest at the Apex

Front 14

What happens when your hearing the S2 part of the heart beat?

Back 14

S2: Second heart sound occurs with the closure of the semilunar valve and signals the end of systole
The Aortic and Pulmonic valve close about the same time
S2 : loudest at the base

Front 15

What is used to describe heart sounds?

Back 15

All heart sounds are described by:
Frequency (pitch) high or low. Most considered low frequency
Intensity: loud or soft
Duration: Short
Timing: Systole: When ejection occurs, or Diastole: When filling occurs

Front 16

What can give the blood more turbulence?

Back 16

Viscosity, velocity, structural defects

Front 17

Where is the heart located in babies and children?

Back 17

It is located near the 4th intercostal space because its more horizontal.

Front 18

What happens to the heart durring prego?

Back 18

Blood volume increases 30-40% and bpm increase 10-15 beats.

Front 19

What happens to our heart and ariteris as we age?

Back 19

Aged: As we age are arteries stiffen and calcify leading to arteriosclerosis causing less flexibility
Arrhythmias: Incidence of irregular heart rates increases

Front 20

What can give the blood more turbulence?

Back 20

Viscosity, velocity, structural defects

Front 21

Where is the heart located in babies and children?

Back 21

It is located near the 4th intercostal space because its more horizontal.

Front 22

What happens to the heart durring prego?

Back 22

Blood volume increases 30-40% and bpm increase 10-15 beats.

Front 23

What happens to our heart and ariteris as we age?

Back 23

Aged: As we age are arteries stiffen and calcify leading to arteriosclerosis causing less flexibility
Arrhythmias: Incidence of irregular heart rates increases

Front 24

Cardiac edema is worse at night and better in morning Why?

Back 24

When you lie down fluid builds up in your lungs because, the fluid comes from salt and water being retained by the kidneys because the heart did not pump them enough blood.

Front 25

What is nocturia and why do people with heart problems get it?

Back 25

people with heart problems get a build up of fluid because less blood flows to the kidneys causing the kidneys to retain water and salt. This often cause a overflow when it reaches the heart again, often the vains get backed up because the heart can not process that much volume, often you will see a jugular sticking out, this means that your heart has blood backed up.

Front 26

What is CAD?

Back 26

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Front 27

What is Angina ?

Back 27

Angina is chest pain or discomfort that occurs when an area of your heart muscle doesn't get enough oxygen-rich blood. Angina may feel like pressure or squeezing in your chest. The pain also may occur in your shoulders, arms, neck, jaw, or back. It can feel like indigestion.

Front 28

What is Bruits?

Back 28

is the term for the unusual sound that blood makes when it rushes past an obstruction

Front 29

What do we look for when inspecting the Precordium?

Back 29

Inspect for an apical impulse at the Lt. 4th or 5th interspace. Look for a heave or lift. A heave or lift is a sustained forceful thrusting of the ventricle during systole. Occurs with ventricular hypertrophy as a result of increased workload.

Front 30

What do we do to find heart murmers while palpating the mid chest with our hands?

Back 30

Use palmar surface and gently palpate apex, sternal border and base for other pulsations. Compare with Carotid pulse. A well defined turbulence or “thrill” (palpable vibration) may be indicative of a murmur.

Front 31

What do we to the apical impulse?

Back 31

Palpate Apical Impulse at PMI (found in about half of adults) Located in one interspace at 4th or 5th at the medial or mid clavicular line.
Use palmar surface and gently palpate apex, sternal border and base for other pulsations. Compare with Carotid pulse. A well defined turbulence or “thrill” (palpable vibration) may be indicative of a murmur
Amplitude is short, gentle tap with short duration
Percussion: Used to outline heart, but Chest XR best tool for this.
Note change from resonance to dullness

Front 32

What do we do when auscultating the heart?

Back 32

Auscultation: Identify the 4 traditional valve areas. Think of using the Z technique:
1. Aortic: 2nd right interspace
2. Pulmonic: 2nd left interspace
3. Tricuspid: Left lower sternal border (5th i.s.)
4. Mitral: 5th interspace at mid-clavicular line
Sounds produced by the valves are heard best at these sites
Repeat sequence using the bell

Front 33

What happens to B/p and apical pulse during pregnancy?

Back 33

Pregnancy: HR increases, B/P decreases
Apical pulses is higher
Aged: B/P may increase, Orthostatic hypotension. Caution with pressure on carotids
May be difficult to palpate apical pulse due to A:P ratio increase

Front 34

What does dyspena mean?

Back 34

Shortness of breath

Front 35

What does proxmal nocturnal dyspnea mean?

Back 35

Proxmal- sudden onset
Nocturnal- At night
Dspnea- Shortness of breath.

Front 36

What is CAD?

Back 36

corrnery artery disease

Front 37

What is PMI and where is it?

Back 37

Point of Maximum Impulse, its found at the Apicaple pulse, 5the intercostal space mid-clavicular line. It is the Vertex of the heart. Seen in 50% of people.

Front 38

What is a normal heart rate for a baby or infant?

Back 38

100-180bpm

Front 39

What is orthopnea?

Back 39

shortness of breath while lying down?

Front 40

What happens if you massage somone carotid artery?

Back 40

There heart rate and BP go down, so much so that there heart can stop at times?

Front 41

What does AV mean?

Back 41

AV usually describes the Valves seperating the atrium and ventricle chambers; tricuspid and mitral

Front 42

What is orthostatic hypotension?

Back 42

B/p is low when lying down, also heart rate is up. This means that there is low blood volume.

Front 43

Where is S1 heard loudest?

Back 43

at the base of the heart, S1 is the sound of the AV valves (tricuspid and Mitral) closing to gether sounding as one.

Front 44

Where is S2 heard the loudest?

Back 44

S2 is heard loudest at the base of the heart. It signafies the end of systole. It is heard at the 2nd intercostal space left or right on the border of the stirnum.

Front 45

What is an arythmia?

Back 45

An irregualar heart beat.

Front 46

What are the 7 pionts that we check pulse @?

Back 46

Femoral, carotid, brachial, radial, popatiel, post tibial, dorlus pedius.