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40 Cards in this Set
- Front
- Back
What does the Cardiovascular system do?
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transports oxygen, nutrients, and other substances to body's tissue and carries metabolic waste product to kidneys and lungs
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How many chambers in the heart?
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4; 2 chambers on each side, atrium and ventricle
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Right side of heart
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receives blood from superior and inferior venae cava and pumps it through pulmonary arteries to pulmonary circulation
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Left side of heart
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receives blood from pulmonary veins and pumps it through aorta into systemic circulation
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Three layers of the heart wall
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pericardium, myocardium and endocardium
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Pericardium
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heart encased in pericardium, which has a fibrous later and two serous layers
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Myocardium
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middle layer, thick muscular tissue that contracts to eject blood from ventricles
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Endocardium
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lines inner chambers and valves
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Tricuspid valve
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right side of heart
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Mitral valve
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left side of heart; atrioventricular (AV) valves -separate atria from ventricles
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Aortic valve
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opens from left ventricle into aorta (semilunar valve)
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Pulmonic valve
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opens from right ventricle into pulmonary artery (semilunar valve)
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Diastole
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ventricles relax and fill with blood from left and right atria; higher atrial pressures passively open AV valves, allowing blood to fill ventricles (80% of blood from atria flows into relaxed ventricles) Contraction forces remaining 20% through (atrial kick) at the end, ventricles are filled with blood
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Systole
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ventricles contract creating pressure to close AV valves (prevents backflow into the atria); semilunar valves open, eject blood to aorta (left) and pulmonary arteries (right). As blood is ejected, ventricular pressure decreases causing semilunar valves to close; ventricles relax...diastole
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Electronic Conduction
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SA (cardiac pacemaker) node through internodal tracts to AV node travel through branches and Purkinje fibers in myocardium which results in ventricular contraction.
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AV node compensation
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If SA node fails to discharge, AV node can generate ventricular contraction at slower rate of 40 to 60 impulses per minute.
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Bundle branches compensation
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If both SA and AV nodes are ineffective, bundle branches may contract, but at very slow rate of 20 to 40 impulses per minute.
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Ventricular systole
1st phase of Cardiac cycle |
(S1 -"lub") closing of MV and TV
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Ventricular diastole
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(S2 -"dub") closing of the AV and PV
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Factors that affect the heart
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Aging, Lifestyle, Disease
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5 points of Auscultation in Heart Assessment
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1. 2nd Right ICS (aortic valve)
2. 2nd Left ICS (pulmonic valve) 3. 3rd Left ICS (Erb's point) 4. 4th Left ICS (Tricuspid valve) 5. 5th Left Midclavicular Line (Mitral valve) -Apical |
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Murmur Intensity Grades
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Grade I barely audible in a quiet room
Grade II quiet but clearly audible Grade III moderately loud Grade IV loud and associated with a thrill Grade V very loud; thrill easily palpable Grade VI very loud; thrill palpable and visible |
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Aortic stenosis (Systolic) [heard over aortic valve area; radiates to neck, down left sternal border]
S1-III-S2 |
(heard between normal heart sounds) -medium pitch, coarse with crescendo-decrescendo pattern; pitch low
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Pulmonic stenosis (Systolic) [heard over pulmonic valve; radiates left to neck; thrill at 2nd & 3rd ICS]
S1-III-S2 |
heard over pulmonic valve; (heard between normal heart sounds) medium pitch, coarse with crescendo-decrescendo pattern
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Aortic regurgitation (Diastolic) [patient sitting and leaning forward, 2nd R ICS, radiates to L sternal border]
S1 S2 III--- |
Blowing in early diastole; pitch high
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Pulmonic regurgitation (Diastolic) [patient sitting or leaning forward; 3rd & 4th ICS]
S1 S2 III--- |
Blowing; pitch high or low
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Mitral Stenosis (Diastolic) [bell at apex with pt in L lateral decubitus position]
S1 S2 |
Low rumble more intense in early and late diastole; pitch low
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Tricuspid Stenosis (Diastolic) [Bell over tricuspid area]
S1 S2 |
Similar to mitral stenosis but louder on inspiration; pitch low
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Mitral regurgitation (Holosystolic) [diaphragm at apex, radiates to left axilla or base]
S1 IIIII S2 |
Harsh blowing quality; pitch high
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Tricuspid regurgitation (Holosystolic) [5th ICS, left sternal border]
S1 IIIII S2 |
Blowing; pitch high
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P
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Atrial depolarization and contraction
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QS
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Ventricular depolarization and contraction
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T
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Ventricular repolarization and relaxation
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Ken-tuck-y
S1 S2 S3 |
Ten-ness-ee
S4 S1 S2 |
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Pulse Amplitude Ratings
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0+ Absent
1+ Diminished, barely palpable 2+ Normal 3+ Full volume 4+ Full volume, bounding hyperkinetic |
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What is "Bruit"?
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a rushing, blowing sound created by the blood passing through the narrowed section of the vessel. (Carotid pulse)
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Normal findings on Auscultation
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S1 loudest at mitral area
S2 loudest at pulmonic area |
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Abnormal findings
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Splitting (valves aren't synchronized) S1 or S2
Third heart sound (S3) -CHF, fluid overload Fourth heart sound (S4) -CAD, cardiomyopathy Opening snap Summation gallop Midsystolic click Pericardial friction rubs Murmurs |
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Inspect upper and lower extremities for
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Symmetry
Skin integrity Color and temperature Capillary refill Hair distribution Sores Varicose veins |
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Peripheral Edema chart
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1+ barely perceptible pit - 2mm
2+ Deeper pit; rebounds in a few seconds - 4mm 3+ Deep pit; rebounds in 10 -20 seconds - 6mm 4+ Deeper pit; rebounds in >30 seconds - 8mm |