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53 Cards in this Set
- Front
- Back
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Right atrium
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Receives deoxygenated blood from systemic circulation from the superior and inferior vena cava
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Right Ventricle
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Receives blood from the right atrium (due to high pressure) and sends it to the pulmonary system via the pulmonary artery to be oxygenated
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Left Atrium
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Receives oxygen-rich blood from the pulmonary system from the pulmonary vein
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left Ventricle
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Receives oxygenated blood from the left atrium and sends it to the systemic circulation via the aorta
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pericardium
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tough fibrous double walled sac that surrounds heart
2 layers - contains pericardial fluid |
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myocardium
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muscular wall of heart, pumps
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endocardium
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thin layer of endothelial tissue; lines inner surface of heart
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AV valves
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Right AV valve or Tricuspid valve
Found between the right atrium and right ventricle Left AV or Mitral valve Found between the left atrium and left ventricle |
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semilunar valves
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Aortic valve
Opens from left ventricle into aorta Pulmonic valve Opens from right ventricle into pulmonary artery |
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arteries
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carry oxygenated blood to capillary bed - gas and nutrient exchange
EXCEPT pulmonary a - carries deoxygenated blood to lungs |
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Arterioles
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Smallest arterial branches
Role in blood pressure maintenance by constricting or dilating |
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Veins
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return deoxygenated blood to heart
EXCEPT - pulmonary vein - delivers oxygenated blood from lungs |
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Problem based history - chest pain/tightness
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where
radiation severity when did it start - factors preceded? intermittent/constant aggravates/alleviates - nitro (how much) related symptoms |
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Problem based history - dyspnea, SOB
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how long
when does it happen interfere with ADLs (occur on exertion) related symptoms aggravates/alleviates night, need to sit up |
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problem based history - cough
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when did it start
cough up anything timing related to position, anxiety, talking/activities aggravates/alleviates |
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problem-based history - nocturia
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can indicate heart failure -excess fluid excreted when laying down
how long has it been going on for how many times a night anything to prevent? success? |
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problem based history - fatigue
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sudden/gradual
time of day iron pills? iron rich foods? related symptoms - cyanosis unusual feelings in feet, hands, muscle weakness, trouble thinking |
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problem based history - fainting
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activity prior to fainting
feel like you were going to faint happened before? how often? other symptoms causes: hypotension, shock, decreased o2 levels, change in HR |
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problem based history - edema of extremities
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where
unilateral/bilateral alleviates? better after sleeping other symptoms (SOB, weight gain, warmth, discoloration) |
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assess general appearance
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skin color, breathing
normal - relaxed, appropriate skin color, unlabored breathing abnormal - tense, dyspnea, accessory muscles, cyanosis, pallor, tenting ,edema |
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carotid artery
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inspect
palpate - one side at a time auscultate - lightly, bell, hold breath normal - nontender, no bounding, 2+, smooth upstroke abnormal - tender, swelling, bruit, bounding, murmur |
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bruit
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whooshing noise indicates turbulent blood flow
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pulse amplitude
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0+ Absent
1+ Barely palpable 2+ Normal 3+ Full volume 4+ Bounding |
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jugular vein
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pulsations - indicate rt sided HF
elevate HOB 30-45 degrees, have client look opposite direction, shine light normal: see pulsation not vein abnormal: vein visible, fluttering pulse, unilateral distension |
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upper and lower extremities - inspect and palpate
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symmetry
skin integrity, color/temp capillary refill, color/angle of nail beds |
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pulses
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brachial
radial femoral popliteal posterior tibial dorsalis pedis rhythm, rate, amplitude, contour |
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precordium
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inspect - apical pulse (lift/heave)
palpate apical pulse - location, size, amplitude, durations palpate precordium - pulsations, nodules, thrill |
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heave/lift
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forceful push from ventricles during systole
indicates hypertrophy r/t increased workload |
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sites to auscultate heart
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aortic
pulmonic erbs pt tricuspid mitral diaphragm and bell |
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S1
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lower pitch - "lub"
closure of AV valves - beginning of systole |
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carotid artery
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inspect
palpate - one side at a time auscultate - lightly, bell, hold breath normal - nontender, no bounding, 2+, smooth upstroke abnormal - tender, swelling, bruit, bounding, murmur |
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bruit
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whooshing noise indicates turbulent blood flow
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pulse amplitude
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0+ Absent
1+ Barely palpable 2+ Normal 3+ Full volume 4+ Bounding |
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jugular vein
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pulsations - indicate rt sided HF
elevate HOB 30-45 degrees, have client look opposite direction, shine light normal: see pulsation not vein abnormal: vein visible, fluttering pulse, unilateral distension |
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upper and lower extremities - inspect and palpate
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symmetry
skin integrity, color/temp capillary refill, color/angle of nail beds |
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pulses
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brachial
radial femoral popliteal posterior tibial dorsalis pedis rhythm, rate, amplitude, contour |
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precordium
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inspect - apical pulse (lift/heave)
palpate apical pulse - location, size, amplitude, durations palpate precordium - pulsations, nodules, thrill |
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heave/lift
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forceful push from ventricles during systole
indicates hypertrophy r/t increased workload |
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sites to auscultate heart
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aortic
pulmonic erbs pt tricuspid mitral diaphragm and bell |
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S1
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lower pitch - "lub"
closure of AV valves - beginning of systole louder at apex coincides with carotid artery pulse and beginning of R wave |
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S2
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higher pitch "dupp"
louder closure of semilunar valves louder at teh base |
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abnormal heart sounds
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muffled or diminished - extra fluid, not pumping well
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S3
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extra heart sound
ventricular filling sound - HF and FVE low pitched early diastole apex while lying on left side follows S2 normal in children, young adults - disapears when sitting abnormal - gallop |
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S4
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tricuspid/mitral/apex on left side
atria contract - late diastole - right before S1 ventricular filling bell of stethoscope gallop - abnormal |
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murmur timing
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systole or diastole (know S1 and S2)
mid, early, late pancystolic, holocystolic/pandiastolic, holodistolic obscures heart sounds |
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murmur loudness
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Grade i—Barely audible
Grade ii—Audible, but quiet and soft Grade iii—Moderately loud, without thrust or thrill Grade iv—Loud with a thrill Grade v—Very loud heard with only part of stethoscope ,with a thrust or a thrill Grade vi—Loud enough to be heard before stethoscope comes in contact with chest |
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murmur pitch
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high
medium low |
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murmur pattern
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crescendo
decrescendo crescendo-decrescendo |
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murmur quality
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harsh, musical, blowing, rumbling
mitral stenosis - rumbling aortic stenosis - harsh |
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murmur location
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area best heard - does it radiate
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murmur and posture
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some disappear with change in posture
innocent - no valvular cause functional - due to increased blood flow |
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innocent murmur
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occurs often in young children
soft, midsystolic, short, cres-decr, musical disappears with sitting |
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Cardiac Auscultation Routine
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Note rate and rhythm
Identify S1 and S2 Assess S1 and S2 separately Listen for extra heart sounds Listen for murmurs |
