Health Assessment Exam 1

Front 1

Resting, healthy adult, the heart contracts 60-100 times while pumping 4-5 liters of blood/min.

Back 1

Info

Front 2

heart located in thoracic cavity between lungs and above diaphragm in an area known as the mediastinum.

Back 2

info

Front 3

uppermost portion, which includes the left and right atria as well as the aorta, pulmonary arteries, and the superior and inferior venae cavae.

Back 3

base

Front 4

lower portion, extends into the left thoracic cavity.

Back 4

apex

Front 5

collection point for the blood returning from the systemic circulation for reoxygenation in lungs.

Back 5

right atrium

Front 6

receives its freshly oxygenated blood via the 4 pulmonary veins, which are the only veins that carry oxygenated blood.
-left ventricle 3xs thicker than right/ pressure is 5 xs greater.

Back 6

left atrium

Front 7

blood exits the heart through the semilunar valves.

Back 7

info.

Front 8

consists of systole & diastole.
systole-myocardial fibers contract and tighten to eject blood from the ventricles.
diastole-period of relaxation and reflects the pressure remaining in the blood vessels after the heart has pumped.

Back 8

cardiac cycle

Front 9

normal pacemaker of the heart; initiates a rhythmic impulse approx. 70xs/min.

Back 9

S-A node

Front 10

consists of the left side of the heart

Back 10

systemic pump

Front 11

represents the right side of the heart

Back 11

pulmonary circuit pump

Front 12

-arterioles are the smallest group of arteries
-arteries do not have valves
-arterial pulsations are caused by the intermittent contractions of the left ventricle.
-arteries transport blood underhigh pressure to tissue
-capillaries exchange fluid,nutirents,electrolytes,hormones,etc.
-veins transport blood from tissues back to the heart.

Back 12

info

Front 13

condition whereby pump failure makes the heart unable to maintain a cardiac output sufficient to meet the metabolic needs of the body
-left sided: anxiety,S3,cough,fatigue
-right sided:dependent pitting edema, weight gain, hepatojugular reflux.

Back 13

congestive heart failure

Front 14

inspection, palpation, and auscultation should be performed in a systematic manner.

Back 14

info

Front 15

2nd ICS to right of sternum
-S2 louder than S1

Back 15

aortic area

Front 16

2nd ICS to left of sternum
-S2 louder than S1
-there is a normal physiological splitting of S2 that is heard best here.

Back 16

pulmonic area

Front 17

3rd ICS to left of sternum
-where murmurs can be auscultated

Back 17

Erb's point

Front 18

4th ICS left of sternum
-S1 louder than S2
-there is a normal physiological splitting of S1 at this area

Back 18

tricuspid area

Front 19

5th ICS at left midclavicular line
where PMI occurs
(point of maximal impulse)

Back 19

mitral area

Front 20

vibrations that feel like a purring cat

Back 20

thrills

Front 21

lifting of the cardiac area

Back 21

heaves

Front 22

patient sitting in supine position; use finger pads
thrills/heaves use ball of hand

Back 22

pulsations

Front 23

caused by rapid ventricular filling. Often indicates congestive heart failure and fluid overload.
-"Kentucky"

Back 23

S3

Front 24

can be auscultated in conditions that increase the resistance to filling b/c of a poorly compliant ventricle.
"Tennessee"

Back 24

S4

Front 25

7 characteristics of a murmur
1-Location
2-Radiation
3-Timing
4-Intensity
5-Quality
6-Pitch
7-Configuration

Back 25

info

Front 26

JVP(jugular vein pulsations) reading less the 4 cm=normal. Most distended when pt is flat.

Back 26

JVP

Front 27

hepatojugular reflux is a test that is very sensitive in detecting right ventricular failure. Procedure performed if the CVP is normal but right ventricular failure is suspected. Using single deep palpation press firmly on right upper quadrant for 30-60sec.

Back 27

hepatojugular reflux

Front 28

function of the right ventricle is gained via the assessment of the venous pulses. Assessment of the arterial pulses provides info about the left ventricle. Pulses to be evaluated are temporal, carotid, brachial, radial, femoral, popliteal, posterior tibial, dorsalis pedis.

Back 28

info

Front 29

arterial pulse: supine position with head of bead 30-40 degrees.
Evaluate pulse in terms of: rate,rhythm,amplitude,symmetry.

Back 29

arterial pulses

Front 30

using bell auscultate temporal, carotid, and femoral pulses for bruits, which are blowing sounds heard when blood flow becomes turbulent as it rushes past an obstruction.

Back 30

arterial pulses

Front 31

components of peripheral perfusion assessment include peripheral pulse, color, clubbing, capillary refill, skin temp, edema, ulcerations, skin texture, heair distrubution.

Back 31

peripheral perfusion

Front 32

homans sign
manual compression
retrograde filling

Back 32

venous system advanced techniques

Front 33

pallor
color return
allen test

Back 33

arterial system advanced techniques

Front 34

location:toes or points of trauma on feet or legs.
characteristics:well-defined edges, black tissue, pale base and lack of bleeding, shiny, thick, waxy skin.
^due to inadequate arterial flow, such as peripheral vascular disease and diabetes. ulcers on tips of fingers,toes or nose can be caused by Raynauds disease.

Back 34

arterial ulcerations

Front 35

occurs on sides of ankles
-uneven edges,ruddy granulation of tissue, thin, shiny skin

Back 35

venous ulcerations

Front 36

risk factors for chronic arterial insufficiency:
-age(>60)
-Gender -Hypertension
-Diabetes -Hyperlipidemia
-Smoking

Back 36

risk factors

Front 37

risk factors for varicose veins:
-obesity

Back 37

risk factors for varicose veins

Front 38

P-presentation
Q-quality
R-region
S-severity
T-time

Back 38

chest pain

Front 39

*inspection
color-pallor/cyanosis
neck-pulsations/CVP
chest-pulsations
*palpation
neck-carotid pulse
chest-pulsations/thrills
PMI
*auscultation
neck-carotid bruit
chest-heart sounds

Back 39

assessment of precordium

Front 40

arterial circulation-high pressure;deliver oxygen
venous circulation-low pressure system;reflects pressure back to heart

Back 40

peripheral vascular & lymphatic system

Front 41

Inadequated blood flow through arteries
-pain comes on during exercise
-pain quickly relieved by rest
-skin pale, shiny, hairless, thickened nails.
Ulcers on toes may be black,gangrene
edema-absent or mild
pulses-absent
lack of circulation,pulses and blood supply

Back 41

arterial insufficiency
(atherosclerosis)

Front 42

Abnormal blood flow through veins.
-pain come on during or after several hours of exercise
-pain tends to be more constant although it may be relieved by rest
-skin pigmented and scaly.Stasis ulcers usually on inner ankle
-edema may obscure pulses

Back 42

venous insufficiency
(varicose veins)

Front 43

right ventricle loses its pumping function and blood may back up into other areas of body, producing congestion. Also, right ventricle may be unable to pump blood efficiently to lungs and left ventricle.
symptoms: swelling of feet and ankles, urinating frequently

Back 43

right-sided heart failure

Front 44

left side receives blood rich in oxygen from lungs and pumps it into the remainder of body. As the ability to pump blood forward from left side of heart is decreased, remainder of body doesn't receive enough oxygen especially when exercising. Results in fatigue.
symptoms:difficulty lying down, decreased urination.

Back 44

left-sided heart failure