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44 Cards in this Set

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Resting, healthy adult, the heart contracts 60-100 times while pumping 4-5 liters of blood/min.
Info
heart located in thoracic cavity between lungs and above diaphragm in an area known as the mediastinum.
info
uppermost portion, which includes the left and right atria as well as the aorta, pulmonary arteries, and the superior and inferior venae cavae.
base
lower portion, extends into the left thoracic cavity.
apex
collection point for the blood returning from the systemic circulation for reoxygenation in lungs.
right atrium
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.
left atrium
blood exits the heart through the semilunar valves.
info.
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.
cardiac cycle
normal pacemaker of the heart; initiates a rhythmic impulse approx. 70xs/min.
S-A node
consists of the left side of the heart
systemic pump
represents the right side of the heart
pulmonary circuit pump
-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.
info
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.
congestive heart failure
inspection, palpation, and auscultation should be performed in a systematic manner.
info
2nd ICS to right of sternum
-S2 louder than S1
aortic area
2nd ICS to left of sternum
-S2 louder than S1
-there is a normal physiological splitting of S2 that is heard best here.
pulmonic area
3rd ICS to left of sternum
-where murmurs can be auscultated
Erb's point
4th ICS left of sternum
-S1 louder than S2
-there is a normal physiological splitting of S1 at this area
tricuspid area
5th ICS at left midclavicular line
where PMI occurs
(point of maximal impulse)
mitral area
vibrations that feel like a purring cat
thrills
lifting of the cardiac area
heaves
patient sitting in supine position; use finger pads
thrills/heaves use ball of hand
pulsations
caused by rapid ventricular filling. Often indicates congestive heart failure and fluid overload.
-"Kentucky"
S3
can be auscultated in conditions that increase the resistance to filling b/c of a poorly compliant ventricle.
"Tennessee"
S4
7 characteristics of a murmur
1-Location
2-Radiation
3-Timing
4-Intensity
5-Quality
6-Pitch
7-Configuration
info
JVP(jugular vein pulsations) reading less the 4 cm=normal. Most distended when pt is flat.
JVP
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.
hepatojugular reflux
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.
info
arterial pulse: supine position with head of bead 30-40 degrees.
Evaluate pulse in terms of: rate,rhythm,amplitude,symmetry.
arterial pulses
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.
arterial pulses
components of peripheral perfusion assessment include peripheral pulse, color, clubbing, capillary refill, skin temp, edema, ulcerations, skin texture, heair distrubution.
peripheral perfusion
homans sign
manual compression
retrograde filling
venous system advanced techniques
pallor
color return
allen test
arterial system advanced techniques
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.
arterial ulcerations
occurs on sides of ankles
-uneven edges,ruddy granulation of tissue, thin, shiny skin
venous ulcerations
risk factors for chronic arterial insufficiency:
-age(>60)
-Gender -Hypertension
-Diabetes -Hyperlipidemia
-Smoking
risk factors
risk factors for varicose veins:
-obesity
risk factors for varicose veins
P-presentation
Q-quality
R-region
S-severity
T-time
chest pain
*inspection
color-pallor/cyanosis
neck-pulsations/CVP
chest-pulsations
*palpation
neck-carotid pulse
chest-pulsations/thrills
PMI
*auscultation
neck-carotid bruit
chest-heart sounds
assessment of precordium
arterial circulation-high pressure;deliver oxygen
venous circulation-low pressure system;reflects pressure back to heart
peripheral vascular & lymphatic system
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
arterial insufficiency
(atherosclerosis)
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
venous insufficiency
(varicose veins)
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
right-sided heart failure
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.
left-sided heart failure