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46 Cards in this Set

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  • Back
What structure is located directly behind and below the sternum
right ventricle
What forms the left lateral margin of the heart and where is this structure located?
The left ventricle and it is located behind the right ventricle and to the left.
What forms the right heart border?
The right atrium.
What produces the sound that forms S1?
Closure of the mitral valve.
What normally corresponds to the systolic blood pressure?
Maximal left ventricular pressure.
What produces the sound that forms S2?
Closure of the aortic valve.
What is thought to cause a S3 sound and what can it indicate?
The sudden deceleration of blood against the left ventricular wall causes S3 and it is thought to be due to decreased ventricular compliance.
What occurs at the same time as S4 and what is it thought to be caused by?
Atrial contraction is thought to cause S4 and it is also associated with decreased ventricular compliance.
What do the P, QRS, and T waves correspond to?
P=atrial depol, QRS=ventricular depol., T=ventricular repol.
What is referred to as the ability of the heart muscle, when given a load, to shorten
contractility
Why are the pulses in the arms and legs unsuitable for timing things in the cardiac cycle?
There is a palpable delay between ventricular contraction and peripheral pulses.
What are the main factors that influence arterial pressure?
left ventricular stroke volume, distensibility of the aorta, PVR, volume of blood in the arterial system
Where is the internal jugular vein located and what an it be used to estimate?
It is deep to the sternomastoid muscles in the neck and its pulsations can be used to estimate the right atrial pressure
What measurement for JVP separates normal from abnormal?
A measurement of 4cm above the sternal angle (total of 9cm above right atrium) is abnormal
What does the "a" wave represent?
the slight rise in atrial pressure that accompanies atrial contraction -- occurs just before the first heart sound and before the carotid pulse
What does the "x" descent reflect?
atrial relaxation.
What does the "v" wave reflect?
during systole blood is flowing into the right atrium from teh vena cavae and this fills the atrium and increases the pressure as the tricuspid valve is closed
What is the "y" descent?
Early in diastole blood from the right atrium flows passively into the right ventricle and right atrial pressure falls
When do the "x" and "y" descents happen?
The "x" descent is more prominent and occurs just before the second heart sound, "y" descent follows the second heart sound, early in diastole
What does a flow murmur usually denote?
Often found in children this is thought to denote pulmonic blood flow
What is a mammary souffle?
This is a mirmur seen in women who are lactating that is due to increased blood flow in the breasts. Usually systolic and diastolic.
How is aortic sclerosis different from aortic stenosis?
aortic sclerosis is just the thickening of the bases of teh aortic cusps with calcification with no obstruction of blood flow while stenosis impedes blood
Is the systolic murmur of mitral stenosis ever considered innocent?
no
Who is a jugular venous hum seen in?
children through young adults
What happens to systolic and diastolic blood pressure as one ages?
Systolic blood pressure rises as one ages and diastolic also rises until about the 6th decade when it begins to remain constant.
What does sharp pain from the chest that radiates into the back or neck imply?
aortic dissection
What arrhythmia can be readily identified at the bedside?
atrial fibrillation, irregularly irregular.
What are some pathologic processes indicated by orthopnea?
left ventricular heart failure, mitral stenosis, and obstructive lung disease.
What is periorbital puffiness indicate? What about enlarged waistline?
periorbital puffiness = nephrotic syndrome, enlarged waistline = ascites and/or liver failure
What are teh optimal levels for LDL, HDL, and total cholesterol?
LDL<100, total cholesterol<200, and HDL between 40 and 60.
What is the starvation response and what can be done to counteract this?
It is the drop in metabolic rate in response to a decrease in caloric intake and exercise can help offset this
What do prominent "a" waves indicate?
increased resistance to right atrial contraction as in tricuspid stenosis or the decreased compliance of the right ventricle
What is indicated by the disappearance of the "a" waves?
atrial fibrillation
What do larger "v" waves indicate?
tricuspid regurgitation.
What can pressure on the carotid sinus do?
cause a reflex drop in the pulse rate of blood pressure
What are bounding pulses usually associated with?
aortic insufficiency
What is the normal upstroke of the carotid pulse like and what is associated with a delayed upstroke
normal is a brisk upstroke and delayed upstroke is seen in aortic stenosis.
What is the left lateral decubitus position good to listen for?
good for hearing low-pitched extra sounds like S3, opening snaps, and diastolic rumble of mitral stenosis.
What is the sitting, leaning forward after full exhalation position good for listening for?
good for hearing the soft decrescendo diastolic murmur of aortic insufficiency
When is S1 decreased and when is S2 decreased?
S1 is decreased in 1st degree heart block, S2 is decreased in aortic stenosis
What is the bell of the stethoscope good for listening to, both generally and specifically?
generally it is good for low-pitched sounds, specifically for things like S3, S4, and the murmur of mitral stenosis
What does the murmur of a patent ductus arteriosus sound like?
it starts in systole and continues without pause through S2 and into but not necessarily through diastole, it is called a continuous murmur
What kind of murmur is often heard in mitral stenosis?
a presystolic murmur
What kind of murmur is heard in aortic regurgitation?
an early diastolic murmur
What kind of murmur is heard in aortic stenosis and innocent flow murmurs
a midsystolic murmur
What kind of murmur is heard in mitral regurgitation?
a pansystolic (holosystolic) murmur