Physiology What conditions contribute to turbulent blood flow or heart murmurs. Turbulent blood flow occurs as blood moves through narrowed or leaking valves producing a swooshing sound over the precordium and a high heart rate combine with narrowing, causing the heart to handle a larger amount of blood flow than normal; the basis is increased blood velocity, structural valve malfunction, or atypical chambers. Some pathological causes of heart murmurs are anemia, high blood pressure, overactive thyroid, pregnancy, and fever are forerunners to producing a number of heart defects. One must understand the location of the point of origin, type and severity, and the different methods of assessing turbulent blood flow to understand the physiology
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Mid-systolic are the most common occurs during ventricular ejection, located between S1 and S2. There are four subdivisions innocent, pulmonic, aortic stenosis, and hypertrophic cardiomyopathy. Physiologic murmur is a temporary increase of blood flow located at the left sternal boarder and the apex. Pulmonic stenosis murmur happens from impeded blood flow across the pulmonic valve. Aortic stenosis murmur ensue when stenosis of the aortic valve obstructs blood flow due to a congenital abnormality, or rheumatic fever. Pan-systolic murmurs are pathological in nature. Mitral regurgitation happens when the mitral valve do not completely close and flow back into the left atrium. Tricuspid regurgitation occurs when there is a back flow into the right atrium; this is a common cause that results in pulmonary hypertension. Ventricular septal defect is a congenital abnormality where there is a hole in the septum allowing blow flow from the left ventricle into the right ventricle. Diastolic murmurs suggestive of heart disease of an ineffectual aortic valve. Aortic regurgitation happens when the aortic valve leaflets do not close fully; if an S3 or S4 is noted, consider sever regurgitation. Mitral stenosis is an outcome of a thick, stiff, and distorted leaflet from rheumatic fever. (Weber & Kelly, 2016 pp. …show more content…
The tools needed for the assessment is a perceptive visual inspection, hands for palpation, and a two part stethoscope with a diaphragm to hear high sounds and bell to hear lower sound for auscultation. Hand washing, self-introduction, and explanation of the assessment procedure is always part of any assessment; place the client in a 30 degree supine position to begin. A set of vital signs is recorded and documented that the client is hypertensive, diaphoretic, and tachycardia. (Skill assessment, 2016) Begin with inspection of the precordium at the sternal angle this will allow the nurse to identify the aortic, pulmonic, tricuspid, and mitral area for auscultation after the inspection. During the inspection the nurse is observing for any abnormality at the anterior chest wall, examined the neck for jugular vein distention which could indicate affected blood vessels that can cause a murmur. To palpate place the client on the left lateral side to palpate the apex with the two fingers or palm to assess for the pulsation of heaves or lifts. If a thrill is palpated this is a possible indication of leaky valves or stenosis which are abnormal findings. Place the stethoscope diaphragm over the apex for auscultation to determine the rate, rhythm, and heart sound characteristics, abnormal or extra heart sounds like a murmur is best heard with the bell side of the
Mid-systolic are the most common occurs during ventricular ejection, located between S1 and S2. There are four subdivisions innocent, pulmonic, aortic stenosis, and hypertrophic cardiomyopathy. Physiologic murmur is a temporary increase of blood flow located at the left sternal boarder and the apex. Pulmonic stenosis murmur happens from impeded blood flow across the pulmonic valve. Aortic stenosis murmur ensue when stenosis of the aortic valve obstructs blood flow due to a congenital abnormality, or rheumatic fever. Pan-systolic murmurs are pathological in nature. Mitral regurgitation happens when the mitral valve do not completely close and flow back into the left atrium. Tricuspid regurgitation occurs when there is a back flow into the right atrium; this is a common cause that results in pulmonary hypertension. Ventricular septal defect is a congenital abnormality where there is a hole in the septum allowing blow flow from the left ventricle into the right ventricle. Diastolic murmurs suggestive of heart disease of an ineffectual aortic valve. Aortic regurgitation happens when the aortic valve leaflets do not close fully; if an S3 or S4 is noted, consider sever regurgitation. Mitral stenosis is an outcome of a thick, stiff, and distorted leaflet from rheumatic fever. (Weber & Kelly, 2016 pp. …show more content…
The tools needed for the assessment is a perceptive visual inspection, hands for palpation, and a two part stethoscope with a diaphragm to hear high sounds and bell to hear lower sound for auscultation. Hand washing, self-introduction, and explanation of the assessment procedure is always part of any assessment; place the client in a 30 degree supine position to begin. A set of vital signs is recorded and documented that the client is hypertensive, diaphoretic, and tachycardia. (Skill assessment, 2016) Begin with inspection of the precordium at the sternal angle this will allow the nurse to identify the aortic, pulmonic, tricuspid, and mitral area for auscultation after the inspection. During the inspection the nurse is observing for any abnormality at the anterior chest wall, examined the neck for jugular vein distention which could indicate affected blood vessels that can cause a murmur. To palpate place the client on the left lateral side to palpate the apex with the two fingers or palm to assess for the pulsation of heaves or lifts. If a thrill is palpated this is a possible indication of leaky valves or stenosis which are abnormal findings. Place the stethoscope diaphragm over the apex for auscultation to determine the rate, rhythm, and heart sound characteristics, abnormal or extra heart sounds like a murmur is best heard with the bell side of the