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27 Cards in this Set
- Front
- Back
vesicular breath sound
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Heard over the thorax (Lung Tissue), a low pitched rustling sound with a high intensity inspiratory phase which is continuous with a less intense and shorter expiratory phase, which normally extends to less than one third of inspiratory phase.
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Diastole
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Represents the period of time when the ventricles are relaxed (not contracting).Throughout most of this period, blood is passively flowing from the left atrium (LA) and right atrium (RA) into the left ventricle (LV) and right ventricle (RV), respectively (see figure at right). The blood flows through atrioventricular valves (mitral and tricuspid) that separate the atria from the ventricles. The RA receives venous blood from the body through the superior vena cava (SVC) and inferior vena cava (IVC). The LA receives oxygenated blood from lungs through four pulmonary veins that enter the LA. At the end of diastole, both atria contract, which propels an additional amount of blood into the ventricles.
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Diastole & Systole
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A single cycle of cardiac activity can be divided into two basic phases -
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Causes for decreased intensity of normal vescular breath sound.
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1. Pleural effusion (Separation of conducting units from chest wall)
2. Pleural thickening (-do-) 3. Collapsed lung with occluded bronchus (Loss of conducting pathways) 4. Emphysema (Loss of laminar flow and low velocity airflow due to distended acinus) 5. Bronchial asthma (occlusion of conducting airways) 6. Thick chest wall (eg;Obesity)(separation of steth from the area of activity” lung”). |
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Vesicle
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small vessels
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Bronchial Breath Sounds
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Breath sounds heard over the tracheobronchial tree have a higher pitch, louder, inspiration and expiration are equal and there is a pause between inspiration and expiration.
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Respiratory Exam
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1. Note the intensity of breath sounds
2. symmetry 3. length of inspiration and expiration 4. Listen for the pause between inspiration, expiration 5. Quality of pitch of the sound. 6. Compare the intensity of breath sounds between upper and lower chest in upright position. 5. Compare the intensity of breath sounds from dependent to top lung in the decubitus position. 6. Note the presence or absence of adventitious sounds. |
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Systole
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the time during which the left and right ventricles contract and eject blood into the aorta and pulmonary artery, respectively. The aortic and pulmonic valves open to permit ejection into the aorta and pulmonary artery. The atrioventricular valves are closed, therefore no blood is entering the ventricles; however, blood continues to enter the atria though the vena cavae and pulmonary veins.
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ATRIAL SYSTOLE
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The end of diastole
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During atrial systole
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the atrium contracts and tops off the volume in the ventricle with only a small amount of blood. Atrial contraction is complete before the ventricle begins to contract.
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Atrial pressure
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The "a" wave occurs when the atrium contracts, increasing atrial pressure (yellow). Blood arriving at the heart cannot enter the atrium so it flows back up the jugular vein, causing the first discernible wave in the jugular venous pulse. Atrial pressure drops when the atria stop contracting.
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A fourth heart sound (S4)
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abnormal and is associated with the end of atrial emptying after atrial contraction. It occurs with hypertrophic congestive heart failure, massive pulmonary embolism, tricuspid incompetence, or cor pulmonale.
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The P wave
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Due to this atrial depolarization.
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The PR segment
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Electrically quiet as the depolarization proceeds to the AV node. This brief pause before contraction allows the ventricles to fill completely with blood.
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Heart Valves
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Open and close during the cardiac cycle in response to differences in blood pressure on their two sides.
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Phases of the Cardiac Cycle
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1. Ventricular Filling
2. Ventricular Relaxation 3. Isovolumetric Relaxation |
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Ventricular Filling (Mid-to-late ventricular diastole)
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Blood flows passively into the atria, through open AV valves, and into the ventricles, where the pressure is lower.
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Ventricular Filling (Mid-to-late ventricular diastole)
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Atria contract, forcing the remaining blood into ventricles.
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Ventricular Systole
Isovolumetric Contraction |
Ventricles contract and intraventricular pressure rises, closing AV valves. Briefly, ventricles are completely closed chambers.
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Ventricular Systole
Ventricular Ejection |
Rising ventricular pressure forces semilunar valves open. Blood is ejected from the heart.
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Isovolumetric Relaxation
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Ventricles relax and ventricular pressure drops. Blood backflows, closing semilunar valves. Ventricles are totally closed off again.
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Isovolumetric Relaxation
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2. The atria have been filling with blood. When atrial pressure exceeds ventricular pressure, AV valves open and ventricular filling, phase one begins again.
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Flow of Blood through Right Side of Heart
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1. Right Atrium
2. R atrioventricular valve opens 3. R ventricle fills 4. Pulmonary semilunar valve opens. 5. Blood flows through pulmonary semilunar valve to pulmonary trunk. |
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Isovolumetric Contraction
Valves are? |
AV valve is closed
Semilunar valve is closed |
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Isovolumetric Relaxation valves are?
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AV valve is closed
Semilunar valve is closed |
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Ventricular ejection
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AV valve is closed
Semilunar valve is open |
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Ventricular Filling
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AV valve is open
Semilunar valve is closed |