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63 Cards in this Set
- Front
- Back
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Why is the heart important? |
you can't live without a functioning cardiovascular system it is one of the first developed and functioning systems in utero cardiovascular disease is the leading cause of death in the U.S. |
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Anatomy of Cardiac System |
heart: pumps the blood arteries, capillaries and vines: the pipes that carry the blood Lymphatics: help drain extra fluid from the periphery |
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Goal of the cardiovascular system |
goal is to move oxygen and nutrients to the cells and to remove waste |
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where is the apex of the heart? |
bottom of the heart (upside down triangle) its in the 5th intercostal mid clavicular line |
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pericardium |
outer membrane, sac the heart sits inside 10-15 mL of fluid to help prevent friction onto the pericardial sac |
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myocardium |
muscle---where there are heart attacks |
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endocardium |
inner covering (inside) |
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blood flow through the heart |
venous system right side of the heart lungs left side of the heart to the body |
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superior vena cava |
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arteries vs veins |
away from the heart veins return to the heart, to the heart |
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how many chambers in the heart? |
four |
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chambers |
atrial and ventricles |
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valves |
AV valves -tripcuspid (3 leaflets, right) -mitral (bicuspid, left) Semi-lunar valves-ventricles to the arteries -pulmonic -aortic (left) |
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mitrovalve prolapse |
valve goes back down the cycle and makes a mid systolic click |
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pressure system in the left and right side of the heart |
left side is a high pressure system and right side is a low pressure system because the muscle is not as thick on the right and the left is known as the muscle horse of the heart
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diastole |
20% of cardiac output ventricles are relaxed AV values are open Atria contract at end of diastole Hear S1 at the end (lub sound) takes 2x as long this is where the heart fills with blood |
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Systole |
quick ventricles contract semi-lunar valves open hear S2 sound (dub sound) |
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Normal sounds of the heart |
S1 -closure of AV valves -heart filled with blood -end of diastole S2 -closure of semi-lunar valves -end of systole |
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Abnormal sounds of the heart |
S3 -heard mid-diastole -fluid overload states -CHF and pregnancy S4 -heart end of diastole -ventricular non-compliance -CAD, MI |
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cardiac conduction |
the heart has its own conduction system affected by sympathetic and parasympathetic systems heart cells can trigger own electrical impulse |
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normal pathway of the cardiac conduction |
SA node (pacemaker) 60-100 bpm internodal pathways AV node-gait keeper 40-60 bpm bundle branches Purkinje fibers 10-40 bpm |
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p wave |
atrial contraction |
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PR intervnal |
length in time impulse of SA to atria to AV node |
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QRS |
ventricular contraction Systole |
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QT interval |
total ventricular cycle time |
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T wave |
ventricular relaxation |
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positive vs negative charge |
negative-rest, polarized positive-more depolarized and muscles then contract |
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Developmental considerations-infants |
heart starts beating at 3 weeks gestation heart is more horizontal-apex is at 4th ICS MCL Altered circulation of oxygenated blood Cardiac disorders: PDA , VSD, Tetralogy of Fallot (4 components, unoxygenated) |
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how many years until the heart moves to the 5th intercostal space, mid clavicular line |
7-8 years |
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PDA |
Patient Ductus Arteriosis, unoxygenated blood flows pulmonary artery doesn't close to the aorta |
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VSD |
ventral septal defect whole, blood shifts right to left, (unoxygenated) |
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Developmental Considerations -Children |
Heart rate varies 70-110, 120 murmurs are common look for any developmental delays, issues with fatigue or exercise intolerance history of infections-strep, bacterial endocarditis |
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Developmental Considerations-Pregnancy |
blood volume increases 30-40% Heart Rate increases by 10-15 bpm increased peripheral vasodilation, blood vessels get wider to arteries dilate causes blood pressure to decrease Murmurs or S3 can be common |
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Developmental Considerations-Elderly |
decreased ability to compensate with cardiac output-tired, no stairs, heart doesn't respond as quick orthostatic hypotension-blood pressure decreased when you stand/sit up dysthrythmias decreased venous return-all blood flow isn't returning like it should atherosclerosis-vessels don't respond, stuck like straw Increased Blood Pressure 140-150-systolic |
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Cultural Considerations-hypertension |
high incidence among blacks, puerto ricans, cubans, mexications |
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Cultural Considerations-smoking |
more blacks and Hispanic men, decreased socioeconomic status |
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Cultural Considerations-cholesterol |
whites > blacks black males have better HDLs (good) |
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Cultural Considerations - obesity |
black and hispanic females |
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Cultural Considerations- diabetes |
native americans (20%) , blacks, hispanics |
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Subjective Data-infants and children |
maternal health during pregnancy nursing habits-feed 15-20 minutes at a time before getting tired growth-milestones strep throat |
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Subjective Data-Pregnancy |
blood pressure should be decreased, increase should be looked at edema fainting/dizziness headaches pre-eclampsia detrimental for mom and baby, protein in the urine |
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JVP-jugular venous pressure-right side of the heart |
elevate HOB for 45 degrees look for highest level of pulsation place ruler on sternal angle measure vertical distance between the sternal angle and the pulsation normal is less than one inch hepatojulgular reflex |
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Inspection |
Apical Impulse should be in the 5th intercostal mid clavicular line use one finger the patient to exhale and hold |
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palpation |
use palms apex, sternal border based heave-pounding thrill-purring, turbulent blood flow |
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auscultation |
diaphragm rate and rhythm, S1, S2 Extra Hear Sounds Murmurs Repeat with Bell Apex in Left Lateral position Base when Sitting up APE TO MAN |
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Split 2 |
normal in some people at end inspiration |
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pericaridal rub |
common in pericarditis or post MI, sounds like rubbing rubber together |
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Murmurs |
timing loudness (1-6) pitch pattern quality location radiation posture |
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Angina |
Chest pain that occurs when the heart's vascular supply cannot keep up with metabolic demand |
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S3 |
Ventricular gallop, a pathological heart sound that occurs with heart failure |
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S4 |
Atrial gallop, a pathological heart sound that occurs with coronary artery disease |
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Pericardial friction Rub |
inflammation of the precordium causes this sound, which is high pitched and scratchy |
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Mitral |
regurgitation through this heart valve results in left ventricular hypertrophy |
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Midsystolic click |
this sound is caused by mitral valve prolapse |
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Venous hum |
this sound is caused by turbulent blood flow, yet is common in normal children |
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Dextrocardia |
a rare anomaly in which the heart is located on the right side of the chest |
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S1 |
the heart sound that occurs at the beginning of systole and is caused by the closure of the AV valves |
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Murmur |
a gentle blowing, swooshing sound that can be heard on the chest wall |
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Thrill |
a palpable vibration that feels like a throat of a purring cat and signifies turbulent blood flow |
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Jugular Veins |
these vessels reflect filling pressure and volume changes of the right side of the heart |
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Tetralogy of Fallot |
a congenital heart defect that has four components |
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Ventricular septal defect |
abnormal opening in the septum between the ventricles |
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Patent Ductus Ateriosus |
a persistence of the channel that joins the left pulmonary artery to the aorta. This is normal in the fetus and normally closes within hours of birth |
