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75 Cards in this Set
- Front
- Back
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precordium
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area on anterior chest overlying the heart and great vessels
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The heart is shaped like an upside down triangle - the “top” is the _____ and the “bottom” is the ______.
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base; apex
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apical impulse
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the apex of the heart beats against the chest wall to produce the
apical impulse, palpable
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myocardium
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muscular wall of heart, it does the pumping
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Identify the 4 valves of the heart.
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Atrioventricular (AV valves)
-Tricuspid -Mitral Semilunar (SL) valves -Pulmonary -Aortic Tip: ATM SPA |
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Describe the direction of blood flow.
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Right atrium
Tricuspid AV Valve Right ventricle Pulmonary valve Pulmonary vein to lungs * Come back via pulmonary arteries * Left atrium Mitral AV valve Left ventricle Aortic valve into aorta Go to body/tissues |
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cardiac cycle
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rhythmic movement of blood through the heart; 2 parts are diastole and systole
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Describe what occurs during diastole vs. systole.
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diastole - ventricles relax and fill with blood
systole - blood is pumped from the ventricles and fills the pulmonary and systemic arteries, mitral and tricuspid valves close |
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Identify and describe the 2 normal heart sounds.
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S1 - 1st heart sound; occurs with closure of the AV valves and thus signals the
beginning of systole. S1 usually loudest at the apex, but heard throughout the
precordium LUB
S2 - 2nd heart sound; occurs with closure of the semilunar valves and signals the end of systole. S2 loudest at the base, but heard throughout the precordium DUB |
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What heart sounds account for "lub" and "dub"?
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lub = S1
dub = S2 |
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Where is S1 the loudest?
Where is S2 the loudest? |
S1 (lub) = apex
S2 (dub) = base |
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Identify and describe the 3 extra heart sounds.
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S3 - vibrations during ventricular filling
S4 - atria contract and push blood into a noncompliant ventricle which creates vibration Murmurs - turbulent blood flow and collision currents against cardiac chambers and/or valves (swooshing sound) |
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Identify the ethnicity that has the highest incidence of heart disease, hypertension, and diabetes.
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African Americans
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thrill
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palpable vibration
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thrombus
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blood clot
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bruit
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turbulent sound heard in jugular vein
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apical pulse
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point of maximal impulse (PMI)
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pericardium
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outer sac of heart
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ischemia
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decreased muscle oxygenation
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congestive heart failure (CHF)
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heart has inability to pump enough blood to meet metabolic demands of body; left and right-sided
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diastole
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filling phase of the heart
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systole
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pumping phase of heart
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Korotkoff sounds
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sounds heard during a blood pressure reading
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murmur
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soft blowing or rasping sound; extra heart sound
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stenosis
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abnormal narrowing of a passage in the body.
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Why does a bruit occur?
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Occurs with turbulent blood flow, indicating partial occlusion
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Identify the 10 peripheral pulses and their locations.
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Identify the 2 ________ valves that separate the atria and ventricles.
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Atrioventricular (AV) Valves - separate the atria and ventricles.
o Tricuspid Valve - Right AV valve o Mitral Valve - Left AV valve Tip: ATM |
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Identify the 2 ________ valves that separate the ventricles and arteries.
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Semilunar valves
o Pulmonic Valve - Right side of heart o Aortic - Left side of heart Tip: SPA |
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The heart is actually 2 pumps, the R side of the heart pumps blood into the _____, the L side pumps blood into the ______.
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lungs, body
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The closure of the AV valves contributes to the ____ heart sound.
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S1 (first heart sound)
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Closure of the semilunar valves causes the _____ heart sound.
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S2 (second heart sound)
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cardiac output (CO)
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the volume of blood ejected from the left side of the heart in one minute
stroke volume x heart rate |
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preload vs afterload
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preload - amount of blood that is sitting in heart before it contracts; ending diastolic volume
afterload - pressure heart must overcome in order to eject that heart into the body; mean arterial pressure |
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How does a faster heart rate affect cardiac output and oxygen needs?
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Faster heart rate means less time the heart has for filling, which means a decreased cardiac output.
Increased HR = increased oxygen consumption. |
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Identify the 2 jugular veins. Which of these do we assess?
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Internal and external jugular veins.
We assess external jugular vein b/c it tells us something about the R side of heart. |
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orthopnea
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difficulty breathing during sleep or lying down
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Identify possible cause(s) for cyanosis and pallor.
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Myocardial infarction due to decreased cardiac output
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Identify the 5 sites for auscultation.
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• Aortic (® 2nd interspace),
• Pulmonic (L 2nd interspace), • Erb’s Point (L 3rd interspace), • Tricuspid (L lower sternal border, 4-5 interspace), • Mitral (5th interspace, L midclavicular line) Tip: APE TM |
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State the location of the follwing auscultation assessment point: aortic area.
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Second intercostal space, right sternal border
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State the location of the follwing auscultation assessment point: pulmonic area.
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Second intercostal space, left sternal border
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State the location of the follwing auscultation assessment point: Erb's point area.
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Third intercostal space, left sternal border
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State the location of the follwing auscultation assessment point: tricuspid area.
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Fourth intercostal space, left sternal border
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State the location of the follwing auscultation assessment point: mitral area.
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Fifth intercostal space, left sternal border
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Murmur that occurs BETWEEN S1 and S2 is a ______ murmur.
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systolic
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Identify the grade(s) of the following murmur: there is a sound, but not palpable.
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Grade 1-3
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Identify the grade(s) of the following murmur: palpable thrill.
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Grade 4-6
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Identify the grade(s) of the following murmur: still heard with entire stethoscope lifted off the chest.
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Grade 6
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Identify the grade(s) of the following murmur: heard with 1 corner of the stethoscope lifted off the chest wall.
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Grade 4-5
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Patent Ductus Arteriosus (PDA)
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channel joining left pulmonary artery to aorta
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Atrial Septal Defect (ASD)
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abnormal opening of the atrial septum resulting
usually in L to R shunt and causing large increase in pulmonary blood flow
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Ventricular Septal Defect (VSD)
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abnormal opening in septum between
ventricles (usually sub aortic area)
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Tetralogy of Fallot
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4 components: shunts a lot of venous blood directly into
aorta away from pulmonary system so blood never gets oxygenated
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Identify the 4 components of the tetralogy of fallot. ("falloh")
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• R ventricular outflow stenosis (Pulmonic stenosis)
• R ventricular hypertrophy • Overriding aorta • VSD Tip: PROV that you have tetralogy of fallot. |
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Coarctation of the Aorta
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severe narrowing of descending aorta, increase
workload on L ventricle
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Mitral Regurgitation
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stream of blood regurgitates back into L atria during
systole through incompetent mitral valve; in diastole, blood passes back into L ventricle again along with new flow
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Identify the grading scale for pulses.
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4+ - bounding (can be seen sometimes),
3+ - increased, 2+ - normal, 1+ - weak, 0- absent |
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If you don’t feel pulse, it is absent. You would need to assess it via ______.
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Doppler
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What is Allen's Test for?
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Testing if ulnar or radial artery is occluded.
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Describe how to perform Allen's Test.
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Compress both radial and ulnar arteries with your
thumbs, ask pt to open and close fists several times, continue to compress the arteries then have pt open their hands, the palms should turn pink promptly
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Is Allen's Test routine?
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No.
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Identify the edema grading scale.
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o 1+ - mild pitting, slight indentation, no perceptible swelling of the leg
o 2+ - moderate pitting, induration subsides rapidly o 3+ - deep pitting, indentation remains for a short time, leg looks swollen o 4+ - very deep pitting, indentation lasts a long time, leg is very swollen |
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Raynaud’s Syndrome
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abrupt episodes of decreased circulation in the hands and
sometimes the feet resulting in color change (pallor to cyanotic) from exposure to cold (most common), vibration, or stress
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Lymphedema
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abnormal drainage of lymph causes protein rich lymph to build up in the interstitial spaces which further raises local colloid oncotic pressure and promotes more fluid leakage
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Arteriosclerosis/Ischemic Ulcer
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build up of fatty plaques on intima (artherosclerosis) plus hardening and calcification of arterial wall (arteriosclerosis)
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Venous Stasis/Ulcer
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following acute deep vein thrombosis or following chronic incompetent valves in deep veins
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Brown color on a venous stasis/ulcer is from ________.
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iron in hemoglobin
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varicose veins
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incompetent valves permit reflux of blood, producing dilated, tortuous veins
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Deep Vein Thrombophlebitis (DVT)
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a deep vein is occluded by a thrombus, causing inflammation, blocked venous return, cyanosis and edema
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Who is at risk for deep vein thrombophlebitis?
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Hospital patients on bed rest or immobile individuals.
This is why we ambulate patients by having them get up/walk around. |
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aneurysm
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sac formed by dilation in the artery wall
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Murmur that occurs AFTER S2 is a ______ murmur.
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diastolic
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Systolic murmurs are associated with _____.
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associated with mechanical systolic and ventricular ejection
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Diastolic murmurs are associated with _____.
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associated with ventricular relaxation and filling
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_________ should be performed before radial arterial cannulation to evaluate radial and ulnar arterial patency.
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Allen's test
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