18 Cardiovascular Sytem

Question 1

the left ventricle is located…

Answer 1

behind the right ventricle

Question 2

incompetent valves

Answer 2

a diseased valve

• either REGURGITATE or STENOSIS
• assessed as MURMURS

Question 3

Regurgitate

Answer 3

forward flow is restricted

-leads to backflow

Question 4

Stenosis

Answer 4

valve does not open completely + creates narrow opening

Question 5

atrioventricular valves

Answer 5

tricuspid (R) + mitral valves (L)

• opens as a result of atrial contraction
• closes when ventricles contract

Question 6

semilunar valves

Answer 6

pulmonary (L) + aortic valve (R)

• opens in response to ventricles contracting
• closes upon ventricle relaxation

Question 7

S1 (lub)

Answer 7

• AV valves close

- occurs when ventricles have been filled

Question 8

S2 (dub)

Answer 8

Semilunar valves close

-when ventricles have emptied their blood

Question 9

Systole

Answer 9

ventricular contraction

-begins w S1 + ends w S2

Question 10

Diastole

Answer 10

ventricular relaxation

-begins w S2 ends w S1

Question 11

S3 “ventricular gallop”

Answer 11

may be heard in children, young adults, or pregnancy (3rd trimester)

• when AV valves open, BF into ventricles cause vibrations
• heard after S2

Question 12

S4 “atrial gallop”

Answer 12

may be heard in children, well-conditioned athletes, + healthy elderlies w/i cardiac disease

• caused by atrial contraction + ejection into ventricles in late diastole
• head before S1

Question 13

heart sounds cycle

Answer 13

S1> Systole> S2> Diastole> S1

Question 14

S1 occurs during ___ is heard best on ___ at ___ position

Answer 14

start of systole, apex w diaphragm, any position

Question 15

S2 occurs during ___ is heard best on ___ at ___ position

Answer 15

end of systole, 2nd ICP [pulmo at LSB, aortc at RSB], sitting/supine

Question 16

S3 S4 are best heard at _____ and is auscultated better in _____ position

Answer 16

apex w bell, left lateral position or supine

-LOW PITCHED

Question 17

S3 abnormalities

Answer 17

occurs when ventricles have reached its elastic limit

• causes BF fr atrium to slow
• may occur w systolic or diastolic ventricular dysfunction
• ischemic hrt disease
• tricuspid, mitral, or aortic regurgitation
• vol overload
• HTN

Question 18

S4 abnormalities

Answer 18

assoc w active atrial contractn that cause late ventricular filling

• ventricular hypertrophy
• acute mI
• angina
• ventricular aneurysm
• hyperkinetic states

Question 19

pt w ____ + S3 have poor prognosis

Answer 19

HF

Question 20

heart murmurs

Answer 20

harsh blowing sounds caused by disruption of BF into heart, bw chambers or hrt, into pulmo/aortic systems

Question 21

coronary arteries fill during…

Answer 21

diastole

Question 22

Heart Murmur GRADE 1

Answer 22

• barely audible w steth

- physiologic rather than pathologic

Question 23

Heart Murmur GRADE 2

Answer 23

v soft but distinguishably audible

Question 24

Heart Murmur GRADE 3

Answer 24

mod loud

-no thrills or thrusting motion

Question 25

Heart Murmur GRADE 4

Answer 25

distinctly loud, palpable thrills

Question 26

Heart Murmur GRADE 5

Answer 26

v loud, can hear w diaphragm of chest | -palpable THRUST + thrill

Question 27

Heart Murmur GRADE 6

Answer 27

loudest, can hear w diaphragm off chest | -visible thrill + thrust

Question 28

thrills

Answer 28

soft vibratory sensation - best assessed w fingertips or palm on chest - heart murmurs grade 4+

Question 29

mitral stenosis is heard during ____ at the ____

Answer 29

diastole, apical

Question 30

tricuspid stenosis is heard during ____ at the ____

Answer 30

diastole, lower LSB

Question 31

aortic regurgitation is heard during ____ at the ____

Answer 31

early diastole, 3rd ICS LSB

Question 32

pulmonic regurgitation is heard during ____ at the ____

Answer 32

early diastole, 3rd ICS LSB

Question 33

AORTIC STENOSIS | [quality, pitch, radiation, changes w resp]

Answer 33

Q: harsh, coarse P: medium R: into neck, carotid area, down to LSB, maybe apex CR: expiration may intensify murmur

Question 34

PULMONARY STENOSIS | [quality, pitch, radiation, changes w resp]

Answer 34

Q: harsh P: medium R: toward upper left neck + shoulder CR: inspiration may intensify murmur

Question 35

MITRAL STENOSIS | [quality, pitch, radiation, changes w resp]

Answer 35

Q: rumbling P: low R: rare CR: expiration may intensify murmur

Question 36

TRICUSPID STENOSIS | [quality, pitch, radiation, changes w resp]

Answer 36

Q: rumbling P: low R: rare CR: inspiration may intensify murmur

Question 37

AORTIC REGURGITATION | [quality, pitch, radiation, changes w resp]

Answer 37

Q: blowing P: high R: 2nd ICS, RSB, maybe apex CR: expiration may intensify murmur if pt leans forward or sits up

Question 38

PULMONARY REGURGITATION | [quality, pitch, radiation, changes w resp]

Answer 38

Q: blowing P: high R: 2nd ICS, RSB, maybe apex CR: inspiration may intensify murmur

Question 39

MITRAL REGURGITATION | [quality, pitch, radiation, changes w resp]

Answer 39

Q: blowing + harsh P: high R: left axilla, LSB, base CR: expiration may intensify murmur

Question 40

TRICUSPID REGURGITATION | [quality, pitch, radiation, changes w resp]

Answer 40

Q: blowing P: high R: may radiate to LSB +MCL but not axilla CR: inspiration may intensify murmur

Question 41

landmark for 2nd ICS

Answer 41

angle of louis

Question 42

P wave

Answer 42

atrial depolarization - initiation of electrical current of SA node - 0.08sec

Question 43

PR interval

Answer 43

time needed for electrical current to travel across both atria + arrive at AV node -0.12-0.20sec

Question 44

QRS complex

Answer 44

ventricular depolarization | -0.08-0.11sec

Question 45

T wave

Answer 45

ventricular repolarization

Question 46

nearly half of african americans have some type of ___

Answer 46

cardiovascular disease | -next common are latino/hispanics

Question 47

how socioeconomic affects cardiovasc disease

Answer 47

- higher incidence of HTN (esp fem) - stress r/t low income - limited exercise - diets w sat fats - lack of access to quality healthcare

Question 48

wt gain/loss may be assoc w

Answer 48

systemic disease like diabetes | -----DM incr risk for cardiovasc disease

Question 49

types of possible infections

Answer 49

- rheumatic fever - viral illness - endocarditis - pericarditis

Question 50

symtoms to suggest cardiovasc disease

Answer 50

- activity intolerance - loss of appetite - bloody sputum - change in sex activity - confusion/difficulty thinking - chest discomfort - cough - dizzy - dyspnea - fatigue - fever - hoarseness - frequent urinatn at night - leg pain after activity - syncope - palpitation - swelling

Question 51

females w angina

Answer 51

atypical symptoms - burning/tenderness in back, shoulders, jaw - may have no chest discomfort

Question 52

females w MI

Answer 52

- SOB - N/V - indigestion - extreme fatigue

Question 53

males w angina/MI

Answer 53

typical symptoms - prolonged dull chest pain radiating to shoulder or jaw accompanies by diaphoresis - SOB - N/V

Question 54

lack of ___ in diet may compromise cardiac function

Answer 54

proteins

Question 55

smoking

Answer 55

- linked w HTN - strongly suspected w injury to walls - injures inner walls of arterial vessels

Question 56

cocaine

Answer 56

- coronary artery spasms - potential dvlpt of ischemia - injury of myocardial tissue

Question 57

menopause

Answer 57

the earlier menopause starts, the greater the risk of heart disease

Question 58

pulsation over pericardium is normally absent, however...

Answer 58

aortic pulsation may be visible w thin pt

Question 59

palpations over pericardium normally has slight vibration in ____ only

Answer 59

apical area

Question 60

name of heart locations

Answer 60

``` AORTIC PULMONIC ERBS TRICUSPID MITRAL ```

Question 61

S2 is louder than S1 in...

Answer 61

aortic valve + pulmonic valve

Question 62

S1 is equal to S2 in...

Answer 62

Erb's point | -3 ICS, LSB

Question 63

S1 is louder than S2 in...

Answer 63

tricuspid valve + apical valve

Question 64

S3 + S4 is best heard in which position?

Answer 64

when pt rolls onto left side | -over mitral area