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Physical Assessment > 18 Cardiovascular Sytem > Flashcards

18 Cardiovascular Sytem Flashcards

1
Q

the left ventricle is located…

A

behind the right ventricle

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2
Q

incompetent valves

A

a diseased valve

  • either REGURGITATE or STENOSIS
  • assessed as MURMURS
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3
Q

Regurgitate

A

forward flow is restricted

-leads to backflow

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4
Q

Stenosis

A

valve does not open completely + creates narrow opening

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5
Q

atrioventricular valves

A

tricuspid (R) + mitral valves (L)

  • opens as a result of atrial contraction
  • closes when ventricles contract
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6
Q

semilunar valves

A

pulmonary (L) + aortic valve (R)

  • opens in response to ventricles contracting
  • closes upon ventricle relaxation
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7
Q

S1 (lub)

A
  • AV valves close

- occurs when ventricles have been filled

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8
Q

S2 (dub)

A

Semilunar valves close

-when ventricles have emptied their blood

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9
Q

Systole

A

ventricular contraction

-begins w S1 + ends w S2

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10
Q

Diastole

A

ventricular relaxation

-begins w S2 ends w S1

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11
Q

S3 “ventricular gallop”

A

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

  • when AV valves open, BF into ventricles cause vibrations
  • heard after S2
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12
Q

S4 “atrial gallop”

A

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
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13
Q

heart sounds cycle

A

S1> Systole> S2> Diastole> S1

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14
Q

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

A

start of systole, apex w diaphragm, any position

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15
Q

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

A

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

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16
Q

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

A

apex w bell, left lateral position or supine

-LOW PITCHED

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17
Q

S3 abnormalities

A

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
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18
Q

S4 abnormalities

A

assoc w active atrial contractn that cause late ventricular filling

  • ventricular hypertrophy
  • acute mI
  • angina
  • ventricular aneurysm
  • hyperkinetic states
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19
Q

pt w ____ + S3 have poor prognosis

A

HF

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20
Q

heart murmurs

A

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

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21
Q

coronary arteries fill during…

A

diastole

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22
Q

Heart Murmur GRADE 1

A
  • barely audible w steth

- physiologic rather than pathologic

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23
Q

Heart Murmur GRADE 2

A

v soft but distinguishably audible

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24
Q

Heart Murmur GRADE 3

A

mod loud

-no thrills or thrusting motion

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25
Q

Heart Murmur GRADE 4

A

distinctly loud, palpable thrills

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26
Q

Heart Murmur GRADE 5

A

v loud, can hear w diaphragm of chest

-palpable THRUST + thrill

27
Q

Heart Murmur GRADE 6

A

loudest, can hear w diaphragm off chest

-visible thrill + thrust

28
Q

thrills

A

soft vibratory sensation

  • best assessed w fingertips or palm on chest
  • heart murmurs grade 4+
29
Q

mitral stenosis is heard during ____ at the ____

A

diastole, apical

30
Q

tricuspid stenosis is heard during ____ at the ____

A

diastole, lower LSB

31
Q

aortic regurgitation is heard during ____ at the ____

A

early diastole, 3rd ICS LSB

32
Q

pulmonic regurgitation is heard during ____ at the ____

A

early diastole, 3rd ICS LSB

33
Q

AORTIC STENOSIS

[quality, pitch, radiation, changes w resp]

A

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

34
Q

PULMONARY STENOSIS

[quality, pitch, radiation, changes w resp]

A

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

35
Q

MITRAL STENOSIS

[quality, pitch, radiation, changes w resp]

A

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

36
Q

TRICUSPID STENOSIS

[quality, pitch, radiation, changes w resp]

A

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

37
Q

AORTIC REGURGITATION

[quality, pitch, radiation, changes w resp]

A

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

38
Q

PULMONARY REGURGITATION

[quality, pitch, radiation, changes w resp]

A

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

39
Q

MITRAL REGURGITATION

[quality, pitch, radiation, changes w resp]

A

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

40
Q

TRICUSPID REGURGITATION

[quality, pitch, radiation, changes w resp]

A

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

41
Q

landmark for 2nd ICS

A

angle of louis

42
Q

P wave

A

atrial depolarization

  • initiation of electrical current of SA node
  • 0.08sec
43
Q

PR interval

A

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

44
Q

QRS complex

A

ventricular depolarization

-0.08-0.11sec

45
Q

T wave

A

ventricular repolarization

46
Q

nearly half of african americans have some type of ___

A

cardiovascular disease

-next common are latino/hispanics

47
Q

how socioeconomic affects cardiovasc disease

A
  • higher incidence of HTN (esp fem)
  • stress r/t low income
  • limited exercise
  • diets w sat fats
  • lack of access to quality healthcare
48
Q

wt gain/loss may be assoc w

A

systemic disease like diabetes

—–DM incr risk for cardiovasc disease

49
Q

types of possible infections

A
  • rheumatic fever
  • viral illness
  • endocarditis
  • pericarditis
50
Q

symtoms to suggest cardiovasc disease

A
  • 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
51
Q

females w angina

A

atypical symptoms

  • burning/tenderness in back, shoulders, jaw
  • may have no chest discomfort
52
Q

females w MI

A
  • SOB
  • N/V
  • indigestion
  • extreme fatigue
53
Q

males w angina/MI

A

typical symptoms

  • prolonged dull chest pain radiating to shoulder or jaw accompanies by diaphoresis
  • SOB
  • N/V
54
Q

lack of ___ in diet may compromise cardiac function

A

proteins

55
Q

smoking

A
  • linked w HTN
  • strongly suspected w injury to walls
  • injures inner walls of arterial vessels
56
Q

cocaine

A
  • coronary artery spasms
  • potential dvlpt of ischemia
  • injury of myocardial tissue
57
Q

menopause

A

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

58
Q

pulsation over pericardium is normally absent, however…

A

aortic pulsation may be visible w thin pt

59
Q

palpations over pericardium normally has slight vibration in ____ only

A

apical area

60
Q

name of heart locations

A 
AORTIC
PULMONIC
ERBS
TRICUSPID
MITRAL
61
Q

S2 is louder than S1 in…

A

aortic valve + pulmonic valve

62
Q

S1 is equal to S2 in…

A

Erb’s point

-3 ICS, LSB

63
Q

S1 is louder than S2 in…

A

tricuspid valve + apical valve

64
Q

S3 + S4 is best heard in which position?

A

when pt rolls onto left side

-over mitral area

Physical Assessment (20 decks)

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