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Health Assessment I > Assessing Heart and Neck Vessels > Flashcards

Assessing Heart and Neck Vessels Flashcards

1
Q

What are the great vessels?

A

Large veins and arteries leading directly to and away from the heart

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2
Q

The superior and inferior vena cava return the blood to the ___ from the ____

A

right atrium

from the upper and lower torsos

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3
Q

Blood vessel that returns oxygenated blood to the left atrium

A

Pulmonary veins

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4
Q

The anterior chest area that overlies the heart and great vessels is called the

A

Precordium

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5
Q

Layer of endothelial tissue that forms the innermost layer of the heart

A

Endocardium

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6
Q

T/F the endocardium is continuous with the endothelial lining of the blood vessels

A

True

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7
Q

Thickest layer of the heart is known as the..

A

myocardium

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8
Q

The myocardium is made of what kind of cell?

A

contractile cardiac muscle cells

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9
Q

Serous membrane lining that secretes a small amount of pericardial fluid for friction-free muscle contraction

A

Parietal pericardium

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10
Q

tough, inextensible, loose-fitting, fibroserous sac that attaches to the great vessels and surrounds the heart

A

Pericardium

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11
Q

T/F the SA node conducts both atria simultaneously

A

True

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12
Q

What is the rate of the rhythmicity of the SA node?

A

60 to 100/min

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13
Q

T/F the AV slightly delays incoming electrical impulses from the atria and then relays the impulse to the AV bundle

A

True

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14
Q

T/F Purkinje fibers contract asynchronouslu

A

False

They contract simultaneously

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15
Q

What is known as the pacemaker of the heart?

A

SA node

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16
Q

What phase of the ECG depicts atrial depolarization?

A

P wave

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17
Q

What phase of the ECG depicts ventricular depolarization?

A

QRS complex

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18
Q

What phase of the ECG depicts atrial repolarization?

A

QRS complex

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19
Q

On the ECG, this phase is the period between ventricular depolarization and the beginning of ventricular repolarization

A

ST segment

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20
Q

What phase of the ECG depicts ventricular repolarization?

A

T wave

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21
Q

What phase of the ECG depicts the time beginning atrial depolarization to the beginning of ventricular depolarization?

A

PR interval

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22
Q

What phase of the ECG depicts total time for ventricular depolarization and repolarization?

A

QT interval

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23
Q

What phase of the ECG may or may not be present?

A

U wave

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24
Q

T/F If the U wave is present it follows the QRS complex representing atrial fibrilation

A

False

U wave follows the T wave and represents the final phase of ventricular repolarization.

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25
Q

Diastole describes what cardiac event?

A

Relaxation of ventricles (filling)

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26
Q

Systole describes what cardiac event?

A

Contraction of the ventricles (emptying)

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27
Q

T/F During ventricular diastole, the AV valves are open and the ventricles are relaxed. This causes higher pressure in the atria than in the ventricles.

A

True

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28
Q

Early, rapid, passive filling is called…

A

Early or Protodiastolic filling

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29
Q

The final act of filling is called ___ and raises ___ pressure (heart chamber)

A

This final active filling phase is called presystole, atrial systole, or sometimes the atrial kick. This action raises left ventricular pressure.

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30
Q

T/F During systole, the pressure in the atria are higher than ventricles

A

False

The pressure in the ventricles are higher than the atria during systole.

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31
Q

Closure of the AV valve produces what sound?

A

S1, First heart sound ; Lub

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32
Q

Name the process when valve closure prevents blood from backflowing

A

Regurgitation

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33
Q

What is isometric contraction?

A

All 4 points are closed and the ventricles contract

34
Q

How are heart sounds produced?

A

Valve closure

35
Q

T/F If the first heart sound is heart as two sounds, the first component represents mitral valve closure (M1) and the second component represents tricuspid closure (T1).

A

True

36
Q

Where is the best location to auscultate for S1?

A

At the apex, left left midclavicular line (MCL), 5th intercostal space (ICS).

37
Q

What is an accentuated S1

A

An accentuated S1 sound is louder than an S2. This occurs when the mitral valve is wide open and closes quickly.

38
Q

What is a diminished S1?

A

Sometimes the S1 sound is softer than the S2 sound. This occurs when the mitral valve is not fully open at the time of ventricular contraction and valve closing

39
Q

What is a split S1?

A

This occurs when the left and right ventricles contract at different times (asynchronous ventricular contraction).

40
Q

What is a varying S1?

A

This occurs when the mitral valve is in different positions when contraction occurs.

41
Q

Why might varying S1 occur?

A

(1) atria and ventricles beat independently
(2) total irregular rhythm

42
Q

Why might split S1 occur?

A

(1) Conduction delaying the cardiac impulse to one of the ventricles, as in bundle branch block
(2) Ventricular ectopy in which the impulse starts in one ventricle, contracting it first, and then spreads to the second ventricle

43
Q

What is an accentuated S2?

A

An accentuated S2 means that S2 is louder than S1. This occurs in conditions in which the aortic or pulmonic valve has a higher closing pressure

44
Q

What is a diminished S2?

A

A diminished S2 means that S2 is softer than S1. This occurs in conditions in which the aortic or pulmonic valves have decreased mobility.

45
Q

What is a wide split S2?

A

This is an increase in the usual splitting that persists throughout the entire respiratory cycle and widens on expiration. It occurs when there is delayed electrical activation of the right ventricle.

46
Q

What is a fixed split S2?

A

This is a wide splitting that does not vary with respiration. It occurs when there is delayed closure of one of the valves.

47
Q

What is a reversed split S2?

A

This is a split S2 that appears on expiration and disappears on inspiration. It occurs when closure of the aortic valve is abnormally delayed, causing A2 to follow P2 in expiration. Normal inspiratory delay of P2 makes the split disappear during inspiration.

48
Q

What are extra heart sounds and what do they result from?

A

S3 and S4 are referred to as diastolic filling sounds, or extra heart sounds, which result from ventricular vibration secondary to rapid ventricular filling

49
Q

Identify 4 conditions that contribute to turbulent blood flow

A

(1) increased blood velocity, (2) structural valve defects, (3) valve malfunction, and (4) abnormal chamber openings (e.g., septal defect).

50
Q

What is cardiac output

A

amount of blood pumped by the ventricles during a given period of time (usually 1 minute) and is determined by the stroke volume (SV) multiplied by the heart rate (HR): SV × HR = CO.

51
Q

What is the normal adult CO?

A

5 to 6 L/min

52
Q

What is stroke volume?

A

amount of blood pumped from the heart with each contraction

53
Q

Which jugular vein is superficial? And which muscle are they next to?

A

External jugular veins.
Jugular veins lie lateral to the sternocleidomastoid

54
Q

a wave of jugular venous pulse

A

reflects rise atrial pressure that occurs with atrial contraction

55
Q

x descent of jugular venous pulse

A

reflects RA relaxation and descent of the atrial floor during ventricular systole

56
Q

v wave of jugular venous pulse

A

reflects RA filling, increased volume, and increased atrial pressure

57
Q

y descent of jugular venous pulse

A

reflects RA emptying into RV and decrease atrial pressure

58
Q

The pressure the heart must exert to pump blood out of the ventricles.

A

Afterload

59
Q

You hear this when auscultating over the second intercostal space, right sternal border

A

Aortic valve

60
Q

The volume of blood ejected by the heart with each contraction

A

Stroke Volume

61
Q

The amount of cardiac muscle stretch before each contraction

A

Preload

62
Q

What is the volume of blood per contraction?

A

70 mL

63
Q

If we have increase preload, what does that mean?

A

It means increased stretch, fluid volume overload, edema

64
Q

If we have decreased preload, what does that mean?

A

Fluid volume deficiency (dehydration)

65
Q

If we have increased afterload, what does that mean?

A

Vasoconstriction and increased BP

66
Q

If we have decreased afterload, what does that mean?

A

Vasodilation and decreased BP

67
Q

Infarction

A

A blockage in a coronary artery leading to cell death

68
Q

SA node intrinstic rate (best rate)

A

60-100

69
Q

AV node intrinsic rate (best rate)

A

40-60

70
Q

Ventricular intrinsic rate (best rate)

A

20-40

71
Q

What happens if the electrical conduction of the heart does not originate from the SA node?

A

AV node becomes the pacemaker; SLOW rate; concerns of decreased perfusion! Dizziness and LOC

72
Q

During diastole (filling), what’s happening on the cellular level?

A

Repolarizing; Resting

73
Q

During systole (contraction), what’s happening on the cellular level?

A

Depolarization; Firing

74
Q

Once tissue ischemia occurs, what happens to the electrical conduction of the heart?

A

Conduction stops

75
Q

Stenosis

A

Valves do not open properly, these are normally open

76
Q

Regurgitation

A

Valves do not close properly when they are normally closed, leading to back flow

77
Q

What are we looking for when inspecting the anterior chest?

A

Heave/Lift
Coming from hypertrophy (enlarged heart).

78
Q

What causes visible pulsation of apical impulse?

A

Hypertrophy

79
Q

What are some physiological (normal) variations

A

Split S2
S3 in youth 0 subsides with sitting or standing
Physiological mid-systolic (S3-S4) murmurs-not associated symptoms

80
Q

T/F S3 and S4 are diastolic sounds

A

True

81
Q

T/F S1 and S2 are systolic sounds

A

True

82
Q

Rubs

A

rubbing sounds due to friction and inflammation

Health Assessment I (6 decks)

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