Assessment of the Heart - Unit 3 Flashcards
Inspect the precordium (portion over heart and lower chest) for…
Symmetry and pulsations.
A normal precordium is……symmetrical or asymmetrical?
Symmetrical.
The apical pulse is located where?
The 5th intercostal space, just internal to midclavicular line.
Apical Pulse - aka…
Point of Maximal Impulse
What is the blood flow of the heart?
- Superior and inferior vena cava to the right atrium.
- Through the tricuspid valve to the right ventricle.
- Through the pulmonary valve to the pulmonary arteries.
- To the lungs blood goes!
- Through the pulmonary veins comes the blood back to the heart.
- Left atrium.
- Through the mitral valve to the left ventricle.
- Through the aortic valve.
- Aorta to the rest of the body!
What is the purpose of the apical pulse?
To obtain the heart rate of newborns, infants and children 2-3 years of age or an adult with an irregular peripheral pulse. Pulmonary and renal patients are also in need of an apical pulse. To establish baseline data for subsequent evaluation and monitor patients receiving medications to improve heart action.
Apical Pulse Assessment -
Rate
Rhythm
Volume
Rate - give in numerical value (also Tachy, Brady, etc.)
Rhythm - regular, irregular, regularly irregular, irregularly irregular.
Volume - distant, strong, weak, etc.
Heart Sounds - S1 - what is this?
First heart sound (LUBB) - closing of AV (mitral and tricuspid) valve.
LU = Mitral Valve Closure
BB - Tricuspid Valve Closure
Heart Sounds - S2 - What is this?
Second heart sound (DUBB) - Closing of the semilunar valves
DU (Aortic Valve Closure)
BB (Pulmonic Valve Closure)
S3 - What is it?
“KENTUCKY” - LUBBDUBBY
It is normal in children and young adults. This originates in the ventricles. It is heard after closure of the aortic and pulmonic valves and comes immediately after S2.
S4 - What is it?
Tennessee - “TENNLUBBDUBB” - Atrial contraction is more forceful than normal, causing increased ventricular pressure. Foreceful rush of blood going from the atria into the ventricles before the mitral and tricuspid valves close for S1. It is heard immediately before S1.
What sounds do murmurs make?
Swooshing!
Murmurs - are they a backflow of blood? Yes or no?
Yes!
Sick Sinus Syndrome - what is this?
An Sa Node/Right Atria/Pacemaker problem. It’s also known as Tachybrady.
Murmurs are graded on a scale of…
1-6. 1 being soft and faint and 6 being heard without a stethoscope!
