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N190 - Physical Assessment > Cardiac > Flashcards

Cardiac Flashcards

1
Q

heart size

A

5in long, 3.5in diameter, 2.5in thick

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2
Q

female heart

A

smaller and less in weight compared to male

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3
Q

precordium

A

area of the chest where you listen to heart sounds and do assessments of the heart

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4
Q

pericardium

A

double layered sac that encloses the heart
- fluid between the layers to prevent friction when the heart is contracting and relaxing

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5
Q

when cardiac valves are pathologic…

A

forward blood flow is restricted, resulting in regurgitation or murmurs

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6
Q

S1

(lub)

A

first heartbeat heard due to the closure of AV (tricuspi and mitral) valves
- when ventricles are filled
- loudest at apex

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7
Q

S2

(dub)

A

second heartbeat heard, due to the closure of semilunar (aortic and pulmonic) valves
- when ventricles empty blood to the pulmonic artery and arota
- loudest at base of heart (top of chest)

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8
Q

pulse grading

A

0: no pulse
+1: faint/weak/thready
+2: normal
+3: brisk
+4: bounding

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9
Q

aortic area

A
  • 2nd ICS
  • RSB (right sternal border)
  • S2 > S1
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10
Q

pulmonic area

A
  • 2nd ICS
  • LSB
  • S2 > S1
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11
Q

erb’s point

A
  • 3rd ICS
  • LSB
  • S2 = S1
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12
Q

tricuspid area

A
  • 4th ICS
  • LSB
  • S1 > S2
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13
Q

mitral area

A
  • 5th ICS
  • left midclavicular
  • S1 > S2
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14
Q

cardiac murmurs are associated with…

A
  • tricuspid regurgitaion
  • tricuspid stenosis
  • mitral regurgitation
  • mitral stenosis
  • aortic regurgitaion
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15
Q

cardiac murmur grading

A

graded 1-6
- 1/6 barely audible
- 6/6 loudest

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16
Q

major risk factors of heart diseases

A
  • HTN
  • smoking
  • DM
  • obesity
  • high cholesterol
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17
Q

heart sounds are interpreted according to…

A

pitch, duration, intensity, and phase

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18
Q

sympathetic cardiac nerve

A

stimulation of heart, increase HR, increase dilation of coronary arterties

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19
Q

parasympathetic cardiac nerve

A

decrease in stimulation, decrease in HR, constriction of coronary artery

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20
Q

PMI

(point of maximal impulse)

A

heard loudest at the 5th ICS, left midclavicular line (mitral or apical pulse)

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21
Q

PMI in infants

A

heard at the 4th ICS, left midclavicular line
- b/c the heart is horizontally positioned

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22
Q

newborn heart rate

A

160-180 bpm

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23
Q

sound on percussion of the heart

A

dullness

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24
Q

normal BP

A

below 120/80

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25
Q

prehypertension

A

120/80-139/89

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26
Q

hypertension

A

140/90+

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27
Q

who has high incidence of HTN?

A

african americans

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28
Q

pedal pulse location

A

lateral to and parallel with the big toe

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29
Q

popliteal pulse location

A

medial behind the knees

30
Q

femoral pulse location

A

inguinal area

31
Q

posterior tibialis pulse location

A

groove behind the medial malleolus and achilles tendon

32
Q

what is ECG

A

electrical representation of the cardiac cycles that are documented by the deflection on recording paper

33
Q

electrical initation of the heart occurs in…

A

the SA node, known as the pacemaker of the heart
- fires 60-100 joules/min

34
Q

av node fires…

A

60 joules/min

35
Q

bundle branches fires…

A

40-60 joules/min

36
Q

cardiac depolarization

A

when current from SA node spreads across the atria causing cardiac contraction
- cardiac cells are positively charges

37
Q

repolarization

A

cardiac cells are relaxed
- negatively charged

38
Q

imbalance in Na, K, and Ca

A

dysregulation of cardiac conduction system

39
Q

p wave

A

atrial depolarization

40
Q

atrial repolarization is…

A

hidden behind the qrs wave

41
Q

qrs wave

A

ventricular depolarization

42
Q

t wave

A

ventricular repolarization

43
Q

v-fib

A

total absence of regular heart rhythm

44
Q

v-tach

A

rhythm is rapid, regular heartbeat
- up to 200 bpm

45
Q

heart block

A

slow heart rate; conduction between atria and ventricles are disrupted
- as low as 20-40 bpm

46
Q

S/S of heart failure

A
  • JV pulsation over 3cm at 45 degree elevation
  • low BP
  • HR >120 bpm
  • angle edema
  • SOB
  • S3 is present
47
Q

severe aortic regurgitation cause

A

synchronous head bobbing and heartbeat

48
Q

infective endocarditis

A

thin red lines or splinter hemorrhages on the nail beds

49
Q

arterial insufficieny

A

legs are cold, with no hair

50
Q

venous insufficieny

A

legs are warm, with pain from prolonged sitting or standing

51
Q

raynauds syndrome

A

fingers and handshave intermittent skin pallor, blueish discoloration, and rubor

52
Q

allen’s test

A

determines the patency of the radial or ulnar arteries

53
Q

expected finding of percussion of the heart

A

dullness

54
Q

varicosities do not…

A

disappear when legs are elevated

55
Q

JVD > 3cm causes:

A
  • increased central venous pressure
  • fluid overload (CHF)
  • pressure at the superior vena cava
56
Q

who has high incidence of CVD

A

caucasian females 65-74 years old

57
Q

who has 2x incidence of cardiovascular mortality

A

native americans < 35 years old

58
Q

use of cocaine is attributed to…

A
  • HTN
  • MI
  • ruptured aorta
59
Q

S3 and S4 are more common in…

A

patients in cardiac anomaly:
- MI
- CHF
- angina
- ventricular hypertrophy

60
Q

S3

(ventricular gallop)

A

when there is vibration when AV valves open and blood goes to the ventricles
- can also be heard in healthy children, healthy adults, and 3rd trimester pregnancy
- S3 follows S2

61
Q

S4

(atrial gallop)

A

when atrial contraction and ejection of blood to the ventricles in the late diastole
- heard before S1
- can be heard in healthy children, well-fit adults, and healthy elderly

62
Q

tetralogy of fallot

(4 cardiac defects)

A
  • dextroposition of the aorta
  • pulmonary stenosis
  • right ventricular hypertrophy
  • ventricular septal defect
63
Q

patent ductus areteriosus

A

opening between pulmonary artery and descending aorta
- should close 24-48 hrs after brith
- if does not close=murmur; manage with SX

64
Q

foramen ovale

A

passageway of bloodbetween right and left atria
- should close shortly after birth
- if does not close=murmur; manage with SX

65
Q

70% of children will have…

A

innocent cardiac murmur

66
Q

innocent cardiac murmurs arise from…

A

high blood flow across normal heart structures
- usually when the individual has a fever and anemia

67
Q

how many hearbeats in 24 hours?

A

100,000x

68
Q

when all blood vessels are connected end to end, how many miles will it be?

A

60,000 miles; 2x around the world

69
Q

difference between S/S of MI and GERD

A

both have indigestion, N/V
MI:
- SOB/dyspnea
GERD:
- hoarseness/eructation

70
Q

S/S, nursing care, and monitoring of pericarditis

A

S/S:
- sharp chest pain on inhalation, pulsus paradoxus, SOB
Actions:
- manage pain/anxiety, bed rest w/ HOB 45, anti-inflam for pain
Monitor:
- signs of tamponade, prepare for pericardiocentesis

71
Q

pulsus paradoxus

A

abnormally large decrease in BP during inspiration
- as much as 10 mmHg
- present with pericarditis
- cause: heart attack, immune system, or cardiac SX

N190 - Physical Assessment (4 decks)

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