Cardiac 2 Flashcards
1
Q
A
2
Q
What is the precordium?
A
Area on anterior chest overlying heart and great vessels
3
Q
How many chambers does the heart have?
A
Four chambers: atria and ventricles
4
Q
What are the two major blood vessel loops in the circulatory system?
A
- Pulmonary circulation
- Systemic circulation
5
Q
What is the pericardium?
A
Tough, fibrous, double-walled sac that surrounds and protects heart
6
Q
What is the myocardium?
A
Muscular wall of heart
7
Q
What is the endocardium?
A
Thin layer of endothelial tissue that lines inner surface of heart chambers and valves
8
Q
What are the two pump systems of the heart?
A
- Right pump (right atrium and ventricle)
- Left pump (left atrium and ventricle)
9
Q
What is the main purpose of heart valves?
A
Prevent backflow of blood
10
Q
How do heart valves operate?
A
Open and close passively in response to pressure gradients in moving blood
11
Q
What are the two types of atrioventricular (AV) valves?
A
- Tricuspid valve (right AV valve)
- Bicuspid or mitral valve (left AV valve)
12
Q
What are semilunar (SL) valves?
A
Valves set between ventricles and arteries
13
Q
What happens during diastole?
A
Ventricles relax and fill with blood; 2/3 of cardiac cycle
14
Q
What is systole?
A
Heart’s contraction, blood pumped from ventricles fills pulmonary and systemic arteries; 1/3 of cardiac cycle
15
Q
What is the first heart sound (S1) associated with?
A
Closure of AV valves, signals beginning of systole
16
Q
What is the second heart sound (S2) associated with?
A
Closure of semilunar valves, signals end of systole
17
Q
What is a third heart sound (S3)?
A
Occurs when ventricles resistant to filling during early rapid filling phase
18
Q
What is a fourth heart sound (S4)?
A
Occurs at end of diastole when ventricle resistant to filling
19
Q
What can cause heart murmurs?
A
- Increased velocity of blood
- Decreased viscosity of blood
- Structural defects in valves
20
Q
What is automaticity in the heart?
A
Heart’s ability to contract by itself, independent of any signals or stimulation
21
Q
What is the role of the sinoatrial (SA) node?
A
Initiates an electric impulse, known as the pacemaker of the heart
22
Q
What do the ECG waves PQRST stand for?
A
- P wave: depolarization of atria
- P-R interval: time for atrial depolarization plus time for impulse to travel through AV node
- QRS complex: depolarization of ventricles
- T wave: repolarization of ventricles
23
Q
What is cardiac output (CO)?
A
In resting adult, heart normally pumps between 4 and 6 L of blood per minute
24
Q
What factors affect cardiac output?
A
- Preload: venous return that builds during diastole
- Afterload: opposing pressure ventricle must generate to open aortic valve
25
What is preload according to Frank-Starling law?
Greater the stretch, the stronger the heart’s contraction
26
What is the carotid artery pulse characterized by?
* Smooth rapid upstroke
* Summit rounded and smooth
* Gradual downstroke with dicrotic notch
27
What does the jugular venous pulse reflect?
Atrial contraction and central venous pressure
28
What is the impact of pregnancy on blood volume?
Blood volume increases by 30% to 40% during pregnancy
29
What happens to blood pressure during pregnancy?
Arterial blood pressure decreases due to peripheral vasodilation
30
What is isolated systolic hypertension?
Increase in systolic BP due to thickening and stiffening of the arteries
31
What should be assessed when evaluating the carotid arteries?
Palpate one carotid artery at a time to avoid compromising arterial blood to brain
32
What is the normal strength of the carotid pulse?
Normal strength is 2+
33
What is the significance of the apical impulse?
Note location, size, amplitude, and duration during inspection
34
What are the auscultatory areas associated with heart valves?
* Second right interspace: aortic valve area
* Second left interspace: pulmonic valve area
* Left lower sternal border: tricuspid valve area
* Fifth interspace at around left midclavicular line: mitral valve area
35
What is the effect of respiration on heart sounds?
Volume of right and left ventricular systole is just about equal but can be affected by respiration
36
What is the significance of lifestyle habits in aging adults regarding heart disease?
Lifestyle habits play a significant role in the acquisition of heart disease
37
What is the aortic valve area location?
Second left interspace
## Footnote
This is a key area for auscultation of heart sounds.
38
Where is the pulmonic valve area located?
Second left interspace
## Footnote
Important for assessing heart function.
39
What area corresponds to the tricuspid valve?
Left lower sternal border
## Footnote
Crucial for auscultation during heart examinations.
40
Identify the location of the mitral valve area.
Fifth interspace at around left midclavicular line
## Footnote
Key point for auscultating heart sounds.
41
What should be noted regarding heart rate and rhythm?
Describe characteristics
## Footnote
Essential for evaluating cardiac function.
42
What are the extra heart sounds to listen for?
Describe characteristics
## Footnote
Important for diagnosing heart conditions.
43
What factors should be assessed when listening for murmurs?
Timing, loudness, pitch, pattern, quality, location, radiation, posture, and change of position
## Footnote
These factors help in characterizing murmurs.
44
What is a screening measure to detect hypertrophic cardiomyopathy?
Transition from standing to squatting
## Footnote
Useful in assessing heart conditions.
45
How is central venous pressure (CVP) estimated?
By assessing jugular venous distention
## Footnote
Important in evaluating heart function.
46
What test is performed if venous pressure is elevated or heart failure is suspected?
Abdominojugular test
## Footnote
A diagnostic procedure for heart failure.
47
What occurs during the transition from fetal to pulmonic circulation?
Occurs in the immediate newborn period
## Footnote
Critical for understanding neonatal heart function.
48
What is the normal heart rate range for a newborn immediately after birth?
100 to 180 beats per minute (bpm)
## Footnote
Essential for assessing newborn health.
49
What should be noted regarding extracardiac signs in newborns?
Skin, liver size, and respiratory status
## Footnote
Indicators of overall health and potential heart issues.
50
What is true about murmurs in the immediate newborn period?
Do not necessarily indicate congenital heart disease
## Footnote
Often due to shunt closure.
51
What are the characteristics of murmurs in newborns?
Grade 1 or 2, systolic, no other signs of heart disease, and disappear in 2 to 3 days
## Footnote
Important for monitoring newborn heart health.
52
What signs may indicate heart disease in infants?
Poor weight gain, developmental delay, persistent tachycardia, tachypnea, dyspnea on exertion, cyanosis, clubbing
## Footnote
Critical indicators for pediatric assessment.
53
When does clubbing of fingers and toes typically appear?
Usually does not appear until late in the first year
## Footnote
Even with severe cyanotic defects.
54
What is characteristic of the rhythm in infants?
Characterized by sinus dysrhythmia
## Footnote
Normal variation in pediatric patients.
55
What is common regarding physiologic S3 in children?
Physiologic S3 is common
## Footnote
Indicates a normal finding in pediatric examinations.
56
What is the significance of a venous hum in children?
Has no pathologic significance
## Footnote
Often found during pediatric assessments.
57
What defines innocent (or functional) murmurs in children?
Soft, relatively short systolic ejection murmur, medium pitch, vibratory
## Footnote
Commonly found in children.
58
Where are innocent murmurs best heard?
At left lower sternal or midsternal border, with no radiation to apex, base, or back
## Footnote
Important for differential diagnosis.
59
What is essential for patient teaching concerning innocent murmurs?
Need to believe that this murmur is just a 'noise' and has no pathologic significance
## Footnote
Helps prevent unnecessary anxiety.
60
What changes occur in a pregnant woman's vital signs?
Increase in resting pulse rate of 10 to 15 bpm and drop in BP from normal prepregnancy level
## Footnote
Important physiological adjustments during pregnancy.
61
How is the palpation of the apical impulse altered in pregnant women?
Higher and lateral compared with normal position
## Footnote
Reflects changes in heart size and position.
62
What is mammary soufflé?
Occurs near term or when a woman is lactating
## Footnote
A benign heart sound during pregnancy.
63
What cardiovascular changes are common in aging adults?
Gradual rise in systolic blood pressure, widening of pulse pressure, left ventricular wall thickness increase
## Footnote
Important for geriatric assessments.
64
What heart conditions increase with age?
Presence of supraventricular and ventricular dysrhythmias
## Footnote
Common in older populations.
65
What is included in differential diagnosis of chest pain?
Ischemic, non-ischemic, pulmonary, gastrointestinal, dermatologic, musculoskeletal/neurologic, psychogenic
## Footnote
Comprehensive approach to evaluating chest pain.
66
What are the variations in heart sounds?
Loud (accentuated), faint (diminished), varying intensity, split
## Footnote
Important for clinical assessment.
67
What are the types of systolic extra sounds?
Ejection click, aortic prosthetic valve sounds, midsystolic click
## Footnote
Key findings during auscultation.
68
What are the types of diastolic extra sounds?
Opening snap, mitral prosthetic valve sound, third heart sound, fourth heart sound, summation sound, pericardial friction rub
## Footnote
Important for diagnosing heart issues.
69
What are abnormal pulsations at the precordium?
Thrill at the base, lift (heave) at the left sternal border, volume overload at the apex, pressure overload at the apex
## Footnote
Significant findings during physical examination.
70
What are examples of congenital heart defects?
Patent ductus arteriosus (PDA), atrial septal defect (ASD), ventricular septal defect (VSD), tetralogy of Fallot, coarctation of the aorta
## Footnote
Important for pediatric evaluations.
71
What are causes of murmurs related to valvular defects?
Aortic stenosis, pulmonic stenosis, mitral regurgitation, tricuspid regurgitation, mitral stenosis, tricuspid stenosis, aortic regurgitation, pulmonic regurgitation
## Footnote
Key for diagnosing heart valve problems.
72
What should be observed when assessing the neck in cardiovascular examinations?
Carotid pulse, jugular venous pulse, and estimate jugular venous pressure
## Footnote
Critical for cardiovascular health assessment.
73
What should be included in the precordium examination?
Inspection and palpation, describe location of apical pulse, note any heave (lift) or thrill
## Footnote
Important steps in a thorough cardiovascular examination.
74
What should be noted during auscultation in heart examinations?
Identify anatomic areas noting rate and rhythm, listen in systole and diastole for murmurs, repeat with bell
## Footnote
Essential for accurate diagnosis.
