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PD Block 2 > Cardiac > Flashcards

Cardiac Flashcards

1
Q

Pericardium

A

Double walled lining covering the heart

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2
Q

R/L Ventricles

A

Lower chambers of the heart. R pumps blood into the pulmonary artery. L pumps blood into the aorta

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3
Q

R/L Atrium

A

Upper chambers of the heart Pumps blood into the ventricles. R receives blood from the SVC/IVC. L receives blood from the Pulmonary vein.

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4
Q

Aortic Valve

A

Separates the L ventricle from the aorta.

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5
Q

Pulmonic valve

A

Separates the R ventricle from the pulmonic valve

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6
Q

Great vessels

A

IVC, SVC, Aorta, pulmonary veins and arteries

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7
Q

Apex

A

The point or tip of the heart. Located around the left 5th intercostal, midclavicular line

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8
Q

Base

A

Broad upper border of the heart

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9
Q

Precordium

A

Area of chest overlying the heart

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10
Q

Tricuspid valve

A

Valve that separates the R atrium and ventricle

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11
Q

Mitral vavle

A

valve that separates the L atrium and ventricle

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12
Q

Systole

A

Ventricles are at maximum contraction

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13
Q

Diastole

A

Ventricles are max relaxation, refilling

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14
Q

PMI

A

Point of maximal pulse at apex. Represents ventricular contraction.

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15
Q

Thrill

A

Palpable murmur, signifies turbulent blood flow. Can be felt with ulnar surface of the hand.

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16
Q

Heave/lift

A

Sustained palpable movements of localized areas of the precordium. Usually due to increased intensity of systolic contraction or hypertrophy

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17
Q

Situs inversus/dextrocardia

A

Condition in which the heart and the liver are flipped. Heart is to the right, liver is the to left

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18
Q

SA Node

A

Start of heart contraction signal

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19
Q

Electrical signal pathway for heart contraction

A

SA node - AV Node (small pause) - Bundle of his - R/L Bundles - Purkinje Fibers

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20
Q

P wave

A

depolarization of the atria

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21
Q

PR interval

A

Stimulation of Atria

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22
Q

QRS complex

A

Ventricular depolarization

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23
Q

ST interval

A

Ventricle repolarization

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24
Q

What do you look for during inspection of the heart

A
  1. Look for signs of acute cardiac distress
  2. Cyanosis of the skin, pallor, cool temp
  3. Respiratory difficulty
  4. Chest pain, levines sign, clutching chest
  5. Anxiety
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25
Q

What external signs do you look for with chronic heart conditions

A
  1. Skin - clubbing, xanthelasma - cyanotic heart disease
  2. Body habitus
  3. Inspection of the PMI
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26
Q

Where is the PMI located (ribs)

A

4th or 5th ICS, midclavicular line

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27
Q

Where do you palpate for a thrill

A

Over each area that corresponds with a valve

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28
Q

What do you hear in the 2nd right ICS

A

Aortic valve

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29
Q

What do you hear in the 2nd and 3rd left ICS

A

Pulmonic valve

30
Q

Erbs point

A

3rd left ICS, tricuspid valve

31
Q

S2

A

Dub, closing of the pulmonic and aortic valves. Means blood as been ejected and the ventricles are relaxing. Marks the end of systole

32
Q

S1

A

Lub, closing of the mitral and tricuspid valves.

Marks the beginning of systole

33
Q

Where is the tricuspid valve best heard

A

4th left ICS or erbs point

34
Q

Where is the mitral valve best heard

A

4th or 5th left ICS

35
Q

What are you assessing for during palpation of the chest

A
  1. PMI

2. Abnormal cardiac impulses, lifts, heaves, thrills

36
Q

What are you listening for during auscultation

A
  1. Normal heart sounds
  2. Rate and rhythm
  3. Abnormal heart sounds
37
Q

When does splitting occur

A

During deep inspiration

38
Q

What happens during splitting (physiological)

A

Deep inspiration, causes an increase in the chest pressure. Causes an increase in venous blood return. Because of this there is more blood to eject from R ventricle during systole which takes longer. This causes a delay in the s2 sound

39
Q

2 types of pathologic splitting

A
  1. Fixed splitting

2. Paradoxic splitting

40
Q

Fixed splitting

A

Splitting sound is always there regardless of breathing. septal defect

41
Q

Paradoxic splitting

A

Aortic valve closure is delayed. Pulmonic valve closes first Reverse of physiologic splitting

42
Q

Which valve closes first during splitting

A

Aortic

43
Q

Fatigue

A

Tired, lethargic, suggests angina, MI, acute endocartitis

44
Q

Dyspea

A

Difficult and labored breathing, chest pain, angina, MI

45
Q

Diaphoresis

A

Excessive sweating, acute cardiac disease

46
Q

Claudication

A

limping due to pain in butt or calf. Suggest muscle ischemia

47
Q

xanthelasma

A

yellow deposits of fat underneath the skin on eyelids, mitral insufficiency

48
Q

cough

A

dry cough with sharp stabbing chest pain may suggest pericarditis

49
Q

orthopnea

A

SOB when lying down, suggest CHF, left side

50
Q

Paroxysmal noctural dyspnea

A

SOB which wakes you in the night, mitral insufficiency

51
Q

What could you do if someone has an irregular rhythm

A

Compare apical and radial pulses. Note the pulse deficit

52
Q

syncope

A

temporary loss of consciousness caused by a drop in blood pressure. May indicate Cor Pulmonale (enlargement of the R ventricle)

53
Q

postural or orthostatic hypotension

A

Decrease in BP when you go from lying to standing. Must be a drop of at least 20mm Hg in systolic pressure

54
Q

Murmur

A

An abnormal turbulent blood flow that occurs because of valve stenosis or damaged (regurgitation) valve

55
Q

Systolic murmurs

A
  1. Aortic/pulmonic stenosis

2. Mitral/tricuspid regurgitation

56
Q

Diastolic murmurs

A
  1. Aortic/pulmonic regurgitation

2. Mitral/tricuspid stenosis

57
Q

7 dimensions of a murmur

A
  1. timing/duration
  2. pitch
  3. intensity
  4. pattern
  5. location
  6. radtiation
  7. respiratory phase variations
58
Q

Timing/duration

A

Is murmur systolic or diastolic and is it mid late

59
Q

Intensity of murmur

A

Measure on a scale of 1-6. Most people would be in the 3 range. Anything 4 and above has a palpable thrill

60
Q

pattern

A

crescendo, decrescendo of a murmur

61
Q

What would you have the patient do to accentuate an aortic murmur

A

Have them sit upright, lean forward and listen the the right 2nd ICS wile exhaling

62
Q

Preload

A

Stretch of ventricular muscle fibers at end of diastole. CO increases with preload

63
Q

Afterload

A

The load or resistance against which the left ventricle must eject its volume of blood during contraction

64
Q

What is the resistance in after load produced by

A

Volume of blood already in the vascular system and by constriction of vessel walls

65
Q

S3

A

Beginning of diastole, first phase of ventricular filling

66
Q

S4

A

Kick of the atria to get all of the blood into the ventricles

67
Q

Gallop

A

General name for hearing s3 or s4

68
Q

Rub

A

Cardiac tissue touching pericardial sac, pericarditis

69
Q

Click

A

Clicking sound made by a mitral valve regurgitation or prolapse

70
Q

Snap

A

Sound of abnormal blood flow through the valve during opening (Mitral stenosis)

71
Q

Ejection sounds

A

High frequency sound that results from abrupt halting of a valve opening

72
Q

When would you hear an ejection sound

A

Aortic valve stenosis, aortic insufficiency

PD Block 2 (6 decks)

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