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Health Assessment > Cardiac/MS > Flashcards

Cardiac/MS Flashcards

1
Q

What are the heart layers?

A

Pericardium, myocardium, and endocardium

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2
Q

What is the pericardium?

A

Sac that surrounds and protects the heart

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3
Q

What is the myocardium?

A

Muscular wall of the heart. Does the pumping.

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4
Q

What is the endocardium?

A

Thin layer of tissue that lines the inner surface of the heart chambers and valves

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5
Q

What are the four valves of the heart?

A

AV (atrioventricular valves)- Open during filing phase (diastole)
Right AV- tricuspid valve
Left AV- bicuspid (mitral) valve

SL (semilunar valves)- Open during pumping phase (systole)
Right SL- pulmonic valve
Left SL- aortic valve

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6
Q

Upside down

A

Base at the top
Apex at the bottom

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7
Q

Sinoatrial (SA) node

A

Pacemaker

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8
Q

Blood flow through Coronary Circulation

A
  1. Right atrium
  2. Tricuspid valve
  3. Right ventricle
  4. Pulmonic valve
  5. Pulmonary artery
  6. Lungs
  7. Pulmonary veins
  8. Left atrium
  9. Mitral valve
  10. Left ventricle
  11. Aortic valve
  12. Aorta
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9
Q

Pulmonary arteries carry __________ blood to the lungs.

A

deoxygenated

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10
Q

Pulmonary veins carry __________ blood from the lungs back to the heart.

A

re-oxygenated

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11
Q

Blood flow through the Cardiac Valves

A

Tissue Paper My Assets

Tricuspid, Pulmonic, Mitral, Aortic

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12
Q

Major risk factors for heart disease

A

Nutrition
Smoking
Alcohol Use
Exercise
Drug Use

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13
Q

IV drug users are at risk for

A

Bacterial Endocarditis

Endocarditis occurs when bacteria or other germs enter the bloodstream and travel to the heart. The germs then stick to damaged heart valves or damaged heart tissue. Endocarditis is a life-threatening inflammation of the inner lining of the heart’s chambers and valves. This lining is called the endocardium.

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14
Q

Orthopnea

A

DIB when supine/laying down

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15
Q

Hyperlipidema

A

High cholesterol

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16
Q

JVD

A

Jugular vein distention- bulging of major veins in the neck

It’s a key symptom of heart failure and other heart and circulatory problems.

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17
Q

Thrill

A

A thrill is a palpable vibration over artery (feels like the throat of a purring cat). It signifies turbulent blood flow. A thrill can accompany a loud murmur.

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18
Q

Lifts and Heaves

A

Thrust of ventricle

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19
Q

Bruit

A

A bruit is auscultated over an artery. Sounds like a blowing & swishing sound. Indicates blood flow turbulence.

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20
Q

__________ a Thrill.
__________ a Bruit.

A

Feel a Thrill.
Hear a Bruit.

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21
Q

What direction is used to auscultate the heart?

A

Listen in a “Z” pattern. Inching the stethoscope from base to apex. Use bell and diaphragm.

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22
Q

What are the Cardiac Landmarks for auscultation of the heart?

A

Aortic Valve- 2nd Intercostal Space, Right Sternal Border
Pulmonic Valve- 2nd Intercostal Space, Left Sternal Border
Erb’s Point Valve- 3rd Intercostal Space, Left Sternal Border
Tricuspid Valve- 4th Intercostal Space, Left Sternal Border
Mitral Valve- 5th Intercostal Space, Midclavicular Line

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23
Q

PMI

A

Point of Maximal Impulse

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24
Q

Auscultating Carotid Arteries

A

Ask patient to briefly hold their breath. Use bell of stethoscope. Listen for bruits.

** BELL for BRUITS **

Do NOT compress the carotid artery with the bell. It can cause an artificial bruit.

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25
Q

APE To Man

A

Aortic –> Pulmonic –> Erb’s Point –> Tricuspid –> Mitral

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26
Q

What is a murmur?

A

Gentle blowing, swooshing sound heard over heart valves

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27
Q

Normal heart sounds

A

S1 and S2

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28
Q

S1

A

1st heart sound – closure of AV valves, beginning of systole

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29
Q

S2

A

2nd heart sound – closure of SL valves, end of systole

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30
Q

Abnormal heart sounds

A

S3 and S4

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31
Q

S3

KEN - TU - CKY
LUB(1) DUB(2) DUB(3)

A

3rd heart sound – ABNORMAL – immediately after S2, when AV valves open and atrial blood goes into ventricles

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32
Q

S4

TEN - NE - SSEE
Hear before LUB(1)
Gallop

A

4th heart sound – ABNORMAL – just before S1, at end of diastole, ventricle resistant to filling

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33
Q

S3 sounds can be normal in

A

young adults & children
pregnancy
athletes

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34
Q

S3 sounds are abnormal in

A

Adults and elderly

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35
Q

S3 sounds indicate

A

Severe Mitral or Tricuspid Regurgitation
Cardiomyopathy
Heart Failure

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36
Q

S4 sounds are almost always __________.

A

Pathological

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37
Q

S4 sounds indicate

A

Indicates DIASTOLIC Heart Failure
Severe Left Ventricular Hypertrophy
Cardiac Ischemia
Uncontrolled HTN
Hypertrophic or Restrictive Cardiomyopathy

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38
Q

ABC’s of Heart Health

A

Appropriate Aspirin Therapy
Blood Pressure Control
Cholesterol Control

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39
Q

Lifestyle changes for Heart Health

A

Smoking cessation
Nutrition
Exercise
Weight management

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40
Q

Arteries are used to pump __________ blood.

A

oxygenated

Temporal, Carotid, Arm, and Leg arteries

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41
Q

Veins have an __________ flow than arteries.

A

opposite

Jugular, Arm, and Leg veins

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42
Q

What is the role of veins?

A

Absorb CO2 and waste and carry back to heart

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43
Q

Retrieve excess fluid and plasma proteins from interstitial spaces and puts them back in bloodstream

A

Lymphatics/Lymph nodes

Cervical nodes
Axillary nodes
Inguinal nodes

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44
Q

Leg pulses and location

A

Femoral- located along the crease midway between the pubic bone and the anterior iliac crest.

Popliteal- The popliteal artery is palpated behind the knee.

Dorsalis Pedis- The dorsalis pedis artery is located on the dorsum of the foot. Palpate just lateral to and parallel with the extensor tendon of the big toe.

Posterior Tibialis- The posterior tibial pulse is palpated in the groove between the medial malleolus and the Achilles tendon.

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45
Q

Edema Scale

A

0= No Pitting

1+= Mild pitting; slight indentation; no perceptible swelling of the leg

2+= Moderate pitting; indentation subsides rapidly

3+= Severe/Deep pitting; indentation remains for a short period of time; leg looks swollen

4+= Very Deep pitting; indentation lasts a long time; leg is grossly swollen & distorted

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46
Q

What is DVT?

A

Deep Vein Thrombosis

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47
Q

Signs and symptoms of DVT

A

Unilateral Edema
Warmth
Redness (Erythema)
Tenderness (Cramping)

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48
Q

What should you avoid doing for DVT patients and why?

A

Do not massage area, use SCDs, or have patient walk.

Can cause pulmonary embolism (PE).

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49
Q

Venous Disease/Insufficiency

Think about WalMart

A

A brown discoloration occurs with chronic venous stasis as a result of hemosiderin deposits (a by-product of red blood cell degradation).

Warm, brown or red, swollen
(bilaterally)
Weeping or excoriating skin
Pitting edema
Varicose veins

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50
Q

Arterial Disease/Insufficiency

A

Pallor, cyanosis, atrophic skin, and unilateral coolness are all signs associated with arterial problems.

Slow healing (if any)
Necrosis
Cold, pale extremity
Peripheral pulses weak
Hairless
Atrophic Skin (Thin, Shiny & tight)
Dry skin

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51
Q

Diabetic patients can have _________ Disease/Insufficiency.

A

Arterial

Microvascular complications –> Slow healing wounds –> Foot Ulcers –> Infection –> Necrosis

52
Q

What are the two types of connective tissues?

A

Tendons and Ligaments

53
Q

Tendons connect __________ to __________.

A

Tendons connect muscle to bone.

54
Q

Ligaments connect __________ to __________.

A

Ligaments connect bone to bone.

55
Q

Cartilage allows bones to __________ over one another.

A

Cartilage allows bones to slide over one another.

56
Q

What is bursae?

A

Fluid filled sacs in area of friction. Act as a cushion for bone.

57
Q

What is inflammation of bursae called?

A

Bursitis

58
Q

What is tendonitis?

A

Inflammation of the tendon

59
Q

What is the cartilaginous disc between bones called and what does it do?

A

Meniscus, acts as a cushion and absorbs shock.

60
Q

What is fascia?

A

Flat sheets that line and protect muscle fibers

61
Q

Flexion

A

Bending the limb at the joint, brings bones together

62
Q

Extension

A

Straightening of the limb at the joint

63
Q

Rotation

A

Turning of a joint around an axis

Ex: Turning head

64
Q

Lateral flexion

A

Lateral movements in the frontal plane

Ex: Bring ear to shoulder

65
Q

Abduction

A

Movement AWAY from the body

66
Q

Adduction

A

Movement TOWARD the center of the body

67
Q

Circumduction

A

Conical movement of a limb extending from the joint at which the movement is controlled.

Combines flexion, extension, abduction, and adduction.

Ex: Rotating arm in a circle

68
Q

Inversion

A

Movement of the sole towards the median plane so that the sole faces in a medial direction

69
Q

Eversion

A

Movement of the sole away from the median plane so that the sole faces in a lateral direction

70
Q

Protraction

A

Movement of body part FORWARD & parallel to the ground

71
Q

Retraction

A

Movement of the body part BACKWARD & parallel to the ground

72
Q

Elevation

A

Raising a body part

73
Q

Depression

A

Lowering a body part

74
Q

Opposition

A

Approximation of the thumb and 5th digit (pinky)

75
Q

Pronation

A

Turning the forearm so the palm is down

Pouring a bowl of soup out

76
Q

Supination

A

Turning the forearm so the palm is up

Holding a bowl of soup

77
Q

Dorsiflexion

A

Flexion of the ankle

78
Q

Plantar flexion

A

Extension of the ankle

Step on the gas

79
Q

Sprain involves

A

Ligament

80
Q

Strain involves

A

Muscle and tendon

81
Q

How does functional assessment /ADL’s tie into MSK issues?

A

Screens for the safety of independent living, need for home health services, and quality of life.

82
Q

Joint Ranges of Motion
Active vs. Passive

A

Active- Patient moves
Passive- Examiner moves the patient

83
Q

Types of spinal curvature

A

Kyphosis and Lordosis

84
Q

Genu Valgum

A

“Gum” makes your knees stick together

Knock Knee

85
Q

Genu Varum

A

“Rum” makes your knees spread apart

Bow-legged

86
Q

Spasticity

A

Tone increases if the examiner moves the joint more quickly (i.e. the hypertonicity is affected by the rate of movement of the joint). This is the typical finding with an upper motor neuron lesion (e.g. stroke or spinal cord injury).

87
Q

Rigidity

A

Tone remains increased regardless of how quickly the joint is moved. One example of this is Parkinson’s disease, where limb movement generates a ratchet-like sensation known as cog wheeling.

88
Q

Flaccidness

A

Complete absence of tone. This occurs when the lower motor neuron is cut off from the muscles that it normally innervates.

89
Q

How do you grade Muscle Strength?

A

-Compare side to side
-Use 0-5 Rating scale
-Interpretation must consider the expected strength of the muscle group being tested

90
Q

Muscle Strength 0/5

A

NO MUSCLE CONTRACTION

91
Q

Muscle Strength 1/5

A

Can visualize muscle contraction, NO MOVEMENT

92
Q

Muscle Strength 2/5

A

Complete ROM with Joint Support

Cannot Perform Against Gravity

93
Q

Muscle Strength 3/5

A

Complete ROM

Against Gravity, without resistance

94
Q

Muscle Strength 4/5

A

Complete ROM, Moderate resistance

95
Q

Muscle Strength 5/5

A

Complete ROM, Full resistance

96
Q

Crepitus

A

Cracking or popping sound

Rice Krispies

97
Q

Verbal ques

A

Ouch, whimper, scream

98
Q

Non-verbal ques

A

Guarding

99
Q

AROM of the shoulder

A

Flexion
Extension
Abduction
Adduction
Internal Rotation
External Rotation
Circumduction

100
Q

Abnormal Findings

A

Back Pain
Falls
Osteoporosis
Osteoarthritis
Rheumatoid Arthritis
Bursitis
Joint Dislocation
Shoulder Dislocation

101
Q

What is the most common musculoskeletal complaint?

A

Back pain

102
Q

What is the leading cause of death for people 65 and older?

A

Falls

103
Q

Falls are associated with

A

Poor balance
Prior falls
Poor muscle strength
Unfamiliar environment
Aging

104
Q

Unfamiliar environment

A

Inconsistency in their surroundings such as rugs and animals (Trip Hazards) etc.

105
Q

What is Timed Up & Go?

A

Get up from chair, walk 10 ft, turn around, come back, & sit down. Use stopwatch –> More than 12 seconds the risk for fall is increased.

106
Q

At least 95% of hip fractures among older adults are caused by __________.

A

falls

107
Q

Reabsorption

A

Osteoclasts break down bone and release minerals in the bloodstream

108
Q

Deposition

A

Bone cells rebuild tissue by depositing minerals from the bloodstream –>Calcium redeposited in bone

109
Q

Osteopenia

A

Reduced or thinning bone mass (precursor to osteoporosis)

110
Q

Osteoporosis

A

is loss of bone mass with associated mineral deficiency

111
Q

What does a Dexa scan do?

A

Determines calcium level in bone. Gives a T-score.

Normal T-score= +1 to -1
Low Bone Density (Osteopenia)= -1.0 to -2.5
High Risk for Osteoporosis= -2.5 or Higher

112
Q

Osteoporosis Risk Factors

A

ACCESS leads to Osteoporosis

Alcohol use
Corticosteroid use
Calcium low
Estrogen low
Smoking
Sedentary lifestyle

Slender, female, Caucasian, alcohol users, & steroid users are highest at risk.

113
Q

Dowanger’s Hump

A

Hyperkyphosis

114
Q

What is osteoarthritis?

A

Age >40, Localized, Relieved by Rest, Worse at the end of day

114
Q

What is Rheumatoid arthritis?

A

Age 20-40, Systemic (Autoimmune), Bilateral & Symmetrical, Stiffness worse in the AM

115
Q

Joint dislocation

A

Ends of bones slip out of usual position

116
Q

MSK Health Promotion and Patient Teaching

A

Diet, Exercise, Osteoporosis screening, and Fall prevention

117
Q

What type of diet decreases the risk of osteoporosis?

A

Diet rich in dark leafy greens, eat the rainbow, and low in fired foods

118
Q

Vitamin D deficiency can cause

A

muscle weakness thus falls and frailty

119
Q

What types of patients may we see with low vitamin D levels?

A

Renal patients (CKD) and nursing home patients

120
Q

How is tobacco and excessive alcohol use harmful to bone health?

A

Smoking reduces bone mineral density (BMD)
Excess drinking increases the risk for falls

121
Q

Physical activity delays and prevents bone loss.

True or False

A

True

122
Q

Fall Prevention- What is the cycle of falling?

A

Inactivity –> Physical deconditioning –> Increased risk of falling –> Fall incident –> Fear of falling –> Back to inactivity

123
Q

In pregnant women, Lordosis compensates for

A

enlarging uterus

124
Q

What does the Allis test check for in infants?

A

Checks for hip dislocation by comparing leg lengths

125
Q

Barlow Maneuver

A

Tests for Developmental Dysplasia of the Hip. May hear a “pop” with hip dislocation.

126
Q

Ortolani Maneuver

A

Done at each visit until age 1. Tests for Developmental Dysplasia of the Hip.

Health Assessment (5 decks)

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