Cardiac & Peripheral Vascular Hx

Question 1

Trace blood flow through the heart.

Answer 1

• deoxygenated blood from SVC and IVC enters right atrium
• passes to right ventricle through tricuspid
• deoxy blood sent through pulmonary arteries to the lungs
• oxygenated blood return to left atrium via pulmonary veins
• goes to left ventricle through bicuspid
• blood ejected through aorta to rest of body

Question 2

Trace the Electrical Conduction System

Answer 2

SA node –> AV node –> Bundle of His –> Purkinke

Question 3

P wave

Answer 3

atrial depolarization (SA node)

Question 4

PR interval

Answer 4

time from atrial depolarization to ventricular depolarization

Question 5

QRS complex

Answer 5

ventricular depolarization

Question 6

T wave

Answer 6

ventricular repolarization

Question 7

Pericardium

Answer 7

• double-walled fibrous sac

- fluid btw the inner and outer layers of pericardium

Question 8

Epicardium

Answer 8

-thin, outermost muscle layer on surface of heart

Question 9

Myocardium

Answer 9

• thick, muscular middle layer

- responsible for pumping of ventricles

Question 10

Endocardium

Answer 10

• innermost layer of the heart

- lines chambers and valves

Question 11

Systole

Answer 11

period of cardiac cycle when blood is ejected from the ventricles

Question 12

Diastole

Answer 12

period of cardiac cycle when blood enters relaxed heart

Question 13

Stroke Volume

Answer 13

amount of blood ejected form left ventricle in one contraction

Question 14

Heart Rate

Answer 14

of ejections/pumps in one minute

Question 15

Cardiac Output

Answer 15

HR x stroke volume

Question 16

Angina

Answer 16

• cardiac chest px precipitated by stress of physical exertion
• alleviated by rest and/or nitro

Question 17

Dyspnea on Exertion (DOE)

Answer 17

SOB precipitated by physical activity

Question 18

Palpitations

Answer 18

unpleasant awareness of one’s heart rate, esp if rapid or irregular

Question 19

Edema

Answer 19

serous fluid collected in dependent tissues (lowest area of body - might be feet or might be butt/thighs) due to improper pump function

Question 20

Orthopnea

Answer 20

SOB precipitated by being in a supine position

Question 21

Family Hx for Cardiac

Answer 21

• DM
• heart dz
• hyperlipidemia
• HTN
• congenital heart defects
• sudden death

Question 22

Social Hx for Cardiac

Answer 22

• smoking
• diet/nutrition
• alcohol consumption
• illicit drugs
• employment risks
• exercise and activity pattern

Question 23

High Risk, Non-Modifiable Risk Factors

Answer 23

• age
• male
• heredity: family hx of CAD/PAD = more likely to develop
• race: AA, Mexican Am, Am Indians, and some Asian Am

Question 24

High Risk, Modifiable Risk Factors

Answer 24

• smoking (CAD risk 2-4x greater than non smoker)
• high cholesterol (over 180)
• HTN (over 120/80)
• overweight and obesity
• DM

Question 25

Ischemia (angina, MI) Signs/Sxs

Answer 25

- worse with exertion, better with rest - radiates to arms, jaw - N&V +/- SOB

Question 26

Aortic Dissection Signs/Sxs

Answer 26

- ripping/tearing px | - radiates between scapulae

Question 27

Pericarditis Signs/Sxs

Answer 27

- sharp and/or pleuritic in nature - preceded by viral illness - relieved by leaning forward

Question 28

Pulmonary Embolism Signs/Sxs

Answer 28

- sharp and/or pleuritic in nature - acute onset - associated with dyspnea - may be preceded by calf pain - well localized - may have cough or hemoptysis

Question 29

Cardiac Musculoskeletal Signs/Sxs

Answer 29

- poorly localized - preceded by physical injury - gradual onset - aggravated by palpation/use

Question 30

Define: Peripheral Vascular System

Answer 30

- all circulatory vessels outside the heart - in clinical practice, all vessels outside the thorax - technically includes the coronary vessels - generally refers to arteries, not veins

Question 31

Arteries

Answer 31

- muscular vessels that carry oxygenated blood from the heart to the tissues - thin to arterioles then capillaries

Question 32

Veins

Answer 32

- carry deoxygenated blood from extremities back to heart | - propulsion of venous blood largely by contraction of large skeletal muscles

Question 33

Lymph Vessels

Answer 33

- network of vessels that collect serum leaked into interstitial areas around capillaries - drain back into venous circulation to re-join circulating blood volume - contain lymph nodes that filter contaminants prior to re-joining blood

Question 34

Pulse

Answer 34

palpable distention of arteries corresponding with cardiac contraction

Question 35

Thrill

Answer 35

palpable turbulence of flow within a vessel

Question 36

Heave

Answer 36

palpable pulsations over an abnormally distended organ

Question 37

Claudication

Answer 37

ischemic pain in an extremity exacerbated by exercise or exertion

Question 38

Pallor

Answer 38

pale coloration of surface anatomy due to poor arterial circulation

Question 39

Pitting Edema

Answer 39

peripheral swelling caused by poor venous and lymphatic return

Question 40

Stasis

Answer 40

stagnant venous return, usually from LEs

Question 41

Thrombus

Answer 41

clot within a vessel

Question 42

Embolus

Answer 42

clot that moves through circulation from original location to other areas