Cardio and Peripheral Vascular Assessment

Question 1

where is the base of the heart located?

Answer 1

at the top of the heart

Question 2

where is the apex of the heart located?

Answer 2

at the bottom of the heart

Question 3

where does the heart span across?

Answer 3

2nd to 5th ICS

Question 4

what area does the jugular vein supply?

Answer 4

brain

Question 5

what area does the subclavian artery and vein supply?

Answer 5

upper limbs

Question 6

what area does the superior vena cava supply?

Answer 6

upper limbs

Question 7

what area does the inferior vena cava and thoracic aorta supply?

Answer 7

lower limbs

Question 8

what area does the carotid arteries supply?

Answer 8

brain

Question 9

define perfusion

Answer 9

process of delivering blood from capillaries to tissues

Question 10

define cardiac output

Answer 10

amount of blood ejected from the left ventricle each minute

Question 11

what is the formula for CO?

Answer 11

stroke volume x HR

Question 12

what is the function of the SA node?

Answer 12

natural pacemaker that sends impulses to atrial muscles to contract and begin the cardiac cycle

Question 13

what is the function of the AV node?

Answer 13

transmits the SA impulse to activate Bundle of His and Purkinje fibers and synchronize/mediate impulses

Question 14

what systems control the rate of the heart?

Answer 14

parasympathetic and sympathetic nervous system

Question 15

what is the path that heart impulses travel through?

Answer 15

SA node → internodal pathways → AV node → Bundle of His → left and right bundle branches → Purkinje fibers → ventricular myocardium

Question 16

what is an ECG?

Answer 16

a tool that utilizes a variety of electrodes placed throughout the body and records electrical changes of the heart

Question 17

what cardiac event occurs during P wave?

Answer 17

atrial depolarization (contraction)

Question 18

what cardiac event occurs during PR interval?

Answer 18

SA to bundle branch conduction

Question 19

what cardiac event occurs during QRS interval?

Answer 19

ventricular depolarization (contraction)

Question 20

what cardiac event occurs during T wave?

Answer 20

ventricular diastole

Question 21

what are common s&s with CVS issues?

Answer 21

• Diaphoresis
• Scar in the chest area
• Central cyanosis
• Changes in peripheral colour
• Edema
• palpations
• chest pain

Question 22

what is the technique for measuring JVP?

Answer 22

• Locate Sternal Angle (Sternal angle is about 5 cm above right atrium)
• Landmark Right Internal JV location (head turned slightly to left) or EJV if that is more visible
• Observe for highest point of distention and measure distance from the sternal angle

Question 23

what is the expected finding of JVP measurement?

Answer 23

Level of pulsations should NOT be >3 cm above the sternal angle

Question 24

what are the expected findings of examining carotid arteries?

Answer 24

Normal rate, rhythm, quality with no adventitious sounds

Question 25

where is the apical pulse located?

Answer 25

5th ICS at the MCL

Question 26

what is S1?

Answer 26

First heart sound (lub) is the closing of the AV valves, marking start of systole

Question 27

what is S2?

Answer 27

second heart sound (dub) is the closing of the SL valves, marking the start of diastole

Question 28

what is the order of auscultation and their landmarks?

Answer 28

1. aortic - R 2nd ICS 2. pulmonic - L 2nd ICS 3. erbs points L 3rd ICS 4. tricuspid L 4th ICS 5. mitral L 5th ICS

Question 29

what is the S2 physiological split?

Answer 29

valves close at slightly different times due to changes in intrathoracic pressure (especially during inspiration) causing a "lub dub dub" sound

Question 30

what is S3

Answer 30

extra heart sound, lub du bub, may be expected in people less than 40 or in CHF

Question 31

what is S4

Answer 31

extra heart sounds, be lub dub, due to pathological origin

Question 32

what are general murmurs caused by?

Answer 32

* disrupted blood flow due to septal defects * valve abnormalities * patent ductus arteriosus (PDA) * stenotic vessels or mitral valve stenosis

Question 33

what are systolic murmurs due to?

Answer 33

* aortic or pulmonic stenosis * AV valve regurgitation * VSD

Question 34

what are diastolic murmurs due to?

Answer 34

* AV valve stenosis * Aortic or pulmonic regurgitation

Question 35

what heart attack symptoms are more common in women?

Answer 35

* unusual fatigue * SOB * anxiety and sleep disturbances * nausea, feeling sick to stomach

Question 36

what red flags do we watch out for relating to CVS?

Answer 36

* LOC changes * chest pain * SOB * lightheadedness * ECG changes * heart attack warnings * fluid volume overload

Question 37

what is fluid volume overload?

Answer 37

condition where the body has too much fluid, potentially leading to swelling, high blood pressure, and heart problems

Question 38

what is the expected finding of cap refill?

Answer 38

≤ 2 sec

Question 39

what are our central pulses?

Answer 39

* carotid * brachial * apical * femoral

Question 40

what are our non-central pulses?

Answer 40

* temporal * radial * popliteal * pedal * posterior tibial artery

Question 41

when are dopplers used?

Answer 41

when pulses are difficult to palpate due to injury, edema or surgery

Question 42

where are the epitrochlear lymph nodes located?

Answer 42

medial aspect between biceps and triceps

Question 43

what is the expected finding of palpating epitrochlear nodes?

Answer 43

non palpable

Question 44

what are the two types of inguinal lymph nodes?

Answer 44

horizontal and vertical

Question 45

what is the expected finding of palpating inguinal nodes?

Answer 45

<2cm, mobile and nontender

Question 46

what is the function of arteries?

Answer 46

carry blood away from heart to the periphery

Question 47

what is the function of veins?

Answer 47

carry blood from the periphery back to the heart

Question 48

what is the function of capillaries?

Answer 48

exchange gases, nutrients and metabolites

Question 49

what is the function of the lymphatic system?

Answer 49

maintain fluid balance and immune function

Question 50

what 2 ducts does lymph drain into?

Answer 50

* thoracic duct * right lymphatic duct

Question 51

define fascia

Answer 51

sheets of connective tissue that enclose the blood vessels, nerves and muscles which make up compartments

Question 52

what is deep vein thrombosis?

Answer 52

formation of a blood clot in one of the deep veins in the body that stops flow of blood to and from toes

Question 53

what are the s&s of deep vein thrombosis?

Answer 53

* Pain * Edema * Warmth * Weak pulses * Delayed cap refill * Swelling

Question 54

what is a tell-tale sign of deep vein thrombosis?

Answer 54

one leg will appear thicker and fuller

Question 55

what is a severe risk associated with DVT?

Answer 55

pulmonary embolism

Question 56

what is pulmonary embolism?

Answer 56

clot is pushed into lungs due to pressure, leading to an obstruction in breathing

Question 57

what are s&s of pulmonary embolism?

Answer 57

* acute respiratory distress * chest pain * high HR * sweating * anxiety

Question 58

what is Raynaud's phenomenon?

Answer 58

loss of circulation in fingertips

Question 59

what is lymphedema caused by?

Answer 59

clotting of lymph in the lymphatic system

Question 60

what is edema?

Answer 60

buildup of fluid in body tissues

Question 61

what constitutes 0+ edema?

Answer 61

No pitting edema – possibly related to lymph

Question 62

what constitutes 1+ edema?

Answer 62

Mild pitting edema, 2 mm depression that disappears rapidly

Question 63

what constitutes 2+ edema?

Answer 63

Moderate pitting edema, 4 mm depression that disappears in 10-15 secs

Question 64

what constitutes 3+ edema?

Answer 64

Moderately severe pitting edema, 6 mm depression that may last more than 1 minute

Question 65

what constitutes 4+ edema?

Answer 65

Severe pitting edema, 8 mm depression that can last more than 2 minutes

Question 66

what is compartment syndrome?

Answer 66

buildup of pressure around a limb usually caused by * bleeding or swelling after injury into a closed compartment * an untreated DVT * significant injury where blood collects under fascia, outside of the vessels

Question 67

what is the tx for compartment syndrome?

Answer 67

fasciotomy, cutting open the limb, to relieve blood

Question 68

how much time can pass until compartment syndrome causes permanent damage?

Answer 68

>6 hrs

Question 69

what is limb ischemia?

Answer 69

death to limb due to lack of blood flow

Question 70

what are the 6 P's of limb ischemia?

Answer 70

* pain * pallor * pulselessness * poikilothermia * parasthesia * paralysis

Question 71

what is Bueger's test?

Answer 71

an assessment tool used to evaluate perfusion sufficiency in the lower limbs by observing color change in the feet and legs during elevation