Cardio vascular system Q1 Flashcards
Significant anatomical features of the heart
Significant anatomical features of the heart
Two atria
Two ventricles
Relate heart sounds to physiological heart sounds
Relate the name of the heart sound to the physiological cause.
S1= a lub sound, resulting from the closure of valves between atria and ventricles (tricuspid valve and mitral valve)
S2=closure of pulmonary and aortic valves (dub)
Relate structures of the heart to land marks on chest
Relate anatomical structures of the hard to the correct landmark or anatomical location (APE To Man)
- Aortic- right side, second intercostal space, right sternal border
- Pulmonic -left side second intercostal space, left to the sternal border
- Erbs point- left side, third intercostal space, left the sternal border
- Tricuspid left side, fourth and fifth intercostal space, left lower sternal border
- Mitral left side fifth intercostal space just medial to the midclavicular line (PMI)
Chest anatomical land marks for auscultation of the heart
Anatomical landmarks for auscultation of the heart
Base right (aortic valve) located at the angle of Lewis. (It is the prominence on the sternum 2 to 3 finger breaths below those supra-sternal notch) slide fingers below until you feel the second intercostal space the right second intercostal space is the best place to auscultate the aortic valve
The best place to locate pulmonic valve is to the left of the angle of Louis
The apex or mitral valve can be located by looking for the PMI is on the fifth intercostal space in the midclavicular line on the left
Left lateral sternal border tricuspid valve. From the apex, slide your finger up to the fourth intercostal space, and move close to the sternum.
Distinguish normal to abnormal heart sounds
Distinguish between normal and abnormal heart sounds.
- Abnormal
- Extra heart sounds (best heard with the bell of the stethoscope)
- S3 ventricular Gallup sounds (KenTUcky) normal and pregnancy
- S4 atrial gallop heard before S1 (FLOrida)
- Murmurs
- Thrill- of vibration or pulsation
Questions to ask when completing a focused interview
Some questions to ask when completing the focused energy
- Are you having any chest discomfort? If yes, when did you begin?
- What were you doing before the pain started japing make it better or worse?
- Have you had pain like this before?
- When does it what does it feel like?
- Show me where hurts.
- On a scale from 1 to 10 how bad does it hurt or is the pain?
- Do you have a history of CVD? If yes, are you taking any medications for? And what and why?
- Do you have any allergies? If yes, describe reaction.
What are some normal physiological changes of the cardiovascular system associated with aging?
Postural hypotension drop in BP when changing body positions (sitting to standing)
Auscultatory gaps systolic pressure fades and reappears at lower pressure points
Incidence of coronary vascular disease increases
Number of cells and efficiency organs declines gradually as people age. The heart muscle loses contractibility strength and the heart valves become thicker and more rigid.
The heart becomes less able to respond to increased arcane commands and needs a longer recovery.
Identify when assessment findings vary from normal
When assessment findings very from normal
- When assessing the heart and listening for S1 and S2 sounds there can be abnormal additions to the heart sounds: S3 which is a ventricular Gallup (normal in pregnancy) and S4 atrial gallop before S1 sound
- It is possible to hear murmurs and thrills (of vibration or pulsation)
- peripheral: clubby, skin lesions, edema, capillary refill.
Describe techniques for assessment of cardiovascular system
Technics required for assessment of the cardiovascular system.
Auscultation of heart sounds point on the chest: aortic, pulmonary, erb’s point, tricuspid, mitral (APE To Man)
Listen for S1 and S2 sounds. If there are additional sounds they’ll be important to chart what they are. S3 and S4
Look for jugular distention, which could be a sign of right-sided heart failure.
Techniques needed for assessment of peripheral vascular system
Describe techniques required for assessment of the peripheral vascular system.
Edema of lower limb
Pallor (which indicates reduced blood flow from the heart)
Cold limbs ( this would indicate reduced blood flow)
If discolored it could mean that the patient is having bad venous flow, purple brown colors could be present
Clubbing of fingers
Different pulses assessable for examination
Recognize the pulses accessible for examination.
Femoral pulse Radial pulse Brachial pulse Carotid pulse Anterior planter pulse Dorsal tibial pulse
How do you assess for quantify edema?
How to assess and quantify edema.
Look in the legs or any area that is swollen they are two different types: pitting and nonpitting edema
+1 slight pitting, 2 millimeters depression and disappears rapidly
+2 is 4 mm depression disappears within 10 to 15 seconds
+3 is 6 mm depression that lasts more than one minute
+4 is very deep, 8mm depression and last ~2-3 min
Differences between arterial ulcers, diabetic ulcers and venous stasis ulcers
The differences between all arterial ulcers, diabetic ulcers and venous stasis ulcers.
Arterial developer between or end of toes, cool cold feet, hair loss, shiny thin skin
Venous stasis ulcers located at the ankle, foot is warm, discoloration, edema, pulses present, minimal pain
Diabetic ulcers located in the planter area of foot pressure or metatarsal points, reports no pain due to peripheral neuropathy
Risk factors for arterial and venous stasis ulcers, thrombophlebitis and varicose veins
Risk factors for arterial and venous stasis ulcers, thrombophlebitis and varicose veins.
Thrombophlebitis: endothelial injury venostasis or hypercoagulability, postop, and mobility (such as sitting still for a long airplane trips)
Varicose veins: adults over 30 years occupations require prolonged standing, people with systemic problems, obesity, and a family history of their coast
The Venous/arterial stasis ulcers: people with long-term venous insufficiency, can result from edema or minor injury to the limb, (arterial develops between or end of toes, Venous develops ankle location)
Differentiate normal and abnormal findings of the peripheral vascular system
Difference between normal abnormals and physical assessment of the proof real faster system.
Normal: warm and dry skin, non-swollen glands, good turgor, skin this pain.
Abnormal: scan is cyanotic, wet from sweat, edema in limbs (particularly in legs), nail clubbing
