Cardiovascular Flashcards
Precordium?
Area on anterior chest overlying heart and great vessels
During contraction, what happens with the apex?
Where do the great vessels lie?
It beats against the chest wall, producing an apical impulse
Great vessels lie bunched above the base of the heart
What do the pulmonary veins do?
What does the aorta do?
Pulmonary veins. return freshly oxygenated blood to the left side of the heart, while the aorta carries it out of the body.
Compliance of lung and cardiac tissue?
It’s ability to stretch and be elastic, allowing the tissue to accommodate what it needs to do.
Where does the cardiac impulse originate? Explain its travel
Originates in the sinoatrial node (SA node), intrinsic rhythm.
Travels to the trail ventricular node.
Travels to the bundle of His, the right and left bundle branches
Then to the ventricles
Circulation of blood through the heart?
Vena cavas Right atrium, tricuspid valve Right ventricle, pulmonary valve Pulmonary artery, lungs Left atrium, left ventricle Aorta, rest of the body
What is the SA node known as?
The pacemaker of the heart
What are the properties of arteries?
Oxygenated blood, elastic fibers, muscle fibers, pulse, high pressure
What are the properties of veins?
Deoxygenated blood, lie close to the surface, skeletal muscle contractions, one directional valves, low pressure
Cardiac subjective data?
Chest pain, dyspnea/orthopnea, cough, fatigue, cyanosis/pallor, edema, nocturia
Peripheral vascular subjective data?
Leg pain or cramps, skin changes, swelling, lymph node enlargement, medications, smoking history
What to inspect for?
Orientation/alertness, jugular neck veins
General and limb skin color/mucous membranes, capillary refill, edema
Edema grade scale?
1+ up to 2mm indentation, <10 sec
2+ 2-4mm, 10-15 sec
3+ 4-6mm, >1 minute
4+ 6-8mm, 2-5 min
Leg inspection?
Arm inspection?
Skin and hair, symmetry (unilateral swelling), temp, calf muscles, inguinal lymph nodes
Skin, capillary refill, symmetry
What to palpate for apically, pulses, etc?
Apical impulse in the 5th intercostal space on the midclavicular line
Pulses: regularity, symmetry, quality, rate
Skin temperature
Pulse locations?
Carotid, brachial, radial, femoral, popliteal, dorsalis pedis, posterior tibial
Apical pulse ranges?
Normal: 50-95
Brachycardia: <50
Tachycahrdia: >100
Hypertension and hypotension?
Hyper: greater than 140/90
Hypo: Systolic less than 100, decreased cardiac output
Cardiac output formula
SV x HR
Heart sounds/ S1/S2?
First: Systole. AV valves/Mitral and tricuspid valves shut (S1). Loudest at the apex. Lub.
Second: End of systole. SL valves/Aortic and pulmonic valves open (S2). Loudest as the base. Dub.
Abnormal S3 heart sounds?
Vibration of the ventricles that resist early, rapid filling
Abnormal S4 heart sounds?
Vibration of the ventricles the occurs when the atria contract and push blood into a noncompliant ventricle.
Explain murmurs?
Increases or decreases in the velocity of blood flow. Structural defects in the valves or unusual openings in the chambers.
Auscultatory areas of the valves?
Aortic: 2nd right interspace
Pulmonic: 2nd left sternal interspace
Erbs’s point/second pulmonic: 3rd left sternal interspace
Tricuspid: 4th interspace left lower sternal border
Mitral: 5th interspace at left clavicular midline
Typical heart rate of infants?
Younger the age, the higher the heart rate
70-90 when sleeping
170 when crying
Brady and tachycardia in infants?
Bradycardia: <90 bpm in newborns. <60 bpm in older infants and children.
Tachycardia: >200 bpm in newborns. >150 bpm in infants
Variations that may be found in pregnant women?
Higher resting pulse.Drop in BP during second trimester and a rise in third trimester. Heart sounds are different because of increased blood volume. Edema.
Variations that may be found in older adults?
Gradual rise of SBP, DBP constant. RF orthostatic hypotension. Premature ectopic beats on ECG.
Be careful palpating carotid pulse because can accidentally lower the heart rate.
104F
98.6F
95F
40C
37C
35C
With every beat the heart pumps an amount of blood into the aorta. Volume?
Stroke volume
About 70 mL in the adult.
The heart rate varies with the respiratory cycle, speeding up at the peak of inspiration and slowing to normal with expiration.
Sinus arrhythmia.
Inspiration momentarily causes a decreased stroke volume from the left side of the heart; to compensate the heart rate increases.
The maximum pressure felt on the artery during left ventricular contraction, or what?
Systolic pressure.
Left ventricular contraction is systole
The elastic recoil, or resting, pressure that the blood exerts constantly between each contraction.
Diastolic pressure
The difference between the systolic and diastolic pressures, reflecting the stroke volume.
Pulse pressure
The pressure forcing blood into the tissues average over the cardiac cycle.
Mean arterial pressure or MAP
It’s a value closer to diastolic pressure plus one third of the pulse pressure
What five things is the blood pressure determined by?
Cardiac output, peripheral vascular resistance, volume of circulating blood, viscosity, elasticity of vessel walls
A tough, fibrous, double-walled sac that surrounds and protects the heart.
The muscular wall of the heart.
The thin layer of endothelial tissue that lines the inner surface of the heart chambers and valves.
Pericardium
Myocardium
Endocardium
Abnormally high pressure in the left side of the heart gives a person symptoms of what?
Pulmonary congestion
Abnormally high pressure in the right side of the heart shows symptoms of?
Distended neck veins and abdomen
