cardiovascular and peripheral vascular Flashcards
what is the pathway of blood through the heart?
Superior and inferior vena cava → right atrium → (through tricuspid valve) → right ventricle → (through pulmonary valve) → pulmonary artery → (through aortic valve) → aorta → rest of the body
Non-modifiable factors for cardiovascular disease
- family history
- increased age
- ethnicity
Modifiable factors for cardiovascular disease
- elevated cholesterol
- high blood pressure
- high blood sugar levels (diabetes mellitus)
- obesity
- cigarette smoke
- sedentary lifestyle
- diet, sodium
signs and symptoms of cardiovascular problems
- pain in chest, jaw, neck, left shoulder, left arm, subscapular, stomach pain
- diaphoresis (unusual sweating)
- cough
- lightheadedness
- dyspnea
- orthopnea
- nausea and vomiting
- paroxysmal nocturnal dyspnea - sudden shortness of breath when asleep
- leg pain, ulcers to lower extremities
- edema
- pressure (elephant sitting on chest)
- nocturia - getting up during the middle of the night to pee
- racing heart
- indigestion or heartburn
- palpitations/dysrhythmia
- fatigue
- presyncope/syncope - fainting
- exertion causing chest pain
what is the first step in the physical assesment
Inspection
what to do in inspection part of cardiovascular assessment?
- the genera survey
- skin colour
- respirations
- speech patterns
- diaphoresis
- size and shape of thorax
- finger - nail beds
- landmarks
- abnormal pulsations
what to take note of in cardiovascular system
- rate of pulse
- rhythm
- strength and volume (absent, weak, thready, normal, full, bounding, symmetry)
what is the point of maximal impulse
the apex
where to auscultate the aortic valve
2nd intercostal space, right sternal border
where to auscultate pulmonic valve
2nd intercostal space, left of sternum
where to auscultate tricuspid valve
4th-5th intercostal space, left sternal border
where to auscultate mitral valve
5th intercostal space, midclavicular line
what is “lub dub”
S1 (lub) and S2 (dub)
S1 cardiac auscultation
- loudest at apex
- its when the closure of mitral and tricuspid valves happen
- happens at beginning of systole
S2 cardiac auscultation
- loudest at base
- when closure of aortic and pulmonic valves happens
- happens at beginning of diastole
what are Heart murmurs
turbulence causing “swooshing” or “blowing” sounds
- result of cardiac abnormalities like inc. blood viscosity, structural valve defects, valve malfunctions, abnormal chamber opening (septal defect), etc.
what are bruits
turbulent blood flow usually caused by partial obstruction
what are the effects of aging on the heart
- amount of collagen in heart increases and elastin decreases
- decreases contractility and heart rate
- the cardiac valves become thicker and stiffer from lipid accumulation, valve incompetence of stenosis = murmur
- # of pacemaker cells in the SA node decreases = bradycardia and heart block
- decrease sympathetic nervous system control of cardiovascular system
- arterial blood vessels thicken and become less elastic which leads to increased blood pressure
what is the peripheral vascular assessment
assessment of the circulatory and nerve function of the extremities (hand/feet)
when to perform a neurovascular assessment
- when there is a trauma/ injury to the limb
- when there is a presence of cast or other protective device
- if there is surgery done to a limb (considered controlled trauma)
- presence of wound on limb or varicose veins
-if there are any conditions which may cause poor circulation such as heart failure, diabetic, peripheral neuropathy, etc. - if the client is complaining of discomfort or pain in a limb
what is venous insufficiency
pain that is described as aching, dull and heavy
- there is swelling as the day progresses
- pain and edema present when legs are elevated
- varicose veins present
what is arterial insufficiency
pain with exertion (ex. while walking) - intermittent claudication
- it is relieved by short rest
- pale when leg is elevated, Rubor (redness) with dependency (when hanging down)
what is Atherosclerosis
build up of fats, cholesterol, and other substances in the artery walls which form plaques and restrict blood flow
what is Intermittent claudication
muscle pain that happens in you legs when you’re active and then stops when you rest
