Cardiovascular and Peripheral Vascular Assessment Flashcards
What is contained within the mediastinum
- Heart
- Great Vessels: aorta, pulmonary artery, & superior/inferior vena cava
- Esophagus
- Trachea
- Thoracic duct
- Thoracic lymph nodes
What chamber of the heart is the most anterior ?
Right ventricle
Where can the RV and pulmonary artery be found?
To the left of the sternum @ the level of the sternal angle (base of the heart)
What intercostal space represents the level of the base of the heart
2nd intercostal space
Point of maximal impulse (PMI)
LV behind the RV & to the Left forms the L lateral margin
5th ICS @ left midclavicular line
- 1 to 2.5 cm in supine
- PMI > 2.5 cm = LVH
Where is the PMI in right & left hypertrophy?
RVH - PMI @ xiphoid or epigastric area
LVH- PMI > 2.5 cm
- PMI displaced laterally to MCL
- PMI > 10 cm from midsternal line
What are the atrioventricular valves
Tricuspid & Mitral
What are the semilunar valves
Aortic & Pulmonic
Which valves closing cause S1? vs S2?
S1 = AV closure S2 = SL closure
Where is the aortic valve located?
Right sternal border 2nd ICS
Where is the pulmonic valve located?
Left sternal border 2nd ICS
Where is the tricuspid valve located?
Right sternal border 5th ICS
Where is the mitral valve located?
Left midclavicular 4th ICS
What is an S3 murmur
Mitral valve opens, allowing abrupt blood flow, filling the left ventricle (compliant/ dilated)
- right after S2 (early diastole)
- during LV PASSIVE filling
- can be normal in kids & teens
- heard best at the cardiac apex
- In older adults it represents pathology
What is the pathology of an S3 in an older adult?
the myocardium is usually overly compliant, resulting in a dilated LV
- CHF (systolic)
- Mitral regurg
What is an S4
Increased LV end diastolic stiffness which decreases compliance
- right before S1 (late diastole)
- during LV active filling
- Pathological ventricular stiffness
What is the pathology of an S4?
Non-compliant heart trying to fill but meeting resistance
- HTN
- MI
- Diastolic HF (problem w/ end diastolic filling)
- Worse d/t not feeding coronary arteries
What causes a heart murmur?
Turbulent blood flow
- distinguished by their pitch and longer duration
- indicate valvular heart disease in the older adult
What is the difference between a stenotic valve and a regurgitant valve?
Stenotic = narrowed orifice that obstructs blood flow
Regurgitant = close abnormally and allows backward flow
Murmurs detected during pregnancy should be immediately evaluated especially ________ & ________.
Aortic stenosis & pulmonary hypertension
Where is the SA node located and what is the intrinsic rate?
In the RA at the junction of vena cava inferior & superior)
- Pacemaker rate 60-100
Where is the AV node located and what is the intrinsic rate?
In the distal atrial septum.
- Pacemaker rate 40-60
HR x SV =
Cardiac output
What is a normal EF
60%