Cardiovascular assessment Flashcards
Whats included in cardiovascular system?
- Blood, blood vessels and heart (low pressure on right (to lungs) and high on left(to body))
Where is the heart located?
The thoaratic cavity – in area called precordium
Base is around 2nd intercostal and apex on the 5th intercostal space
What is the pathway of blood around the heart?
- Veins (valves, elastic walls (calf muscle pump), thoracic pump (negative vs positive pressures)
- Vena cava
- Right atrium
- Atrioventricular valve (tricuspid)
- Right ventricle
- Semi-lunar valve
- Pulmonary artery (left and right)
- Lungs
- Pulmonary vein (4 times)
- Left atrium (very thick walls)
- Atrioventricular valve (mitral)
- Left ventricle (very thick walls)
- Aorta
What are the three layers of the heart muscle?
Tough – pericardium and myocardium is muscular (containing cardiac myocytes cells of heart)
Explain the cardiac conduction system
- SA node (sinoatrial) – in right atrium – the natural pacemaker cell (P wave)
- AV node (atrioventricular node) – slows and facilitates conduction down to bundle of his (hispurkyne system)
- Moves frown to purkyne fibres (ventricular depolarisation) – muscular contraction occurs (QRS)
What is Pulseless electrical activity?
PPA No mechanics occurring but there’s still electrical impulses that can be seen on ECG.
What are the two sections of the cardiac cycle?
Diastole – relaxation (rapid filling, slow filling then presystole) – lub
Systole – contracting (isometric contraction then ejecting of blood) - dub
Atrium and ventricle doing opposite to the other one.
What are coronary arteries?
Heart blood supply from the aorta – to oxidate the myocardium muscle layer.
Left and Right (nodal arteries) – can be blocked and so stop oxygenating.
What would you inspect during a cardiovascular system assessment?
- Inspection – general demeanour (restless, confused, pain, posture, anxiety, chest pain and sweating)
- Inspection – sputum and cough – haemoptysis (blood coughing) – frothy/coloured
- Inspection – cardiac distress – shortness of breath, wheeze, severe chest pain, radiation, fear of im pain ding doom
- Inspection – colour – cyanosis or pallor
- Inspection – dysmorphic features (misshapen face? Like down syndrome), peripheral oedema and leg/calf pain
What would you look at in the hands and arms of a cardiovascular assessment?
- Hands and arms – inspection (peripheral cyanosis (capillary refill), clubbing or splinter haemorrhages(bruise looking section on nail – sign of an infection in the heart)
- Hands and arms – palpation – temperature, moisture/sweating, capillary refill test – pulse (rate, rhythm, volume)
What would you look for in the face and neck of a cardiovascular assessment?
- Face and neck – inspection – conjunctiva (eye lid should be red if white could be anemic), xanthalasmata(lipid deposit around the eye), corneal arch’s (lipid causing a white ring around the eye), mouth – mucosa, dentition, colour
- Face and neck – palpation – carotid pulse
What precordium inspection would you look for in a cardiovascular assessment?
- shape (chest abnormalities) – scars – sternotomy, thoracotomy or pacemaker/devices
- Check pain/tenderness on chest – palpation
When asculatating what would you look for in a cardiovascular assessment?
- normal lub dub regular (2nd or 5th (mitral area for apex) 2. if louder around edge then enlarged heart cardio 3. hypertrophy due to enlargement of heart or blood vessels (can also listen to pulmonary oedema to fluid in the liquid can sound like crackling)
WHat would you focus your history on during a suspected cardiovascular problem?
- OLDCART – presenting complaint
- PMH, drugs and allergies
- Access specific risk factors – Hypertension (BP), high cholestrol, genetics and family history, smoking, diabetes, obesity, age, chest pain, breathlessness, sweating, age (over 50), exercise tolerance/fatigue and palpitations
What does the heart sounds (lub dub) signify?
S1 – Lub – mitral and tricuspid valve closing
S2 – Dub – closer of aortic and pulmonary valves together
If listening from the apex LUB should be loader however if lobstering from base of heart then DUP should be loader.
