Cardiovascular (Chapter 20) Flashcards
bruit is caused by
stenosis
where is the apex located
left 5th intercostal midclavicular
where is the base of the heart located
near aortic and pulmonic location
2nd intercostal just lateral of sternum
what other names are used for apex of heart
mitral
apical
PMI (point of maximum impulse
where is S1 the loudest
apex
where is S2 the loudest
base
what are the AV valves
tricuspid
mitral
how many flaps does the tricuspid valve have
3
how many flaps does mitral valve have
2
what AV valve is located on the right side
tricuspid
what AV valve is located on the left side
mitral
what are the two semilunar valves
pulmonic
aortic
what is the left semilunar valve
aortic
what is the right semilunar valve
pulmonic
S1 is the closure of
AV valves
S2 is the closure of
semilunar valves
what are the two abnormal heart sounds
S3, S4
when would you hear S3
after S2
when might S3 be normal
children, pregnancy
does the S3 in pregnancy resolve
yes after delivery
why do pregnant people experience S3
additional workload
when might S3 be abnormal
post MI
elderly
do the S3 in post MI disapate
yes after healing
what are S3 in elderly related to
disease
- coronary artery disease
when might the S4 be normal
athletes
why do athletes experience S4
decrease pulse produces a lag
when might S4 be abnormal
elderly
what diseases will promote S4
aortic stenosis
cardiomyopathy
hypertension
carotid pulse coincides with
S1
what pulse site do we use to check for effectiveness of CPR
carotid
what is important to know about palpating the carotid
one at a time
why do we not want to palpate bilaterally the carotid
decrease the amount of blood to brain (could cause stroke)
the right jugular vein provides information about
right side of heart
why do assess from the right side of the bed
to assess the right jugular vein (and to assess for heaves and lifts)
right side of the heart provides us information about
heart failure
what question should you ask if someone is experiencing chest pain
does the pain get worse when you take a deep breath
what would you expect if the patient reports the chest pain does get worse with a deep breath
associated with the lungs
what would you expect if the patient reports the chest pain stays the same when taking a deep breath
heart associated, possible MI
what might you expect if someone reports pain after car crash
superficial muscles are damaged/sore
dyspnea
difficulty breathing
orthopnea
difficulty breathing when laying flat
dyspnea and orthopnea may mean
heart failure
fatigue can be associated to
decreased cardiac output
cyanosis/pallor will mean
less O2
nocturia
urinating frequently at night
what might nocturia mean
heart failure
what are some important diseases when asking for cardiac hisotry
hypertension, increased cholesterol, murmur, history of MI
family cardiac history is important becasue
genesis plays a large roll and may be a cue
what are some personal habits important to ask the patient
history of smoking
nutrition (related to cholesterol)
illegal drug use (COCAINE)
any exercise
in heart failure you might experience ________ in lower extremities
edema
what side of the stethoscope do we use to listen to carotids
bell
what is something important we instruct our patients when auscultating the carotid
inhale, exhale, hold breath
what are we auscultating for when listening to carotid
bruit
a bruit in carotid might be caused by
carotid stenosis
carotid stenosis increases risk of
stroke
jugular vein distension
edema in jugular vein
how do we inspect for jugular vein distension
have patient lay flat
- if present raise HOB to 30-40 degrees
why do we raise the head of the bed if JVD is present when laying flat
to confirm if patient actually has JVD because when laying flat increase blood rushes to head
why do we tell patient to hold breath when auscultating carotid
so we do not hear bronchial sounds
are heaves/lifts normal
no
what might you assume if you see pulsations of the aorta
abdominal aortic anyserusm
how long do we count for apical
1 min
what is the most frequent cause of irregular rhythm
a fib
pulse deficit
evaluating the apical and radial pulse
take both simultaneously
apical- radial= deficit
any deficit is not normal
S1 is louder than S2 at the
apex
S1 coincides with the _____________ pulse
carotid
S1 coincides with the ___ wave on EKG
R
where is aortic auscultation area
2nd intercostal right side of sternum
where is the pulmonic auscultation area
2nd intercostal left
where is erbs point
3rd intercostal left
where is mitral area
5th intercostal mid clavicular
where is tricuspid auscultation
5th intercostal left of sternum
what side of stethoscope do we use to listen to heart
both
what position do we put the patient in when listening to S3 and S4
left lateral position
why do we put the patient in the left lateral position when listening to S3 and S4
pushes heart toward wall
innocent murmur
dissipate after the child gets older
the first heart sound is produced by
closure of the AV valves
which of the following is an appropriate position to have the patient assume when auscultating the heart sounds
recombent position
a bruit heard while auscultating the carotid artery of a 65 year old women is caused by
turbulent blood flow through carotid artery
