cardiovascular part 1 (2) Flashcards
describe blood flo through heart?
inferior vena cava → right atrium → tricuspid valve → right ventricle → pulmonic valve → pulmonary arteries → lungs → pulmonary veins → left atrium → mitral valve → aortic valve → aorta → body
what are the 2 atrioventricular (AV) valves?
separate atrium and ventricles, name right and left
tricuspid = right AV valve
mitral = left AV valve
which 2 valves are semilunar valves?
pulmonic valve
aortic valve
what node is the pacemaker of the heart?
SA node
what cells initiate electrical impulse?
specialized cells in right upper atrium near superior vena cava (SA node!!!)
where is the AV node located?
low in atrial septum
why do PICC lines casue increased risk for arrythmias?
they are near the SA node, amy touch and interfere
describe pathway of conduction?
SA node → AV node → bundle of HIS → R and L bundle branches → purkinje fibers
what signifies atrial depolarization
P wave
what is the time from beginning of atrial depolarization to beginning of ventricular depoalrization
PR interval
what is ventricular depolarization
QRS complex
what is ventricular repolarization
T wave
what is the period between ventricular depolarization and repolarization?
ST segment
when can electrical conduction be measured PQRST
if pt. is in sinus rhythm with 5 leads
what is the amount of oxygen that can be delivered to tissues
oxygen saturation
what measures arterial oxygen saturation?
SpO2 (pulse ox)
normal pulse ox?
95-98
what will require a child to need oxygen?
can not maintain 92% while awake or 88% while sleeping
what is the point if maximum impulse for children 7 and younger?
4th intercostal space (ICS) medial to left midclavicular line (MCL)
what is the point of maximum impulse over age 7?
5th ICS, left MCL
what is the volume of blood ejected from the left ventricle each minute
cardiac output
how is cardiac output controlled in young children
heart rate
what is the ability of the heart muscle fibers to contract forcefully?
contractibility
what si teh systemic resistance to the ventricular ejection of blood?
afterload
how long does a child rely on heart rate for cardiac output?
until 5 y.o.
what heart sound is produced by the closure of the tricuspid and mitral valves when ventricular contraction begins?
S1 (first heart sound)
what heart sound is produced by the closure of the aortic and pulmonic valves
S2 (secind sound)
what is the bell of the steth used to hear?
low pitched murmur
where is the aortic area auscultated?
2nd ICS RSB
where is the pulmonic area auscultated?
2nd ICS, LSB
where is the tricuspid area auscultated?
5th ICS, LSB or RSB
where is the mitral area auscultated in infants?
3rd or 4th ICS, just left of MCL
where si the mitral area auscultated in children (not infants)
5th ICS, LSB
where do you listed for heart rate
apex
normal awake and sleeping heart rates for newborn-3 m.o.
- awake = 85-205
- sleep = 80-160
normal awake and sleeping heart rates for 3 months-2 y.o.
- awake = 100-190
- sleep= 75-160
normal awake and sleeping heart rates for 2 y.o.-10 y.o.
- awake = 60-140
- sleep = 60-90
normal awake and sleeping heart rates for greater than 10 y.o.
- awake = 60-100
- sleep = 50-90
what arm is best for blood pressure
right
if a cuff is too small, the bp will be falsely ____?
high
if a cuff is too big, the bp will be falsely ____?
low
bp is higher in the ____
legs (not preffered)
how do you calculate 50th percentile BP?
(90+(age in years x 2))
how do you calculate 5th percentile BP (hypotension)?
used in 1 y.o. to 10 y.o.
(70+(age in years x 2))
what is newborn-30 d.o. systolic hypotension?
less than 60
what is hypotension in 1 m.o.-1 y.o.?
less than 70
what shows abnirmal neurological status in babies
disinterest in feeding, weak suck, irritability, weak cry, lethargic, poor tone
when does acrocyanosis resolve?
w/in 48 hr (immature circulation)
what causes heart murmurs?
4 of them
- turbulent flow
- forced through narrow passage
- regurgitation
- increased flow (anemia)
are all murmurs bad?
no
what are abnormal cap refill, skin, and temp findings?
- cap refill greater than 3 and uneven upper/lower
- mottling, pallor
- cold/cool
what are the muscle fibers in the interventricular septum called?
1. purkinje fibers
2. bundle of HIS
3. bundle branches
4. atrioventricular fibers
2
which extremity is best to take BP in?
right arm
what is the 50th percentile systolic for a 6 y.o.?
1. 114/66
2. 90/64
3. 96/68
4. 102/66
4
what will a cardiovascualr peripheral assessmnet include?
color, temp, cap refill, pulses, edema
