Cardiovascular System Flashcards
1
Q
Mediastinum
A
Compartment for the thoracic organs
2
Q
What is the superior border of the heart?
A
Base –> Base of the heart is at the right and left 2nd intercostal
space at the sternal border
3
Q
What is the inferior border of the heart?
A
Apex –> Apex of the heart is in the fifth left intercostal space
7-9cm to the midsternal line
4
Q
What is the Myocardium?
A
Muscle of the heart that Consists of 4 chambers
5
Q
What are the upper chambers of the heart?
A
Atria
6
Q
What are the lower chambers of the heart?
A
Ventricles
7
Q
What is the septum of the heart?
A
Separates the left and right sides of the heart
8
Q
What is the purpose of the heart valves?
A
Regulates heart flow in and out of the ventricles
9
Q
What are the 2 valves of the heart?
A
1) Atrioventricular Valves
2) Semilunar Valves
10
Q
What are the atrioventricular valves of the heart?
A
Separate the atria from the ventricles (Tricuspid and Mitral)
11
Q
What are the semilunar valves of the heart?
A
separate the ventricles from the great vessels (pulmonic and aortic)
12
Q
How many layers does the heart have?
A
The wall of heart has 3 layers
and a sac surrounding the
heart
13
Q
What is the pericardium?
A
- is a tough, fibrous, double-walled sac that surrounds and protects the heart
- Helps limit ventricular
dilation - Protects the heart from
infection and disease
14
Q
What is pericardial fluid?
A
This ensures smooth, friction-free movement of the heart muscle
15
Q
What is pericarditis?
A
swelling and irritation of the thin, saclike tissue surrounding the heart
16
Q
What is pericardial tamponade?
A
pressure on the heart that occurs when blood or fluid builds up in the space between the heart muscle and the outer covering sac (pericardium) of the heart
17
Q
What does the cardiovascular system consist of?
A
1) Heart
2) Blood Vessels
18
Q
What intercostal spaces does the heart occupy?
A
2nd to 5th intercostal space from the right border of the sternum to the left midclavicular line
19
Q
What are the 2 ways that the blood vessels are arranged?
A
1) Pulmonary circulation
2) Systemic circulation
20
Q
What is the pulse at the apex of the heart called?
A
Apical Pulse at the 5th intercostal space
21
Q
What does the superior and inferior vena cava do?
A
Return deoxygenated venous blood to the right side of the heart
22
Q
What does the pulmonary artery do?
A
leaves the right ventricle, bifurcates, and carries the venous blood to the lungs
23
Q
What do the pulmonary veins do?
A
return the freshly oxygenated blood to the left side of the heart
24
Q
What does the right side of the heart do?
A
the right side of the heart pumps blood into the lungs
25
What does the left side of the heart do?
the left side simultaneously pumps blood into the body
26
What doe the AV valves do during the opening of the heart's filling phase?
The AV valves open during the heart's filling phase or diastole to all the ventricles to fill with blood
27
What happens to the AV during the pumping phase?
During the pumping phase, or systole, the AV valves close to prevent regurgitation of blood back up into the atria
28
What is the cardiac cycle?
The rhythmic movement of blood through the heart
29
What are the 2 phases of the cardiac cycle?
1) Diastole: the ventricles relax and fill with blood
2) Systole: heart contraction
30
What are 2 normal heart sounds?
1) The first heart sound (S1 ) occurs with closure of the AV valves and thus signals the beginning of systole.
2) The second heart sound (S2 ) occurs with closure of the semilunar valves and signals the end of systole
31
What is the extra heart sound S3?
Normally diastole is a silent event. However, in some conditions ventricular filling creates vibrations that can be heard over the chest.
These vibrations are S3 . S3 occurs when the ventricles are resistant to filling during the early rapid filling phase
32
What is the extra heart sound S4?
Occurs at the end of diastole, at presystole, when the ventricle is resistant to filling.
The atria contract and push blood into a non compliant ventricle. This creates vibrations that are heard as S4
33
What is a heart murmur?
Some conditions create turbulent blood flow and collision currents.
A murmur is a gentle, blowing, swooshing sound that can be heard on the chest wall.
34
What are some conditions that result in a murmur?
1) Velocity of blood increases (flow murmur) -- in exercise or thyrotoxicosis
2) Viscosity of blood decreases (ex., in anemia)
3) Structural defects in the valves (a stenotic or narrowed valve, an incompetent or regurgitant valve) or unusual openings occur in the chambers (dilated chamber, septal defect)
35
What does the electrical impulse stimulate the heart to do?
The electrical impulse stimulates the heart to do its work, which is to contract
36
Can the heart alter its cardiac output?
The heart can alter its cardiac output to adapt to the metabolic needs of the body
37
What is the formula for Cardiac output?
CO= Stroke Volume X HR
Cardiac Output = This cardiac output equals the volume of blood in each systole (called the stroke volume) times the number of beats per minute (rate)
38
What affects the hearts ability to increase cardiac output?
Preload and afterload affect the heart's ability to increase cardiac output
39
What is preload?
Preload is volume
—it is the venous return that builds during diastole (It is the length to which the ventricular muscle is stretched at the end of diastole just before contraction)
40
What is the afterload?
Afterload is pressure
-- it is the opposing pressure the ventricle must generate to open the aortic valve against the higher aortic pressure. It is the resistance against which the ventricle must pump its blood
41
Where is the carotid artery located?
The carotid artery is located in the groove between the trachea and the sternomastoid muscle, medial to and alongside that muscle
42
What do jugular veins do?
empty deoxygenated blood directly into the superior vena cava
43
What can the jugular veins indicate?
Because no cardiac valve exists to separate the superior vena cava from the right atrium, the jugular veins give information about activity on the right side of the heart.
44
Which side of the heart has greater blood supply?
Left side of the heart has 2 main arteries (left coronary arteries and circumflex arteries)
45
Do the coronary arteries fill when the heart relaxes?
YES
46
What do cardiac veins do?
Cardiac veins empty deoxygenated blood
into the coronary sinus at the base.
47
What do the Carotid Arteries do?
deliver blood to your brain and head.
48
What do the Jugular Veins do?
takes deoxygenated blood from the head back to the heart
49
What is Systole in the Heartbeat?
Ejection of blood into the aorta and pulmonary trunk.
Blood moves from the ventricles and eject blood to the lungs and body.
50
What is Diastole in the heartbeat?
Heart muscles relaxes and allows chambers to fill with blood
51
What is the sympathetic response when controlling the heart rate?
“flight-or-flight” reactions,
triggers the release of epinephrine. Increases
heart rate, contractility and blood pressure.
52
What is the parasympathetic response when controlling the heart rate?
“rest and repose” system,
triggers a decreased heart rate by stimulated the Vagus nerve, innervates the SA node to slow the natural pacemaker.
Vagus nerve slows conduction thorough the AV junction
53
What are the 4 Steps of Electrical cardiac Conduction?
1. Pacemaker (SA Node)
Impulse Generation
2. AV Node Impulse
Conduction
3. AV Bundle Impulse
Conduction
4. Purkinje Fibers Impulse
Conduction
54
What are some hemodynamic changes with Aging?
- Increase in systolic BP
- Left ventricular wall thickness
- No change in resting heart rate occurs with aging.
- Cardiac output at rest is not changed with aging.
- There is a decreased ability of the heart to augment cardiac output with exercise
55
Why does an increase in blood pressure occur as a result of aging?
termed isolated systolic hypertension
This is caused by thickening and stiffening of the large arteries, which in turn are caused by collagen and calcium deposits in vessel walls and loss of elastic fibers. This stiffening (arteriosclerosis) creates an increase in pulse wave velocity because the less compliant arteries cannot store the volume ejected
56
Does the overall size of the heart increase with age?
NO but left ventricular wall thickness increases
57
Why does left ventricular wall thickness increase with age?
This is an adaptive mechanism to accommodate the vascular stiffening mentioned earlier that creates an increased workload on the heart
58
What is some subjective data to assess for a cardiac assessment?
1. Chest pain
2. Dyspnea
3. Orthopnea
4. Cough
5. Fatigue
6. Cyanosis or pallor
7. Edema
8. Nocturia
9. Past cardiac history
10. Family cardiac history
11. Patient-centered care (cardiac risk factors)
59
How do you assess the jugular veins and the precordium?
the person should be supine with the head and chest elevated between 30 and 45 degrees
Stand on the person's right side; this facilitates your hand placement, viewing of the neck veins, and auscultation of the precordium
60
What does the Assessment of the Precordium include?
- Inspect the anterior chest
- Palpate the apical impulse
- Palpate across the precordium
- Percussion
- Auscultation
61
Assessment of the Precordium: Inspect the Anterior Chest
Look for pulsations of the apical pulse at the 4th and 5th intercostal spaces on the patients chest wall (normal findings is no pulsations)
Inspect the anterior chest for any lesions, masses, heaves or lifts that appear as a forceful thrusting on the chest
62
Assessment of the Precordium: Palpate Across the Precordium
Use the palmer aspects of your 4 fingers, gently palpate over the apex, the left sternal border, and the base searching for any other pulsations (normally none are felt)
63
Assessment of the Precordium: Percussion
Used to outline the heart’s borders -- there should be a dullness when percussing
HOWEVER --> percussion has been replaced with chest radiographic imaging or echocardiogram
64
Assessment of the Precordium: Auscultation
Second right Intercostal Space: aortic valve
Second left intercostal space: pulmonic valve area
Third left intercostal space: Erb's point
Fourth intercostal space at left lower sternal border: tricuspid valve area
Fifth interspace at approximately left midclavicular line: mitral valve area (apical)
65
How do you move your stethoscope when auscultating the heart?
Start at the base and then move it in a rough “Z” pattern across the heart and down over to the apex
66
Second right Intercostal Space
aortic valve
67
Second left intercostal space
pulmonic valve area
68
Fifth intercostal space at left lower sternal border
tricuspid valve area
69
Fifth interspace at approximately left midclavicular line
mitral valve area
70
What is Dyspnea?
Difficulty breathing
SOBOE is an early symptom of pulmonary congestion
71
What is Orthopnea?
cannot breath while lying down and can only breathe when sitting up
72
How do you assess the carotid artery?
Head of the bed at 30-45 degrees
Have the client turn head away slightly
toward the opposite side
Palpate artery medial to the sternomastoid
muscle in the neck.
PALPATE ONE ARTERY AT A TIME!
73
How do you auscultate the carotid arteries?
Neck in neutral position
Lightly apply the bell over each carotid artery in turn while the client holds their breath
74
What three locations do you auscultate for the carotid artery?
- Angle of the jaw
- Midcervical area
- Base of the neck
75
What are you listening for when auscultating the carotid arteries?
Noting: bruits (swooshing sounds resulting
from turbulent blood flow- partial obstruction
of the artery).
May hear normal heart sounds.
