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Nurs 252 > Cardiovascular System > Flashcards

Cardiovascular System Flashcards

1
Q

Precordium

A

Area on anterior chest overlying the heart and great vessels

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2
Q

Great vessels

A

Major arteries and veins connected to the heart

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3
Q

The heart and great vessels are located between the

A

Lungs in the middle third of the thoracic cage

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4
Q

Mediastinum

A

Where the heart and great vessels are located
-between the lungs in the middle third of the thoracic cage

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5
Q

The heart extends from the levels of the ___ to ____ intercostal spaces

A

Second and fifth

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6
Q

During contraction, which part of the heart is creating the apical impulse by beating against the chest wall

A

The apex (bottom of the heart)

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7
Q

Where is the apical pulse palpable

A

The fifth intercostal
-7 to 9cm from Midsternal line

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8
Q

The great vessel lies

A

Bunched above the base of the heart

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9
Q

The superior and inferior venae cavae return ____ ___ blood to the ___ side of the heart

A

Return DE-OXYGENATED VENOUS

To the RIGHT side

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10
Q

Pulmonary artery leaves the __ ventricle

A

Right
-carries venous blood to lungs

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11
Q

Pulmonary veins return what type of blood?

A

Freshly oxygenated blood to left side of the heart

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12
Q

What carries oxygenated blood out to the body?

A

Aorta

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13
Q

Pericardium

A

Tough, fibrous, double walled sac surrounding/protecting the heart

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14
Q

What is found in between the two layers of the pericardium?

A

Pericardial fluid
-aids in reducing friction allowing for smooth movement of heart muscle

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15
Q

Myocardium

A

Muscular wall of the heart
-does the pumping

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16
Q

Endocardium

A

Thin layer of endothelial tissue lining the inner surface of heart chamber and values

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17
Q

Atrium vs ventricle

A

Atrium- thin walled reservoir for holding blood

Ventricle- thick walled muscular pumping chamber

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18
Q

How many chambers are there in the heart

A

Fourt

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19
Q

How are the chambers separated

A

By swinging door like structures called valves

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20
Q

Function of valves

A

Prevent back flow of blood

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21
Q

What does it mean by the valves are unidirectional

A

They can open only one way
-open and close passively in response to pressure gradients in the moving blood

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22
Q

What valves separate the atria and ventricles

A

Atrioventricular valves

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23
Q

The right AV valve

A

Tricuspid valve

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24
Q

Left Av valve

A

Bicuspid or mitral valve

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25
Q

Two different types of atrioventriclar valves

A

Tricuspid (right) and mitral (left)

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26
Q

The valves thing leaflets are anchored by collagenous fibres to papillary muscles embedded in the ventricle floor called

A

Chordae tendineae

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27
Q

When do the AV valves open

A

During hearts filling stage or diastole

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28
Q

Why do AV valves open

A

During diastole so that ventricles can fill with blood

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29
Q

When do the AV valves close

A

During the pumping phase or systole

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30
Q

Why do AV valves close

A

To prevent regurgitation of blood back up into atria

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31
Q

When do the papillary muscles contract

A

During systole
-so that the valve leaflets meet and untie to form a perfect seal without turning themselves inside out

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32
Q

Where are the semilunar valves

A

Between ventricles and pulmonary arteries

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33
Q

Each semi lunar valve has

A

Three cusps that look like half moons

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34
Q

What are the two semilunar valves

A

Pulmonic valve (right side) and aortic valve (left side)

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35
Q

Semilunar valves open during

A

Pumping (systole) to allow blood to be ejected from the heart

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36
Q

Where are there no valves

A

Between the venae cavae and right atrium, or between pulmonary veins and left atrium

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37
Q

Because there are no valves between venae cavae and right atrium, and the pulmonary veins and left atrium what can happen on the left side of the heart

A

Abnormal high blood pressure in the left side of the heart produce symptoms of pulmonary congestion, heart failure

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38
Q

Because there are no valves between venae cavae and right atrium, and the pulmonary veins and left atrium what can happen on the right side of the heart

A

Abnormally high pressure in the right side of the heart manifests as distension of neck veins and abdomen

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39
Q

Blood flows from liver to

A

Right atrium via inferior vena cava

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40
Q

Superior vena cava drains venous blood from

A

Head and upper extremities

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41
Q

From right atrium venous blood travels through tricuspid valve to

A

Right ventricle

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42
Q

From right ventricle, enough blood flows through

A

Pulmonary valve to pulmonary artery

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43
Q

Pulmonary artery delivers

A

unoxygenated blood to lungs

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44
Q

Lungs oxygenate the blood then travels to

A

Pulmonary veins where it returns fresh blood to left atrium

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45
Q

From left atrium arterial blood travels through

A

Mitral valve to left ventricle

46
Q

Left ventricle ejects blood through

A

Aortic valve into aorta

47
Q

What are the two phases of the cardiac cycle

A

Diastole and systole

48
Q

Diastole vs systole

A

Diastole- ventricles relax and fill with blood

Systole- hearts contraction and blood is pumped from ventricles (into pulmonary and aortic arteries)

49
Q

In diastole the ___ valves are open

A

AV

50
Q

During diastole the pressure in the ___ is higher than in the __

A

Atria, ventricles

-so that blood pours rapidly into the ventricles

51
Q

Early or protodiastolic filling

A

First passive filling phase

52
Q

Presyostole or atrial systole

A

Toward end of diastole, atria contract and push last amount of blood into ventricles
-atrial kick

53
Q

Presystole or atrial systole causes a

A

Small rise in left ventricular pressure

54
Q

As ventricular pressure rises due to the increased volume at the end of diastole, what happens

A

The mitral and tricuspid valves swing shut

55
Q

First heart sound (S1) is caused by

A

Closing of the AV valves

56
Q

What is the signal of systole

A

S1

57
Q

For a very brief time after S1 what is happening

A

All four valves are closed

58
Q

What happens due to the brief period of time where all the valves are closed

A

Ventricular walls contract within the closed system increasing the pressure to a higher level —> ISOMETRIC CONTRACTION

59
Q

When the pressure in the ventricle finally exceeds pressure in the aorta (isometric contraction) what happens

A

The aortic valve opens and blood is ejected rapidly

60
Q

What happens once all the ventricles are ejected

A

Pressure falls, and when pressure is below aorta pressure some blood flows backward toward ventricle causing aortic valve to shut

61
Q

What is the cause of the second heart sound (S2)

A

Closure of semilunar valves
-end of systole

62
Q

Isometric or isovolumic relaxation

A

After end of systole, all four valves are closed and ventricles relax

-but atria have been filing with blood from lungs and so pressure in atrias are higher than ventricles again, so mitral valve drifts open and diastolic filling begins again

63
Q

During inspiration ___ pressure is decreased, this pushes more

A

Intrathoracic pressure
-pushes more blood into venae cavae increasing venous return to right side of the ehart

64
Q

moRe to the

A

Right

65
Q

Less to the

A

Left

66
Q

Normally ___ is a silent event

A

Diastole

67
Q

S3

A

In some conditions ventricular filling creates vibration that can be heart over the chest

-ventricles are resistant to filling during protodiastole

68
Q

Where is S2 loudest

A

At the base

69
Q

S4

A

End of diastole at presystole, when ventricle is resistant to filling
-atria contracts and pushes blood into a non compliant ventricle, creating vibrations

70
Q

S4

A

End of diastole at presystole, when ventricle is resistant to filling
-atria contracts and pushes blood into a non compliant ventricle, creating vibrations

71
Q

What three conditions cause murmurs

A
  1. Increase in velocity of blood flow
  2. Decrease in viscosity of blood
  3. Structural defects in valves or unusual opening in the chambers
72
Q

Murmur

A

Gentle, blowing, swooshing sound

73
Q

Increases in velocity of blood flow example

A

Flow murmur, exercise, thyrotoxicosis

74
Q

Example of decreases in viscosity of blood

A

Anemia

75
Q

Four characteristics of sound

A
  1. Frequency
  2. Intensity
  3. Duration
  4. Timing
76
Q

Sinoatrial node

A

Intrinsic rhythm know as the pacemaker

77
Q

Sequence of conduction

A

SA node across atria to AV to bundle of his to fascicles branches then ventricles

78
Q

P wave

A

Depolarization of the atria

79
Q

P wave

A

Depolarization of the atria

80
Q

P-R interval

A

Time necessary for atrial depolarixaiton plus time for the impulse to travel through the AV node to the ventricles

81
Q

QRS complex

A

Depolarization of the ventricles

82
Q

T wave

A

Repolarixaiton of ventricles

83
Q

Order of an ECG wave

A

P wave, P-R interval, QRS complex, T wave

84
Q

Electrical events slightly ___ the mechanical events in the heart

A

Precede

85
Q

How much blood does a resting adult pump per minute throughout the body

A

4 and 6 L

86
Q

Preload

A

Venous return that builds during diastole

-length to which ventricular muscle is stretched at the end of diastole before contraction

87
Q

Frank startling law

A

The greater the stretch the stronger the hearts contraction

88
Q

After load

A

Opposing pressure that the ventricle must generate to open the aortic valve against the higher aortic pressure

89
Q

Where is the carotid artery located

A

In the groove between the trachea and sternomastoid msucle

90
Q

Function of the jugular vein

A

Empties unoxygenated blood directly into the superior vena cava

91
Q

What do the jugular veins tell us

A

About activity on the right side of the heart

92
Q

What are the two jugular veins

A

Internal jugular vein and external jugular vein

93
Q

Internal jugular vein

A

Deep and medial to sternomastoid muscle
-not usually visible

94
Q

When can you see pulse from internal jugular vein

A

Supine position, seen in sternal notch

95
Q

External jugular vein

A

Superficial- lies lateral to sternomastoid muscle above clavicle

96
Q

Fetal considerations

A

-fetal heart function at 3 weeks gestation
-oxygenation at placenta
-blood doesn’t pump through pulmonary system instead via foremen ovale into left side of heart
-ductus arteriosus moves from pulmonary artery to aorta

97
Q

When does the foremen ovale close

A

Within first hour of after birth due to new pressure

98
Q

When does the ductus arteriosus close

A

10 to 15 hours after birth

99
Q

Heart position in the chest as an infant

A

More horizontal than in adults

100
Q

Heart considerations in pregnant women

A

-blood volume inc 30/40%
-inc SV, CO, pulse
-decrease in BP

101
Q

Why does blood pressure decrease in pregnancy

A

Peripheral vasodilation

102
Q

Blood pressure and aging- why?

A

Systolic blood pressure increases
-thickening and stiffening of large arteries
-increases pulse wave velocity and arteries cannot store volume ejected

103
Q

Left ventricular wall in OA

A

Thickness increases
-adaptive to accommodate vascular stiffening which makes an increase in workload

104
Q

Variations in S1

A

-loud/accentuated
-faint/diminished
-varying intensity
-split

105
Q

Examples of loud S1

A

Hyperkinetic states in which blood velocity is increased: exercise, fever, anemia, hyperthyroidism

Mitral stenosis

106
Q

Examples of faint S1

A

First degree heart block

Mitral insufficieny

Severe hypertension

107
Q

Varying intensity of S1 examples

A

Arteries fibrillation

Complete heart block with changing PT interval

108
Q

Split S1 example

A

Normal but uncommon

109
Q

Variations in S2

A

-accentuated
-dismissed

110
Q

Example of accentuated S2

A

Systemic hypertension

Exercise and excitement

Mitral stenosis, heart failure

Aortic or pulmonic stenosis

111
Q

Examples of dismissed S2

A

Shock

Aortic or pulmonic stenosis

Nurs 252 (13 decks)

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