Ch 19 Heart & Neck Vessels

Question 0

Dyspnea

Answer 0

Difficulty breathing

Question 1

Orthopnea

Answer 1

Not being able to breath while laying flat. Needing to be elevated to breath properly

Question 2

Nocturia

Answer 2

Need to urinate frequently at night

Related to the heart because of fluid imbalance and the kidney secretes a hormone to allow the fluid to leave via urine

Question 3

Pericardium

Answer 3

Tough, fibrous, double walled sac that surrounds and protects the heart

Question 4

Myocardium

Answer 4

The muscular wall of the heart it does the pumping

Question 5

Endocardium

Answer 5

A thin layer of endothelial tissue that lines the inner surface of the heart chambers and valves

Question 6

Heart Valves

Answer 6

Atrioventricular: two atria/ventricle valves
1. Tricuspid- right valve 3 cusps
2. Mitral- left valve 2 cusps
Anchored by the chordae tendinea and papillary muscles

Semilunar (SL): two ventricles/arteries valves with three cusps

1. aortic
2. pulmonic

Question 7

1st heart sound S1

Answer 7

Occurs with the closure of the av valves and thus signals the beginning of systole. Loudest at the apex

The rhythm coincides with the carotid artery

Question 8

Second heart sound S2

Answer 8

Occurs with closure of the semilunar valves as signals the end of systole . Loudest at the base

Question 9

3rd heart sound S3

Answer 9

Is a ventricular filling sound hear during the diastole rapid filling phase. Also called the ventricular gallop. normally silent heard in young children/adult. Heard at the apex or lower left eternal border

Question 10

4th heart sound S4

Answer 10

Occurs at the end of the diastole at the presystolic when the ventricle resistant to filling the atria contract and pushes blood into the non compliant ventricle this vibration is the S4

Question 11

Murmurs

Answer 11

Blood circulating through normal cardiac chambers and valves usually makes no noise. Some conditions create turbulent blood flow and collision currents.

To auscultate roll pt. toward the left side

Question 12

Preload

Answer 12

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

Question 13

Afterload

Answer 13

The opposing pressure the ventricle must generate to open the aortic valve against the higher aortic pressure

Question 14

Arrhythmia

Answer 14

Irregularity or loss of rhythm, esp. of the heart

Question 15

Paraoxysmal nocturnal dyspnea

Answer 15

PND Sudden attacks of dyspnea that usually occur when patients are asleep in bed. Occurs with heart failure

Question 16

Risk factors for CAD Coronary Artery Disease

Answer 16

Elevated cholesterol , blood pressure, and blood sugar levels above 130mg/dL, obesity, smoking, low activity levels

Question 17

Carotid Sinus Hypersensitivity

Answer 17

Condition in which pressure over the carotid sinus leads to decreased BP, and cerebral ischemia with syncope.

Question 18

Bruit

Answer 18

Blowing swishing sound indicating blood flow turbulence ; normally not present auscultate the carotid artery

Question 19

Hepatojugular reflux

Answer 19

Performed if you suspect heart failure. Supine instruct to breathe quietly through mouth push down on RUQ below rib cage watch the level of the jugular pulsation sustains pressure for 30 secs

Normal the jugular vein will rise for a few secs then recede back
Abnormal the vein will rise and stay along as you push

Question 20

Apical impulse (palpate)

Answer 20

Occupied the fourth or Fifth intercostal space at or inside the midclavicular line only palpable in half the adults.

Question 21

Heave / Lift

Answer 21

A sustained forceful thrusting of the ventricle during systole it occurs with ventricular hyper trophy as a result of increased workload

Question 22

Thrill

Answer 22

Palpable vibration it feels like the throat of a purring cat signifies turbulent blood flow and accompanies loud murmurs

Question 23

Auscultate the Heart Areas

Answer 23

Aortic area 
Pulmonic area
Erbs point 
Tricuspid area 
Mitral area

Question 24

Venous Hum

Answer 24

Due to turbulence of blood flow in jugular venous system common in healthy children has no pathological significance

Question 25

Orthostatic hypotension

Answer 25

A sudden drop in blood pressure when rising to sit or stand