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Health Assessment Theory Exam 1 > Ch. 20- Cardiovascular and Neck Vessels Assesment > Flashcards

Ch. 20- Cardiovascular and Neck Vessels Assesment Flashcards

1
Q

The heart chambers are separated by valves, whose main purpose is what?

A

To prevent backflow of blood

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2
Q

Valves are unidirectional meaning what?

A

They can only open one way.

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3
Q

How many valves are in the heart?

A

4

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4
Q

What are the 4 valves in the heart?

A
  • Two antrioventricular (AV) valves known as tricuspid (R) and mitral (L)
  • Two semilunar (SL) valves known as aortic (L) and pulmonic (R)
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5
Q

The AV valves separate what?

A

Atria and ventricles.

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6
Q

AV valves open during what?

A

Diastole to allow ventricular refill

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7
Q

AV valves close during what?

A

Systole to prevent backflow

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8
Q

What is S1?

A

first heart sound (AV valve closing: systole)

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9
Q

SL valves are set between what?

A

Ventricles and arteries.

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10
Q

SL valves open during what?

A

Systole to allow ventricular ejection.

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11
Q

SL valves close during what?

A

Diastole to allow ventricular filling.

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12
Q

What is S2?

A

Second heart sound (SL valves closing: diastole)

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13
Q

Where can S1 be heard?

A

Over all pericardium, but loudest at apex

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14
Q

Where can S2 be heard?

A

Over all pericardium, but loudest at base

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15
Q

What are two extra heart sounds?

A

S3 and S4

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16
Q

When is S3 heard?

A

When ventricles resistant to filling during early rapid filling phase.

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17
Q

Ventricular filling causes what?

A

Vibrations

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18
Q

What does S3 sound like?

A

“lub, dub, a” (Kentucky)

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19
Q

When does S4 occur?

A

At the end of diastole, when ventricle is resistant to filling
(Just before S1)

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20
Q

What do the atria do during S4?

A

Atria contract and push blood into noncompliant ventricle

this creates vibrations heard as S4

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21
Q

What does S4 sound like?

A

“dah, lub, dub” (Tennessee)

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22
Q

What are murmurs created by?

A

Conditions that cause turbulent blood flow and collision currents

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23
Q

What do murmurs sound like?

A

Gentle, blowing, swooshing sounds (lower frequency, use bell)

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24
Q

What are causes of a murmur?

A
  • Increased blood velocity-flow murmur
  • increased blood viscosity
  • structural defects in valves
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25
Q

What is regurgitation?

A

A backflow of blood caused by failure of the heart’s mitral valve to close tightly.

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26
Q

What is Stenosis?

A

Narrowing of the valve in the large blood vessel branching off the heart (aorta).

27
Q

How do you grade murmurs?

A 
1- barely audible
2- clearly audible, but faint
3- moderately loud, easy to hear
4- loud, associated with palpable thrill
5- very loud, part of stethoscope off of chest, thrill
6- can hear without stethoscope
28
Q

Explain thrill:

A

palpable vibration

29
Q

How do you document a murmur?

A

Example: 2/6 best heard over RSB

30
Q

What are all heart sounds described by?

A
  • Pitch
  • Loudness
  • Quality
  • Duration
  • Timing
31
Q

Explain Pitch:

A

described as high pitched or low pitch

32
Q

Explain Loudness:

A

loud or soft

33
Q

Explain Quality:

A

blowing, harsh

34
Q

Explain Duration:

A

very short for heart sounds; silent periods are longer

35
Q

Explain Timing:

A

Systole or diastole

36
Q

The carotid artery is what type of artery?

A

Central artery

37
Q

Timing of the carotid artery closely coincides with what?

A

ventricular systole (S1)

38
Q

Where is the carotid artery located?

A

In the groove between trachea and medial to the sternomastoid muscle

39
Q

Jugular veins empty what? and where?

A

unoxygenated blood directly into superior vena cava

40
Q

There are two jugular veins present where?

A

In each side of the neck

41
Q

Where does the internal jugular lie?

A

Medial to sternomastoid muscle- usually not visible

42
Q

When may internal jugular pulsations be noted?

A

When supine in suprasternal notch

43
Q

Where does the external jugular vein lie?

A

Lateral to sternomastoid muscle, above clavicle

44
Q

What objective data assessment techniques do we use in a cardiovascular assessment?

A
  • Palpation
  • Auscultation
  • Bruit
  • Inspection
45
Q

During palpation of the carotid artery what should be done?

A
  • Palpate only one carotid artery at a time to avoid cutting off circulation
  • feel amplitude of pulse (ex: normal strength bilaterally)
46
Q

During auscultation of the carotid artery what should be done?

A
  • Assess for presence of carotid bruit
  • Avoid compressing the artery which can create an artificial bruit
  • Ask client to exhale and hold breath while examiner listens
47
Q

What is a Bruit?

A

Narrowing; indicates turbulent blood flow (Ex: Carotids 2+ with no bruit noted bilaterally)

  • Bruits are vascular sounds resembling heart murmurs. Sometimes they’re described as blowing sounds
  • If bruits are present, you’ll typically hear them over the aorta, renal arteries, iliac arteries, and femoral arteries.
48
Q

When performing inspection of jugular venous pulse, it is best viewed from which patients side?

A

right side of neck

49
Q

What position should the patient be in when inspecting the jugular venous pulse?

A

Supine at 30-45 degree angle, pillow removed, and pt. head slightly turned away from examiner

50
Q

When inspecting the jugular venous pulse what equipment should be used?

A

A pen light

51
Q

What areas are you observing when inspecting the jugular venous pulse?

A
  • Suprasternal notch (internal jugular)

- lateral to sternocleidomastoid (external jugular)

52
Q

What are normal findings when inspecting the jugular venous pulse?

A
  • In some these veins aren’t visible, in others they are full in supine positions
  • should disappears person sits up around 45 degrees (document no JVD at 45 degrees)
53
Q

Patient can be supine when inspecting the anterior chest for what?

A
  • Apical impulse at apex of heart, 5th intercostal space/mid calvicular line
  • PMI- point of maximum impulse
54
Q

When palpating anterior chest localize apical pulse precisely by what?

A
  • using one finger pad and asking person to exhale and then hold it
  • if sitting lean forward, or ask pt. to lie in ? position to palpate
55
Q

How do you palpate the anterior chest in a cardiovascular assessment?

A

Using palmar aspect of four finger, gently palpate sex, left sternal border, and base, searching for any other pulsations or thrills

56
Q

When auscultating the heart it is important to know what about the valves areas?

A

Valve areas are not over actual anatomic locations of valves but sites in chest wall where sounds produced by valves are best heard

57
Q

Where is the pulmonic valve area?

A

2nd ICS left sternal border

58
Q

Where is the aortic area?

A

2nd ICS right sternal border

59
Q

Where is herbs point?

A

3rd-4th ICS left sternal border

60
Q

Where is the tricuspid area?

A

left lower sternal border

61
Q

Where is the mitral area?

A

5th ICS left mid clavicular line

62
Q

What should you note when performing auscultation of the heart?

A
  • Rate and rhythm
  • Identify S1 and S2
  • Listen for extra heart sounds
  • Listen for murmurs
  • Assess all five areas with diaphragm and bell
63
Q

What are additional heart sounds?

A
  • Mitral prosthetic valve sound
  • Pericardial friction rub
  • Aortic prosthetic valve sounds
  • Ejection murmurs-aortic stenosis
  • Regurgitation murmurs

Health Assessment Theory Exam 1 (8 decks)

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