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Health Assessment NUR 202 > CH: 20 Heart and Neck Vessels > Flashcards

CH: 20 Heart and Neck Vessels Flashcards

1
Q

bruit is caused by?

A

stenosis

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2
Q

where is the apex located?

A

left midclavicular 5th intercostal
*bottom of the heart

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3
Q

where is the base located?

A

2nd intercostal lateral to sternum

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4
Q

other terms for apex of heart?

A

mitral
apical
PMI (point of maximum impulse)

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5
Q

the pulmonary artery is the ONLY artery that carries _____?

A

DEOXYGENATED blood (leaves from right ventricle)

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6
Q

the pulmonary vein is the ONLY vein that carries _____?

A

OXYGENATED blood

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7
Q

where is S1 the loudest?

A

apex
*S1: beginning of systole
*lub: signifies closure of AV valves

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8
Q

where is S2 the loudest?

A

base
*S2: end of systole
*dub: signifies closure of SL valves

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9
Q

what are the atrioventricular (AV) valves?

A

tricuspid
mitral

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10
Q

how many flaps does the tricuspid valve have?

A

3

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11
Q

how many flaps does the mitral valve have?

A

2

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12
Q

which AV valve is located on the right side?

A

tricuspid

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13
Q

which AV valve located on the left side?

A

mitral

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14
Q

what are the semilunar valves (SL)?

A

pulmonic
aortic

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15
Q

which is the left SL valve?

A

aortic

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16
Q

which is the right SL valve?

A

pulmonic

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17
Q

S1 is the closure of?

A

AV valves

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18
Q

S2 is the closure of?

A

SL valves

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19
Q

regurgitation is usually?

A

mitral

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20
Q

stenosis is usually?

A

aortic

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21
Q

moRe to the ______, Less to the ______?

A

moRe to Right, Less to Left

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22
Q

what are the abnormal heart sounds?

A

S3 (possibly normal during pregnancy)
S4 (possibly normal in athletes)

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23
Q

carotid pulse coincides with which sound?

A

S1

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24
Q

which pulse site is assessed for CPR effectiveness?

A

carotid

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25
Q

palpating carotids?

A

ONE at a time

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26
Q

what can palpating carotids bilaterally cause?

A

*decrease blood to brain (cause stroke)
*stimulate vaso-vagal response (HR drops when nerve stimulated=BP drop)

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27
Q

the right jugular vein provides info about which side of the heart?

A

right
*this is why we assess from right side of patient

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28
Q

right side of heart provides info about?

A

heart failure

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29
Q

what question to ask if pt experiencing chest pain?

A

does it worsen with deep breaths?

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30
Q

if chest pain worse with deep breath, indicates?

A

lung association

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31
Q

chest pain same with deep breath, indicates?

A

heart association

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32
Q

layers of the heart wall?

A

pericardium: outer layer that protects/surrounds heart, tough fibrous double-walled sac
myocardium: muscle layer, does the pumping
endocardium: inner layer, thin endothelial tissue

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33
Q

blood flow direction?

A

-deoxygenated blood from body to right atrium
-through tricuspid valve to right ventricle
-through pulmonic valve to pulmonic artery
-artery delivers DEOXYGENATED blood to lungs
-lungs oxygenate blood
-pulmonary veins return blood to left atrium
-through bicuspid (mitral) valve to left ventricle
-through aortic valve to aorta
-oxygenated blood to body

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34
Q

venous blood=?

A

DEoxygenated

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35
Q

arterial blood=?

A

OXYgenated

36
Q

what is the P wave?

A

depolarization of atria

37
Q

what is the P-R interval?

A

from beginning of P wave to beginning of QRS complex (time necessary for atrial depolarization plus time for impulse to travel through AV node to ventricles)

38
Q

what is QRS complex?

A

depolarization of ventricles

39
Q

what is T wave?

A

repolarization of ventricles

40
Q

what is S3?

A

usually abnormal
*vibration when ventricle is filling when lots of fluid- beginning or during diastole (heart failure)
also known as ventricular gallop

41
Q

what is S4?

A

usually abnormal
*softer sound from vibration at end of diastole

42
Q

the sinoatrial (SA) node is considered?

A

the pacemaker of the heart

43
Q

what is the conduction pathway?

A

-atria contracts
-signal travels across atria to AV node
-through bundle of His
-down right and left bundle branches
-through purkinje fibers to ventricles
-ventricles contract

44
Q

how many liters of blood does the heart pump throughout the body per minute?

A

4-6L

45
Q

what is cardiac output?

A

the volume of blood in each systole (stroke volume) times the number of beats per minute (heart rate)
CO= SV x HR

46
Q

what is preload?

A

volume
*venous return that builds during diastole
*length the ventricular muscle is stretched at end of diastole before contraction

47
Q

what is afterload?

A

pressure
*opposing pressure ventricle generates to open aortic valve against higher aortic pressure

48
Q

what side of stethoscope should you use for carotids?

A

bell

49
Q

what abnormality are you looking for in carotids?

A

bruit
*means blockage or obstruction
(usually atherosclerosis) results in stroke bc blood cannot get to brain
*might be caused by CARDIAC STENOSIS

50
Q

nocturia?

A

frequent urination at night

51
Q

what could nocturia indicate?

A

heart failure

52
Q

important cardiac disease history?

A

hypertension
increased cholesterol
MI
heart murmurs

53
Q

important personal habit risk factors?

A

smoking
nutrition
drug use (cocaine)
exercise

54
Q

when might you experience edema in lower extremeties?

A

heart failure

55
Q

patient instruction when auscultating the carotid?

A

inhale, exhale, hold

56
Q

what does cardiac stenosis increase risk of?

A

stroke

57
Q

what is jugular vein distention?

A

edema in jugular vein

58
Q

how to assess for JVD?

A

have pt lay flat
-if present, raise HOB to 30-40 degrees

59
Q

what is the internal jugular vein?

A

not visible
-larger, deep, and medial to sternomastoid muscle
*pulsations may be seen in sternal notch when supine

60
Q

what is the external jugular vein?

A

more superficial
-lateral to sternomastoid muscle and above clavicle

61
Q

what does the circle of willis do?

A

provides extra blood flow to brain during damage

62
Q

why do we tell pt to hold breath when auscultating carotid?

A

so we don’t hear bronchial sounds

63
Q

what does JVD usually indicate?

A

right sided heart failure

64
Q

what could pulsations of the aorta indicate?

A

abdominal aortic aneurysm

65
Q

auscultate first with ______ then with ______?

A

diaphragm, bell

66
Q

where is the aortic valve area?

A

second right interspace

67
Q

where is the pulmonic valve area?

A

second left interspace

68
Q

where is the tricuspid valve area?

A

left lower sternal border

69
Q

where is the mitral valve area?

A

fifth interspace around left midclavicular line

70
Q

what pattern do you use to auscultate heart sounds?

A

zigzag starting at base (top)

71
Q

what is splitting of 2nd heart sound? where is it heard?

A

more blood flow with inspiration (right valves don’t close as quickly as left valves)
*only heard in pulmonic valve area

72
Q

what is the medication requirement for mechanical valves?

A

must always be on blood thinners
-metal bell increases clotting risks

73
Q

in what position can you best hear abnormal sounds?

A

left lateral

74
Q

we see ______, we feel ______, and we hear _____?

A

we see heaves/lifts
we feel thrills
we hear bruits

75
Q

aortic stenosis and pulmonic stenosis can cause what murmur?

A

midsystolic ejection murmur

76
Q

mitral stenosis and tricuspid stenosis can cause what murmur?

A

diastolic rumbles of AV valves

77
Q

mitral regurgitation and tricuspid regurgitation can cause what murmur?

A

pansystolic regurgitant murmur

78
Q

aortic regurgitation and pulmonic regurgitation can cause what murmur?

A

early diastolic murmur

79
Q

what is the most common extra sound?

A

midsystolic click

80
Q

a diastolic murmur always indicates _____?

A

heart disease

81
Q

left vs right sided heart failure?

A

left:
-fluid buildup or backflow
-usually effects lungs
right:
-fluid in veins (JVD)
-usually develops from left sided

82
Q

S1 coincides with which wave on ECG?

A

R wave

83
Q

where is erb’s point?

A

3rd interspace on the left

84
Q

innocent murmur vs functional murmur?

A

innocent: no valvular or pathological cause
functional: increase blood flow in heart

85
Q

paradoxical split is associated with?

A

left bundle branch block
aortic stenosis

86
Q

wide split is associated with?

A

right bundle branch block

87
Q

what are the congenital heart defects?

A

-patent ductus arteriosus
-atrial septal defect
-ventricular septal defect
-tetralogy of fallot
-coarctation of aorta

Health Assessment NUR 202 (17 decks)

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