Ch 20 - PPT notes Flashcards
what is a split S2?
-during inspiration there is a pressure change
- more blood comes in the right than the left
- the aortic valve closes before the pulmonary
- this causes a split S2 sound
when is S3 heard? what is happening?
-immediately after S2
-ventricles are resistant to filling at the beginning of diastole
when is S4 heard? what is happening?
- right before S1
- ventricles resistant to filling at the end of diastole
what does a murmur sound like?
gentle, whooshing, blowing
what is pulse pressure?
the difference between systolic and diastolic pressure
what are three hemodynamic changes with aging?
- increased systolic blood pressure
- increased pulse pressure
- no change in HR or CO during rest
what are there increased rates of in the elderly?
- CAD
- heart failure
- hypertension
what is the most common underlying cause of death globally?
CVD
what does HTN accelerate?
atherosclerosis
how does smoking and tobacco use impact heart disease?
it impacts oxygenation
how does elevated cholesterol contribute to heart disease?
LDL adds to plaque formation
what do you need to control in T2 diabetes?
glycemic control
what disease is the number 1 killer of women?
heart disease
why do women usually have delayed diagnosis of heart disease?
women usually have different symptoms than the typical chest pain that men feel
what are the eleven types of subjective data to gather during an assessment of CV health ?
chest pain, dyspnea, orthopnea, cough, fatigue, cyanosis, edema, pallor, nocturia, past cardiac history, past family history, personal habits
what position should the patient be for you to asses carotid artery?
patient should be sitting
what position should the patient be in for you to asses the precordium and jugular vein?
patient should be supine with chest and head slightly elevated
what are you looking for when inspecting the neck?
- jugular/carotid artery pulsations
- jugular distention
what are you looking for when inspecting the chest wall? where should it be seen? in whom is it easier to see the apical pulse?
- the apical pulse
- in the fourth or fifth intercostal space
- it is easier to see the apical pulse in children or those with thinner chest walls
what can you ask to help you find the apical pulse?
- “exhale and hold it”
what regions do you palpate across the precordium? what should you expect?
- the apex, left sternal border and base
- no pulsations
where is the aortic valve found for auscultation?
2nd right intercostal space
where is the pulmonic valve found for auscultation?
2nd left intercostal space
where is the tricuspid valve found for auscultation?
lower left sternal border on the fourth intercostal space
where is the mitral valve found for auscultation?
left fifth intercostal space, medial to midclavicular line
where is Erb’s point found?
3rd left intercostal space
summary checklist: heart and neck vessel examination – precordium asucultation
Auscultation
Identify anatomic areas noting rate and rhythm
Listen in systole and diastole for murmurs
Repeat with bell
Listen at apex and base
summary checklist: heart and neck vessel examination - precordium inspection and palpation
Describe location of apical pulse
Note any heave (lift) or thrill
summary checklist: heart and neck vessel examination - neck
Carotid pulse – observe and palpate
Observe jugular venous pulse
