Ch. 20 (The Heart & Neck Vessels) Flashcards
What part of the heart anatomy would be called the base?
the top
What part of the heart anatomy would be called the apex?
the bottom
There are three layers to the heart.
What layer is a tough sac that surrounds and protects the heart?
pericardium
There are three layers to the heart.
What layer is a muscular wall that does the pumping in the heart?
myocardium
There are three layers to the heart.
What layer is a thin wall that lines the inner surface?
endocardium
What happens during diastolic (bottom number-BP)?
blood floods into the heart
aortic & pulmon. valves are closing, S2 - best heard at erb’s/pulmonic
louder at base (DUB)
What happens during systole (top number-BP)?
pushes blood out to the system
mitral & tricuspid valve are closing, S1 - best heard at mitral & tricus
louder at apex (LUB)
What is happening during s1 (lub)?
mitral and tricuspid valve closing
systole -best heard at the tricuspid & mitral listening points
louder at apex (LUB)
What is happening during s2 (dub)?
aortic and pulmonic valve closing
diastole - best heard at erbs point/pulmonic area
louder at base (DUB)
We live most of our lives in what heart cycle?
diastole (2/3)
systole - 1/3
Where do we hear S1 loudest?
apex
Where do we hear S2 loudest?
base
What are some conditions that would cause heart murmurs?
- thickness (viscosity) of blood increases
- viscosity decreases
- valve problems (most common)
pregnancy can cause temporary murmurs
What does a heart murmur sound like?
a gentle “wooshing” sound
What portion of the heart contains specialized cells near the superior vena cava that initiates electrical pulse?
SA Node
natural pacemakers
What portion of the heart is located low in septum of right atrium, making it contract?
AV node
During heart conduction, the impulse travels into branches in the left atrium called what?
bundle of his
What is the equation used to calculate cardiac output?
CO = SV x R
stroke volume x rate = cardiac output
What are the main two neck vessels?
- carotid artery (in groove between trachea and sternomastoid process)
- jugular veins
What main neck vessel carries O2 blood to the head?
carotid artery
What main neck vessel empties deoxygenated blood into the superior vena cava?
jugular vein
What can chest pain be described as in subjective data?
- squeezing
- crushing
People who have heart problems usually experience dyspnea with what?
supine position (laying down)
People who have heart problems usually ease their orthopnea with what?
tons of pillows to prop themselves up
Women compared to men tend to experience what sort of symptoms when experiencing a heart attack?
- stomach pain (GI issue)
- extreme fatigue
men is usually the classic symptoms
What type of symptoms could you have with heart problems?
- chest pain
- dyspnea (laying down pain when breathing)
- orthopnea (ease in pain when sitting up)
- coughing
- fatigue
- cyanosis or pallor
- edema/swelling
- nocturia (getting up to pee alot at night due to extra pressure on kidneys when laying down)
- diabetes
- hypertension
dental problems are correlated with heart problems due to bacteria
How do you inspect the jugular venous pulse?
pt lies supine 30-45 degree angle, no pillow, turn head slightly away, use good light
when palpating the chest, what part of the hand are you using and why?
- ulnar surface of hand
- checking vibrations
When palpating across the precordium using the ulnar surface of your hand, the vibration feels similar to a cat purring. What kind of vibration would that be called and would that cause any concern?
- thrill (vibration)
- usually present in patients with really bad heart problems
When auscultating the chest, what acronym do we use to remember the order we go in?
- Aortic
- Pulmonic
- Erbs point
- tricuspid
- o
- Mitral
- n
ape to men
Every what heart beat, will you hear the pulmonic area inspirate?
4th beat
When listening for murmurs, timing is important. When the brewer sound/murmur is heard during the systole cycle, what would it be called?
systolic murmur
usually not that serious
When listening for murmurs, timing is important. When the brewer sound/murmur is heard during the diastole cycle, what would it be called?
diastolic murmur
usually serious
When listening for murmurs, position can help detect it. What positions can the pt follow to help you detect your confirmation of heart mumurs?
- roll pt on left side, listen w/bell on apex
- sit up and lean forward, listen w/diaphragm on base
What type of abnormal finding is classified as chest pain?
angina
stable is predictable, variant is anything goes
What type of abnormal finding is classified as sudden decrease in blood flow to the heart?
acute coronary syndrome (classic heart attack)
usually from a clot
What type of abnormal finding is classified as clot that lodges in the lungs, described as sharp and stabbing that is worse with a deep breath?
pulmonary embolism
Heart failure can either be classified as…?
- acute (sudden)
- chronic (slow)
What type of abnormal finding occurs with abdominal swelling, dilated jugular veins (jvd), swollen feet, nocturia?
right sided heart failure
usually left side eventually joins in (congestive heart failure)
What type of abnormal finding occurs with coughing, shortness of breath (SOB), crackles upon ascultation, orthopnea (needing a pillow to breathe), lower O2?
left sided heart failure
usually right side eventually joins in (congestive heart failure)
What kind of heart problem causes atrial spasming (irregular beating), electrical conduction issue, and blood pools causing clots which increases risk of MI and strokes?
atrial fibrillation (AFIB)
blood thinners are usually prescribed
Describe the steps of heart conduction.
- S.A. Node activates flowing across the atria to the AV node - making AV contract
- impulse travels into right and left bundle branches (Bundle of His) and then into the ventricles - causing rest of heart to contract
What peripheral vascular abnormality is caused by a blood clot in the lower extremities which is shown through redness, swlling, discomfort and asymmetry in the legs?
deep vein thrombosis (DVT)
What peripheral vascular abnormality is caused by the valves in veins not closing all the way, resulting in enlarged veins, and painful heavy-feeling legs?
varicose veins
What peripheral vascular abnormality describes pain and discomfort felt in the legs when walking and exercising?
claudication
major symptom of peripheral artery disease
What peripheral vascular abnormality causes pooling of blood in the lower extremities resulting in incompetent valves, enlarged veins, edema, brown patches, soggy skin and a normal pulse?
venous insufficency
What peripheral vascular abnormality is caused by plaque build up in the arties resulting in cold temperature in the lower extremities, very pale skin, pain in the calf when wlaking, shiny skin, no hair, and a light pulse?
arterial insufficency
What peripheral vascular abnormality is caused by narrowed arteries resulting in reduce blood flow, leg pain when walking and increases risk of heart attack and stroke?
peripheral artery disease
What vascular abnormality causes buildup of plaque on artery walls, making the arteries become rigid and harden?
atherosclerosis
eventually leads to stenosis
What can atherosclerosis eventually evolve into?
stenosis
What vascular abnormality is caused by narrowing of an artery?
stenosis
generally developed after atherosclerosis
