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Comprehensive Health Assessments > Chapter 12: Heart and Peripheral Vascular System > Flashcards

Chapter 12: Heart and Peripheral Vascular System Flashcards

1
Q

Angina

A

chest pain or discomfort that happens when the heart doesn’t get sufficient oxygen-rich blood

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2
Q

Ankle/Brachial Index

A

test that compares the blood pressure measured at the ankle with the blood pressure measured at the arm

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3
Q

Aortic Valve

A

heart valve located between the left ventricle and the aorta

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4
Q

Apical

A

pulsation at the apex of the heart

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5
Q

Arteries

A

muscular-walled tubes in the circulation system that transport oxygenated blood from the heart to all parts of the body
- carry oxygenated blood away from the heart and the rest of the body

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6
Q

Amplitude

A

pulse volume; may be described as weak, faint, strong, or bounding

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7
Q

Atrioventricular Valve (AV-valve)

A

valves in the heart that causes blood flow through the heart in one direction from the right side to the left side

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8
Q

Bruit

A

blowing vascular sounds resembling heart murmurs

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9
Q

Carotid

A

blood vessels located on both sides of the neck that deliver blood to the brain and head

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10
Q

Contour

A

smooth outline or shape of carotid arteries with a rapid upstroke and normal strength

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11
Q

Diastolic

A

pressure of blood vessels after the initial force of contraction of the heart
- the minimum amount of pressure exerted on the vessels; this occurs when the ventricles relax and fill with blood

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12
Q

Dorsalis Pedis

A

pulse palpable on the dorsum of the foot in the first intermetatarsal space just lateral to the extensor tendon of the great toe

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13
Q

Edema

A

swelling due to small blood vessels (arteries and veins) leaking fluid into nerby tissues

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14
Q

Electrocardiogram

A

test to evaluate the electrical impulses generated by the heart during the cardiac cycle to assist with diagnosis of cardiac dysrhythmias, blocks, damage, infection, or enlargement

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15
Q

Jugular Vein

A

veins in the neck that drain blood from the head, brain, face and neck and convey it toward the heart

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16
Q

Mitral Valve

A

heart valve that lies between the left atrium and the left ventricle to support one-directional blood flow through the heart

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17
Q

Orthostatic Hypotension

A

form of hypotension that:
- is a decrease in systolic blood pressure of greater than or equal to 20 mm of mercury
- a decrease in the diastolic pressure of greater than or equal to 10 mm of mercury
- when a patient changes from a recumbent or sitting position to a standing position

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18
Q

Perfusion

A

passage of bodily fluids, such as blood, through the circulatory or lymphatic system to an organ or tissue

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19
Q

Popliteal

A

artery that is primary vascular supply in the region of the knee and lower leg or vein that runs posterior to the popliteal artery and receives blood from multiple tributaries

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20
Q

Posterior Tibial

A

artery that passes posterior to medial malleolus at the ankle

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21
Q

Pulmonic Valve

A

one of four valves that regulate blood flow in the heart; lies between the lower right ventricle and the pulmonary artery

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22
Q

Pulse Deficit

A

difference between the apical and peripheral pulse rates

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23
Q

Pulse

A

number of times the heart beats in one minute

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24
Q

Pulsation

A

act of pulsating: beating or throbbing, a beat or throb, as the pulse vibration or undulation

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25
Q

Radial

A

artery in the wrist

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26
Q

Rate

A

number of contractions

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27
Q

Rhythm

A

amount of electrical energy generated as a heart beats

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28
Q

Semilunar Valves

A

separates and controls the blood flow from the right ventricle of the heart to the pulmonary artery without any backflow
- pulmonary and aortic valves

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29
Q

Systolic

A

top number in a blood pressure reading
- the maximum pressure exerted on arteries when the ventricles contract or eject blood from the heart

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30
Q

Temporal

A

artery at the temple above the ear

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31
Q

Thrill

A

vibratory sensation felt on the skin overlying an area of turbulence; indicates a loud heart murmur usually caused by an incompetent heart valve

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32
Q

Tricuspid Valve

A

regulates blood flow from the heart’s upper right chamber (right atrium) to the lower right chamber (right ventricle)

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33
Q

Veins

A

return blood to the heart; dark red because oxygen has been replaced with carbon dioxide and other wastes
- carry deoxygenated blood back to the heart
- no (natural) force that propels blood flow
- valves, muscle contraction, and pressure gradient have to propel blood to heart

34
Q

What are signs of right-side heart failure ?

A
  • edema
  • distension in jugular vein
  • ascites
  • weight gain
35
Q

What are signs of left-side heart failure ?

A
  • not much edema
  • back upped blood goes to the lungs
  • any symptoms that have to do with the lungs (dyspnea, crackles, cough)
  • more serious since it’s the main pumping chamber
36
Q

What is the pneumonic for knowing the cardiac landmarks ?

A

APETM

37
Q

Where is the aortic valve heard ?

A

2nd right intercostal space

38
Q

Where is S1 best heard ?

A

apex of the heart

39
Q

Where is S2 best heard ?

A

base of the heart
- since blood is flowing towards the base

40
Q

Where is the aortic valve heard ?

A

2nd ICS
- RSB

41
Q

Where is the pulmonic valve heard ?

A

2nd ICS
- LSB

42
Q

Where is Erbs point heard ?

A

3rd ICS
- LSB
- S1 & S2 heard equally
- where murmurs best heard

43
Q

Where is the tricuspid valve heard ?

A

4th ICS
- LSB

44
Q

Where is the mitral valve heard ?

A

5th ICS
- left midclavicular line

45
Q

What side of the stethoscope does the diaphragm listen for ?

A

high-pitched sounds
- (lub/dub)

46
Q

What side of the stethoscope does the bell listen for ?

A

low-pitched sounds
- murmurs

47
Q

How does excess alcohol, cocaine, and nicotine affect the CVPV system ?

A
  • associated with HTN and development of cardiomyopathy
  • associated with MI (myocardial infraction aka heart attack) and stroke
  • causes vasoconstriction
48
Q

What is orthostatic hypotension ?

A

a decrease of SBP of at least 20 mmHg and/or DBP of at least 10 mmHg within 3 mins of standing
- associated with fluid volume deficit, antihypertensive medications or prolonged bed rest

49
Q

When palpating the pulses what do you do ?

A
  • use finger pads of first 2 fingers
  • apply light pressure
  • feel for rate, rhythm, and amplitude
  • compare bilaterally (except carotid)
  • use Doppler to amplify sound if needed
50
Q

What are the different levels of the pulse amplitude ?

A

0+: absent
1+: diminished, barely palpable
2+: normal
3+: full volume
4+: full volume, bounding
5+: full volume, bounding hyperkinetic

51
Q

What pulse do you palpate 1 at a time ?

A

the carotid because you don’t want to reduce blood flow to the brain

52
Q

What pulse is commonly used in CPR adult assessments ?

A

carotid

53
Q

What pulse is commonly used in CPR and cap refill in infants/small children ?

A

brachial

54
Q

What is the Allen’s test ?

A

tests for blood flow or perfusion of the hand through the radial and ulnar artery
- color of hand should return within 10 secs and

55
Q

What are the different levels of the edema scale ?

A

0+: no edema (we don’t use 0+ but instead just say “no edema”)
1+: (2 mm) barely perceptible but hard to tell
2+: (4 mm) deep pit with rebound in a few secs
3+: (6 mm) comes back in 20-30 seconds and is more deep
4+: (8mm) even deeper with rebound of more than 30 secs of return

56
Q

What should the cap refill in infants be ?

A

<1 sec

57
Q

What should the angle of the nail beds be ?

A

160 degrees
- >180 degrees is considered clubbing

58
Q

What does the S1 sound mean and what occurs ?

A
  • systolic BP
  • closing of mitral (M1) and tricuspid (T1) valves at the same time
  • ventricles contract
  • beginning of systole
  • heard best at apex
59
Q

What does the S2 sound mean and what occurs ?

A
  • diastolic BP
  • closure of aortic (A2) and pulmonic (P2) valves
  • ventricles relax
  • beginning of diastole
  • heard best at base
60
Q

What are examples of abnormal heart sounds ?

A
  • S3: Ken-tuck-y (slosh’ing-in) (s1,s2,s3)
  • S4: ten-ness-ee (a stiff wall) (s4,s1,s2)
61
Q

Is S3 an abnormal heart sound ?

A

when blood rushes quickly into the ventricle from the atrium
- can be normal in children and pregnant women
- when heard in adult over age 30 it can mean CHR, fluid volume overload or abnormal ventricular valves
- when heard its right after S2 (.16 secs after)
- can be indicative of heart failure (not always)

62
Q

What occurs during S4 and is it abnormal ?

A

rush of blood heard with atrial contraction against the ventricles after atrial contraction
- can be normal in athletes and older adults, and adults younger than age 30
- usually an abnormal sound though
- also called noncompliant or stiff ventricle
- occurs just before S1 (.20 secs before)

63
Q

What do P-waves mean ?

A

atrial depolarization (contraction)

64
Q

What does the QRS complex mean ?

A

ventricular depolarization (contraction) and atrial repolarization

65
Q

What do T-waves mean ?

A

ventricular repolarization

66
Q

Where is the location of the SA nodes and the function ?

A

right atrium
- determine how much electrical impulse is given and it stimulates the atrium to contract (p-wave)
- 60-100 impulses

67
Q

What is the function of the AV node ?

A

causes ventricles to contract
- QRS complex
- slow down to 40-60 impulses

68
Q

What is arterial insufficiency (peripheral artery disease) ?

A

any condition that slows or stops the flow of blood through the arteries
- blood can’t go back down
- commonly because of atherosclerosis or hardening of the arteries

69
Q

What are the symptoms of arterial insufficiency ?

A
  • leg pain increases when elevated (painful because your blood isn’t going down and working against gravity)
  • cooler skin temp
  • minimal or no edema
  • absence of hair (no blood flow to follicles)
  • capillary refill >3 secs
  • diminished/absent pulses
  • shiny, thin, taut, pale
  • cramping in legs because of exercise or activity
70
Q

Where can arterial insufficiency happen ?

A

anywhere in the body
- if it affects your heart arteries it can give you a heart attack or chest pain
- if it affects brain arteries it can cause a stroke
- if it affects in the belly it can cause pain after eating

71
Q

What is venous insufficiency ?

A

blood can’t go back up so it pools

72
Q

What are some symptoms of venous insufficiency ?

A
  • pain is aching or cramping (relieved with elevation)
  • lower leg edema present (worse in evening since you’ve been on your feet all day)
  • skin may feel warm or hot
  • cramping is not reproducible consistently with exercise
  • hair may be present or absent
  • brown color on lower legs
  • spider and varicose veins
  • pulses present
  • ulcerations (medial malleolus)
  • thick, tough, brawny, woody skin
  • cap refill <3 secs
73
Q

What is telangiectasias ?

A

spider veins
- are skinnier veins (common in face)

74
Q

What is Deep Vein Thrombosis (DVT) ?

A

when a thrombus (clot) develops within a vein
- usually on lower extremity, in deep veins

75
Q

What are some signs/symptoms of Deep Vein Thrombosis (DVT) ?

A
  • low grade fever
  • fatigue
  • Malaise (sick feeling)
  • extremity may feel tense, full and heavy
  • nodules or lumps (inflammation of vein wall)
  • pain (50% are asymptomatic)
  • warm to hot OR cool to cyanotic with severe edema
  • red to blue color
76
Q

What is important about aspirin with blood ?

A

prevents platelet aggregation (thins blood)

77
Q

What are some health promotion activities that relate to the CVPV ?

A
  • physical activity 30 mins 5x a week prevents coronary artery disease, HTN, and obesity
  • stress raises BP
  • caffeine can cause tachycardia
78
Q

What is orthopnea ?

A

difficulty breathing while lying down

79
Q

Is visible jugular veins normal ?

A

no

80
Q

When assessing the jugular vein what considerations must be taken ?

A
  • elevate HOB 30-34 degrees
  • elevate chin slightly and tilt head away from side being examined
  • visible pulsation is normal but you shouldn’t be able to see the jugular vein itself

Comprehensive Health Assessments (13 decks)

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