Chapter 17—Cardio & Lymph Flashcards
diastole
valves opening and closing?
chambers filling & relaxing?
- AV valves open
- ventricles relaxed & filling
- SL valves closed
- atria contracting
systole
valves opening and closing?
chambers filling & relaxing?
AV valves closed
ventricles contract
SL valves open
atria relaxed
what is S1?
what does it signify?
where do we hear it?
Lub
closure of AV valves
start of systole
apex of heart (PMI)
What is S2?
what does it signify?
where do we hear it?
Dub
closure of SL valves
start of diastole
base of heart (2nd ICS)
spots to listen to valves of the heart (5)
- Aortic - 2nd ICS, R sternal border
- Pulmonic - 2nd ICS, L sternal border
- Erb’s - 3rd ICS, L sternal border
- Tricuspid - 4th ICS, L sternal border
- Mitral - 5th ICS, L midclavicular - point of maximum impact (PMI)
S3
technical name
“___”
caused by…
pathological? normal?
heard where/how?
Ventricular Gallop
“Kentucky”
rapidly flowing blood hits compliant ventricular wall
pathological in most adults
normal in children/young adults/pregnancy/athletes
apex with bell
S4
technical name
“___”
caused by…
pathological? normal?
heard where/how?
Atrial Gallop
“Tennessee”
blood hits less compliant ventricle
almost never normal
diastolic HF, untreated HTN, coronary heart disease, aortic stenosis, etc
apex with bell
turbulent blood flow caused by leaky valves
murmur
how are murmurs graded?
1-6
1 is quietest, 6 is strongest
at what grade can you palpate a murmur?
4 +
what is a thrill?
palpable murmurs
CO =
stroke volume x HR
what is preload?
volume of blood at end of diastole
what is afterload?
pressure the ventricle has to overcome to eject blood into aorta
what is depolarization?
contraction
what is repolarization?
relaxation
primary pacemaker
sinoatrial node
other fibers that control cardiac rhythm if SA node fails
AV node
Bundle of His
Purkinje fibers
what does HR drop down to if AV node or Purkinje fibers have to take over conduction?
- AV - 40-60 bpm
- Purkinje - 20-40 bpm
what is P-R?
beginning of electrical conduction in atria
what is the Q-R-S complex?
coincides with ventricles’ contraction
what is the S-T interval?
heart muscles relax & fill
what is T?
beginning of the next electrical conduction
normal jugular vein
6-8 cm
JVP indicates… (4)
right sided heart failure
pulmonary HTN
PE
cardiac tamponade
how to check JVP
stand on right side, HOB at 30-45, turn head to left, shine flashlight, look for pulsation
intermittent pain r/t PVD, often with activity & relieved by rest
intermittent claudication
Allen test
obliterate radial & ulnar pulses - release one at a time to see if BF returns
hands - numbness, tingling, pain, coolness, extreme pallor, extreme abrupt tricolor in hands with cold
Raynaud’s disease/sign
manual compression assessment of veins
palpable vein indicates?
incompetent venous valve
pressure buildup from internal bleeding/edema - decreases BF - severe pain
compartment syndrome
thickening of inner wall of artery
arteriosclerosis
plaque formation in arteries
atherosclerosis
arterial ulcers
edges?
colors?
temp?
dry/wet?
pain?
skin appearance?
location?
well defined edges
deep pale base - black necrotic tissue
cool skin
dry ulcer
intense pain
shiny hairless skin
on distal toes or foot
venous ulcers
edges?
colors?
temp?
dry/wet?
pain?
location?
skin appearance?
uneven edges
reddish brown - pale dead tissue lining crater
warm skin
exudate
moderate/no pain - itching
usually around ankle
darkening skin
Virchow’s node
left supraclavicular
location of iliac nodes
pelvic girdle
Label: P, Q, R, S, T
