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Health Assessment Exam 2 > Chapter 19: Cardiac > Flashcards

Chapter 19: Cardiac Flashcards

1
Q

Pericardium

A

tough, fibrous, double-walled sac that surrounds and protects heart

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2
Q

Myocardium

A

muscular wall of heart; it does pumping

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3
Q

Endocardium

A

thin layer of endothelial tissue that lines inner surface of heart chambers and valves

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4
Q

How many pumps does the heart have?

A

2

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5
Q

Are valves uni or multidirectional?

A

Unidirectional

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6
Q

Do the valves work active or passively?

A

Valves open and close passively in response to pressure gradients in moving blood

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7
Q

What is the S1 sound?

A

Closing of AV valve

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8
Q

What is the S2 sound?

A

Closing of semilunar valve

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9
Q

When do you hear S3 and S4

A

S3 is after S2 and S4 is before S1

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10
Q

What is systole?

A

Ventricular contraction

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11
Q

What is diastole?

A

Ventricular relaxation

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12
Q

What is friction rubs?

A

Rubbing of the pericardium

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13
Q

Heart murmur grades

A

1-6

Grade 1 needs a bell and grade 6 can be heard with diaphragm

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14
Q

Physiologic murmur

A

a heart murmur that is primarily due to physiologic conditions outside the heart.
Ex: first trimester in pregnancy

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15
Q

Pathologic murmur

A

a pathologic murmur is produced by blood flowing through a narrowed blood vessel or hole in the heart.

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16
Q

S3 murmur

A

“Ventricular gallop”
S3 occurs when ventricles resistant to filling and ventricles have reached the elastic limit (dilated ventricles)
Occurs immediately after S2, when AV valves open and atrial blood first pours into ventricles
**Normal in children

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17
Q

S4 murmur

A

“Atrial gallop”
Occurs at end of diastole, at presystole, when ventricle resistant to filling
Atria contract and push blood into non compliant ventricle
This creates vibrations that are heard as S4
S4 occurs just before S1
Always a disease, never innocent

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18
Q

How do you characterize heart sounds?

A

Frequency, Loudness/Intensity, Duration, Timing

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19
Q

What impacts BP?

A

C.O, PVR, Viscosity, blood vessel elasticity, volume of circulating blood,

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20
Q

Should you hear blood circulating through normal cardiac chambers and valves?

A

Blood circulating through normal cardiac chambers and valves usually makes no noise

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21
Q

Reasons for murumr

A

Velocity of blood increases (flow murmur), for example, in exercise, thyrotoxicosis
Viscosity of blood decreases, for example, in anemia
Structural defects in valves, narrowed valve, incompetent valve
Unusual openings occur in chambers, dilated chamber, wall defect

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22
Q

Conduction

A

SA to AV to Bundle of His to Purkinje fibers to Apex then up ventricles

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23
Q

ECG: Electrocardiograph

A

P wave: depolarization of atria
P-R interval: 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)
QRS complex: depolarization of ventricles
T wave: repolarization of ventricles

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24
Q

Stroke volume

A

Volume of blood that ejected from the left ventricle with each contraction

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25
Q

Cardiac Output

A
  • Stroke volume x Heart Rate

- Amount of blood heart pushes per minute

26
Q

Carotid artery

A

Close to heart; timing closely coincides with ventricular systole
Located in groove between trachea and sternomastoid muscle, medial to and along-side that muscle
(+2 pulse)

27
Q

Jugular vein purpose

A

Jugular veins empty un oxygenated blood directly into superior vena cava
Usually not visible, although diffuse pulsations may be seen in sternal notch when person is supine

28
Q

Distended jugular vein means what?

A

Cardiac failure

29
Q

How does oxygenation take place for a baby in utero?

A

Placenta is where oxygenation takes place because of shunts that allow it to bypass the lungs
-Foramen ovale and Ductus arteriosus

30
Q

Heart rate for infant

A

110 - 160

31
Q

What murmur is normal for infants in the first few hours

A

Physiologic S3

32
Q

How many arteries and veins does an umbilical have?

A

2 arteries and a vein

33
Q

Special considerations in pregnant females

A

Blood Volume increases, BP decreases, S1 louder, Mammary souffle (continuous murmur from breast vasculature) [Heard in 2nd, 3rd, 4th intercostal], Physiologic anemia (bc blood is diluted), Supine hypotensive syndrome

34
Q

Special considerations in older adult

A

Risk for CVD, ability to augment cardiac output, Left ventricle thickens, Valves thicken, Systolic BP increases, Pulse pressure widens, Arteriosclerosis (hardening of blood vessels and BP increases)

35
Q

Diabetes mellitus effects on heart

A

Increases risk for CVD

36
Q

Hypertension is more common in who?

A

Blacks and women taking oral contraceptives and in obese women

37
Q

Risk factors for Cardiac Disease

A

Obesity, High cholesterol, HTN, Smoking, Diet, Physical inactivity, Family history, Diabetes

38
Q

When is it hard to find Apical pulse?

A

obese, have barrel chest, if a lot of muscle, if pregnant woman or child

39
Q

Heaves vs Thrill

A

Thrill is palpable murmur

Heaves is lifting when you palpate the area

40
Q

When percussing the heard and cardiac border what should you hear?

A

A dull sound, you should not hear it between 7 and 8 intercostal though

41
Q

Where is S1 and S2 the loudest

A

S2 at the base and S1 at the apex

42
Q

Where do you auscultate for murmurs?

A

Aortic, Pulmonary, Erbs, Tricuspid, Mitral

43
Q

Developmental competence in infants

A

Heart rate may range from 100 to 180 beats per minute (bpm) immediately after birth

44
Q

Infant murmurs

A

Usually a grade I or II
They are systolic and accompany no other signs of cardiac disease, and they disappear in 2 to 3 days
Murmur of patent ductus arteriosus is continuous machinery murmur, which disappears by 2 to 3 days

45
Q

Signs in children that may indicate heart disease

A

Poor weight gain, developmental delay, persistent tachycardia, DOE, cyanosis, clubbing

46
Q

Venous hum in children

A

Venous hum, due to turbulence of blood flow in jugular venous system, common in healthy children and has no pathologic significance

47
Q

BP and HR in pregnant women

A

BP drops slightly and HR increases 10-15 bpm

48
Q

Thrill at 2nd and 3rd right interspace occurs with

A

Severe aortic stenosis and systemic hypertension

49
Q

Thrill in the 2nd and 3rd left intercostal space occurs with

A

pulmonic stenosis and pulmonic hypertension

50
Q

Lift or Heave at the left sternal border indicates

A

right ventricular hypertrophy which is found in pulmonic valve disease, pulmonic hypertension and chronic lung disease

51
Q

Cardiac enlargement displaces apical pulse which causes

A

Volume overload, heart failure, mitral regurgitation, aortic regurgitation and left to right shunts

52
Q

Left ventricular hypertrophy occurs without dilation which causes

A

Pressure overload which is found in aortic stenosis or systemic hypertension

53
Q

PDA: Patent Ductus Arteriosus

A

Connection of pulmonary artery and aorta

54
Q

ASD: Arterial Septal Defect

A

Opening between aortas, increasing pulmonary blood flow

55
Q

VSD: Ventricular septal defect

A

Opening between ventricles in usually the sub-aortic area

56
Q

Tetralogy of Fallot

A

Right ventricular outflow stenosis, VSD, right ventricular hypertrophy, overriding aorta

57
Q

Coarctation of the aorta

A

Severe narrowing of descending aorta usually at the ductus arteriosis and aortic arch
Associated w/ defects of aortic valve

58
Q

Mitral stenosis

A

Narrowing of left mitral valve

Can be due to rheumatic fever or cardiac infection

59
Q

Aortic Stenosis

A

Narrowing or aortic valve

Congenital bicuspid valves, rheumatic heart disease and atherosclerosis can cause it

60
Q

Mitral regurgitation

A

Back flow of blood from left ventricle into the left atrium

Due to rupture of chordae tendineae, MI

61
Q

Pulmonic stenosis

A

Narrowing of the opening between the pulmonary artery and the right ventricle
Congenital

62
Q

Coarctation of the aorta

A

Different BP with higher and lower extremities

Pulse difference so, 3+ in top extremities and 1+ with lower extremities

Health Assessment Exam 2 (7 decks)

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