Chapter 19 Heart and Neck Vessels Flashcards
Precordium
Area on the anterior chest directly over the heart and great vessels (outside)
Mediastinum
The heart and great vessels are located between the lungs in the middle third of the thoracic cage called the mediastinum. (Inside)
Apex of the heart
The bottom of the heart, you can plapate the apical impulse on some people at the 5th intercostal space mid clavicular line
Base of the heart
The top of the heart
PMI
Point of maximal impulse found at 5 ICS Mid clavicular line on the apex of the heart
Pulmonary veins dump into
the left atrium
Chordae Tendineae
connect valve to muscle
Heart Anatomy
Lies in thoracic cavity Behind sternum Left of mid-line Precordium Base Apex 12cm x 8cm x 6cm
Pericardium
tough fibrous, double walled sac that surrounds and protects the heart
Atrioventricular valves-
mitral (left) and tricuspid (right)
separate the atria and the ventricals
Purpose: to maintain unidirectional blood flow through the chambers of the heart
Myocardium
Muscular wall of the heart
Endocardium
thin layer of endothelial tissue that lines the inner surface of the chambers of the heart and valves
Semilunar valves-
aortic (left side) and pulmonic (right side)
set between the ventricals and the arteries
Purpose: to maintain unidirectional blood flow through the chambers of the heart
Great Vessels
These blood vessels circulate blood to and from the body and the lungs.
Superior Vena Cava Inferior vena cava Pulmonary artery Pulmonary vein Aorta
How Does Blood Pump Through the Body?
Closed System: Heart and Pulmonary and Systemic Circulation
Coronary Arteries
Left coronary artery
Left anterior descending
Right coronary artery
Left circumflex artery
s3 heart sound
S3-ventricular filling
comes after diastole
can mean congestive heart failure
s4 heart sound (atrial kick)
S4-atrial contraction
comes before systole
can mean congestive heart failure
s1 heart sound (lub)
occurs with closure of the av valves and signals the beginning of systole
the mitral component is the 1st sound followed by the tricuspid component . can be heard together all over the precordium but loudest at the apex
S2 heart sound (dub)
occurs with closure of the semilunar valves and signals the end of systole
s2 is the loudest at the base
The ____ atrium and _____ ventrical are facing forward as the heart sits inside the body
Right, right
The heart is positioned twisted slightly to the left.
Blood flow-
From Liver/ head- upper extremeties - through superior and inferior vena cava- to right atrium- through tricuspid- into right ventrical - through pulmonic valve - to pulmonary artery- to lungs - pulmonary veins - left atrium - through mitral valve- to left ventrical- through aortric valve - to aorta
flows from high pressure to low pressure
Anterior
front
Posterior
Back
viceral
near the organ
Inferior vena cava
brings unoxengenate blood up from the feet and legs
Widow maker
left coronary artery
Aortic stenosis
calcification of aorta
aortic valve problems cause
shortness of breath
erbs point
3rd ICS on left
where all heart sounds are heard the same loudness
systolic murmur=
lub swish dub
diastolic murmur=
lub dub swish
mitral valve prolapse
backflow into the mitral valve
Mitral valve closure can be heard at
Apex. 5th left ICS @MCL
Tricuspid valve closure can be heard at
Left SB @ 4th Left ICS
Pulmonic valve closure can be heard at
2nd left ICS @ SB
Aortic valve closure can be heard at
2nd right ICS @ SB
MURMURS
Blowing, swishing sound related to turbulent blood flow. May be caused by: Increased velocity of blood flow Decreased viscosity of blood (anemia) Valvular/structural defects
Grade iv heart murmur
loud, with a palpable thrill
Systolic Murmurs:
- Aortic Stenosis
- Mitral Regurgitation
Diastolic Murmurs:
Aortic Regurgitation
-Mitral Stenosis
Aortic heart murmurs will radiate to the
neck
Mitral heart murmurs will radiate to the
axillary
Bundle Branch block
a block in electrical flow in the heart at the av node
Older adults
myocardium more fibrous.
sa node more fibrous.
valves calcify
systolic pressure stays the same, distolic pressure gets higher
paroxymal dyspnea
waking up with labored breathing that comes and goes thoughout the right
orthopnea
shortness of breath when you lay down
JVD
jugular vein distention
right ventricular/valvular failure
lay at a 35 degree angle to test
Heart rate for a newborn
100-180 bpm
murmurs common in the 1st 2-3 days
Systole the ____ and ______ valves are open
pulmonic and aortic
Diatole the ______ and ______ valves are open
tricuspid and mitral (AV)
Electrical Conduction Through the Heart
SA node in right atrium starts electrical current
Passes through AV node in atrial septum
Bundle of His
Purkinje fibers in myocardium of ventricles
EKG records electrical current
Depolarization (p wave and QRS complex)
Repolarization (T wave)
Developmental Considerations
FETUS-changes at birth include closure of patent ductus arteriosus within 24-48 hours
INFANT-at birth, systemic vascular resistance increases; pulmonary vascular resistance decreases causing blood to flow to pulmonary arteries; which closes interatrial foramen ovale within 1 hour of birth
INFANT- heart lies more horizontally in thoracic cavity
CHILD - By age 7, adult heart position is achieved
Developmental Considerations-
Older Adults
Myocardium becomes more rigid, delaying contractility and irritability
Atherosclerotic changes cause dilation and tortuosity of aorta and carotid arteries
SUBJECTIVE DATA
Chest pain Dyspnea Orthopnea Cough Fatigue Cyanosis or pallor Edema Nocturia
LIFT:
slightly more sustained than normal.
occurs with right ventrical hypertrophy as found in pulmonic valve disease, pulmonic hyperstension, and chronic lung disease
HEAVE:
EXCESSIVE thrust of heart against chest wall
