Chapter 20: Heart and Neck Vessels Flashcards
1
Q
Angina pectoris
A
Acute chest pain that occurs when myocardial demand exceeds its oxygen supply
2
Q
Aortic regurgitation
A
(Aortic insufficiency) incompetent aortic valve that allows backward flow of blood into left ventricle during diastole
3
Q
Aortic stenosis
A
Calcification of aortic valve cusps that restricts forward flow of blood during systole
4
Q
Aortic valve
A
The left semilunar valve separating the left ventricle and the aorta
5
Q
Apex of the heart
A
Tip of the heart pointing down toward the 5th left ventricle and the aorta
6
Q
Apical impulse
A
Point of maximal impulse (PMI); pulsation created as the left ventricle rotates against the chest wall during systole, normally at the 5th left intercostal space in the midclavicular line
7
Q
Base of the heart
A
Broader area of heart’s outline located at the 3rd right and left intercostal spaces
8
Q
Bell (of the stethoscope)
A
Cup-shaped endpiece used for soft. low-pitched heart sounds
9
Q
Bradycardia
A
Slow heart rate, less than 50 beats per minute in the adult
10
Q
Clubbing
A
Bulbous enlargement of distal phalanges of fingers and toes that occurs with chronic cyanotic heart and lung conditions
11
Q
Coarctation of aorta
A
Severe narrowing of the descending aorta, a congenital heart defect
12
Q
Cor pulmonale
A
Right ventricular hypertrophy and heart failure due to pulmonary hypertension
13
Q
Cyanosis
A
Dusky blue mottling of the skin and mucous membranes due to excessive amount of reduced hemoglobin in the blood
14
Q
Diaphragm (of the stethoscope)
A
Flat end of the stethoscope used for hearing relatively high-pitched heart sounds
15
Q
Diastole
A
The heart’s filling phase
16
Q
Dyspnea
A
Difficult, labored breathing
17
Q
Edema
A
Swelling of legs or dependent body part due to increased interstitial fluid
18
Q
Erb’s point
A
Traditional auscultatory area in the 3rd left intercostal space
19
Q
First heart sound (S1)
A
Occurs with closure of the atrioventricular valves signaling the beginning of systole
20
Q
Fourth heart sound (S4)
A
S4 gallop, atrial gallop; very soft, low-pitched ventricular filling sound that occurs in the late diastole
21
Q
Gallop rhythm
A
The addition of a 3rd or a 4th heart sound; makes the rhythm sound like the cadence of a galloping horse
22
Q
Inching
A
Technique of moving the stethoscope incrementally across the precordium through the auscultatory areas while listening to the heart sounds
23
Q
Left ventricular hypertrophy (LVH)
A
Increase in thickness of myocardial wall that occurs when the heart pumps against chronic outflow obstruction (e.g. aortic stenosis)
24
Q
Midclavicular line (MCL)
A
Imaginary vertical line bisecting the middle of the clavicle in each hemithorax
25
Mitral regurgitation
Mitral insufficiency; incompetent mitral valve allows regurgitation of blood back into left atrium during systole
26
Mitral stenosis
Calcified mitral valve impedes forward flow of blood into left ventricle during diastole
27
Mitral valve
Left atrioventricular valve separating the left atrium and ventricle
28
Palpitation
Uncomfortable awareness of rapid or irregular heart rate
29
Paradoxical splitting
Opposite of a normal split S2 so that the split is heard in expiration, and in inspiration the sounds fuse to one sound
30
Pericardial friction rub
High-pitched, scratchy extracardiac sound heard when the precordium is inflamed
31
Physiologic splitting
Normal variation in S2 heard as two separate components during inspiration
32
Precordium
Area of the chest wall overlying the heart and great vessels
33
Pulmonic regurgitation
Pulmonic insufficiency; backflow of blood through incompetent pulmonic valve into the right ventricle
34
Pulmonic stenosis
Calcification of pulmonic valve that restricts forward flow of blood during systole
35
Pulmonic valve
Right semilunar valve separating the right ventricle and pulmonary artery
36
Second heart sound (S2)
Occurs with closure of the semilunar valves, aortic and pulmonic; signals the end of systole
37
Summation gallop
Abnormal mid-diastolic heart sound heard when both the pathologic S3 and S4 are present
38
Syncope
Temporary loss of consciousness due to decreased cerebral blood flow (fainting); caused by ventricular asystole, pronounced bradycardia, or ventricular fibrillation
39
Systole
The heart's pumping phase
40
Tachycardia
Rapid heart rate, greater than 95 beats per minute in the adult
41
Third heart sound (S3)
Soft, low-pitched ventricular filling sound that occurs in early diastole (S3 gallop) and may be an early sign of heart failure
42
Thrill
Palpable vibration on the chest wall accompanying severe heart murmur
43
Tricuspid valve
Right atrioventricular valve separating the right atrium and ventricle
44
Define apical impulse and describe its normal location, size, and duration
k
45
Which abnormal conditions may affect the location of the apical pulse
l
46
Explain the mechanism producing normal first and second heart sounds
k
47
Describe the effect of respiration on the heart sounds
,
48
Describe the characteristics of the first heart sound and its intensity at the apex of the heart and at the base
k
49
Describe the characteristics of the second heart sound and its intensity at the apex of the heart and at the base
k
50
Explain the physiologic mechanism for normal splitting of S2 in the pulmonic valve area
j
51
Define the third heart sound. When in the cardiac cycle does it occur? Describe its intensity, quality, location in which it is heard, and method of auscultation.
.
52
Differentiate a physiologic S3 from a pathologic S3
k
53
Define the fourth heart sound. When in the cardiac cycle does it occur? Describe its intensity, quality, location in which it is hear, and method of auscultation.
k
54
Explain the position of the valves during the cardiac cycle in diastole, isometric contraction, systole, and isometric relaxation.
.
55
Define venous pressure and jugular vein pressure.
.
56
Differentiate between carotid artery pulsation and jugular vein pulsation
.
57
List the major risk factors for heart disease and stroke as identified in this text.
.
58
Define bruit, and discuss what it indicates.
.
59
State 4 guidelines to distinguish S1 and S2.
.
60
Define pulse deficit, and discuss what it indicates.
.
61
Define preload and afterload.
Preload: Volume; the venous return that builds during diastole Afterload: Pressure; the opposing pressure the ventricle must generate to open the aortic valve against the higher aortic pressure
62
List the characteristics to explore when you hear a murmur, including the grading scale of murmurs
.
63
Discuss the characteristics of an innocent or functional murmur.
.
64
Identify label A
Internal Jugular Veins
65
Identify label B
Superior vena cava
66
Identify label C
Right atrial appendage
67
Identify label D
Right atrium
68
Identify label E
Right ventricle
69
Identify label F
Inferior vena cava
70
Identify label G
Aorta (thoracic)
71
Idenfity label H
Common carotid arteries
72
Ifentify label I
Aorta (arch)
73
Identify label J
Pulmonary artery
74
Idenfity label K
Left atrial appendage
75
Identify label L
Left ventricle
76
Identify label M
Apex
77
Identify label N
Base
78
Identify label A
Superior vena cava
79
Identify label B
Right pulmonary artery
80
Identify label C
Right atrium
81
Identify label D
Right pulmonary veins
82
Identify label E
Fossa ovalis
83
Identify label F
Right atrioventricular valve (tricuspid valve)
84
Identify label G
Right ventricle
85
Identify label H
Chordae tendineae
86
Identify label I
Inferior vena cava
87
Identify label J
Aorta
88
Identify label K
Left pulmonary artery
89
Identify label L
Left atrium
90
Identify label M
Left pulmonary veins
91
Identify label N
Pulmonary semilunar valve
92
Identify label O
Left atrioventricular valve (bicuspid valve)
93
Identify label P
Aortic semilunar valve
94
Identify label q
Left ventricle
95
Identify label r
Interventricular septum
96
Identify label s
Myocardium
97
Identify label t
Visceral pericardium
98
Identify label A
Right external jugular vein
99
Identify label B
Right common carotid artery
100
Identify label C
Sternomastoid muscle
101
Identify label D
Superior vena cava
102
Identify label E
Neck Vessels
103
Identify label F
Aorta
104
Identify label H
Left internal jugaular vein
105
Identify label i
Left common carotid artery
106
Identify label j
Left external jugular vein
107
The precardium is:
a. A synonym for the mediastinum
b. The area on the chest where the apical impulse is felt
c. The area on the anterior chest overlying the heart and great vessels
d. A synonym for the area where the superior and inferior venae cavae return oxygenated venous blood to the right side of the heart
c. The area on the anterior chest overlying the heart and great vessels
108
Select the best description of the tricuspid valve.
a. Left semilunar valve
b. Right atrioventricular valve
c. Left atrioventricular valve
d. Right semilunar valve
b. Right atrioventricular valve
109
The function of the pulmonic valve is to:
a. Divide the left atrium and left ventricle
b. Gaurd the openings between the right atrium and right ventricle
c. Protect the oriface between the right ventricle and the pulmonary artery
d. Gaurd the entrance to the aorta from the left ventricle
c. Protect the oriface between the right ventricle and the pulmonary artery
110
Atrial systole occurs:
a. During ventricular systole
b. During ventricular diastole
c. Concurrently with ventricular systole
d. Independently of ventricular function
b. During ventricular diastole
111
The second heart sound is the result of:
a. Opening of the mitral and tricuspid
b. Closing of the mitral and tricuspid valves
c. Opening of the aortic and pulmonic valves
d. Closing of the aortic and pulmonic valves
d. Closing of the aortic and pulmonic valves
112
The examiner has estimated the jugular venous pressure. Identify the finding that is abnormal.
a. Patient elevated to 30 degrees, internal jugular vein pulsation at 1 cm above sternal angle
b. Patient elevated to 30 degrees, internal jugular vein pulsation at 2 cm above sternal angle
c. Patient elevated to 40 degrees, internal jugular vein pulsation at 1 cm above sternal angle
d. Patient elevated to 45 degrees, internal jugular vein pulsation at 4 cm above sternal angle
d. Patient elevated to 45 degrees, internal jugular vein pulsation at 4 cm above sternal angle
113
The examiner is palpating the apical impulse. Which is a normal-sized impulse?
a. less than 1 cm
b. Approximately 1 x 2 cm
c. 3 cm
d. Varies depending on the size fo the person
b. Approximately 1 x 2 cm
114
The nurse auscultates the pulmonic valve area in which region?
a. Second right interspace
b. Seond left interspace
c. Left lower sternal border
d. Fifth interspace, left midclavicular line
b. Seond left interspace
115
Which description would differentiate a split S2 from S3?
a. S3 is lower pitched and is heard at the apex
b. S2 is heard at the left lower sternal border
c. The timing of S2 varies with respirations
d. S3 is heard at the base; the timing varies with respirations
a. S3 is lower pitched and is heard at the apex
116
You ausculatate a patient to rule out a pericardial friction rub. Which assessment technique is most appropriate?
a. Listen with the diaphragm, patient sitting up and learning forward, breath held in expiration
b. Listen using the bell with the patient leaning forward
c. Listen at the base during normal respiration
d. Listen with the diaphragm, patient turned to the left side
a. Listen with the diaphragm, patient sitting up and learning forward, breath held in expiration
117
When ausculatating the heart, your first step is to:
a. Identify S1 and S2
b. Listen for S3 and S4
c. Listen for murmurs
d. Identify all four sounds on the first round
a. Identify S1 and S2
118
You will hear a split S2 most clearly in which area?
a. Apical
b. Pulmonic
c. Tricuspid
d. Aortic
b. Pulmonic
119
The stethoscope bell should be pressed lightly against the skin so that:
a. Chest hair doesn't stimulate crackles
b. High-pitched sounds can be heard better
c. The bell does not act as a diaphragm
d. The bell does not interfere with amplification of heart sounds
c. The bell does not act as a diaphragm
120
A murmus is heard after S1 and before S2. This murmur would be classified as:
a. Diastolic (possibly benign)
b. Diastolic (always pathologic)
c. Systolic (possibly benign)
d. Systolic (always pathologic)
c. Systolic (possibly benign)
121
When assessing the carotid artery, the nurse whould palpate:
a. Bilaterally at the same time while standing behind the patient
b. Medial to the sternomastoid muscle, one side at a time
c. For a bruit while asking the patient to hold his or her breath briefly
d. For unilateral distention while turning the patient's head to one side
b. Medial to the sternomastoid muscle, one side at a time
122
S1 is best heard at the _______ of the heart, where as S2 is loudest at the _____ of the heart. S1 coincides with the pulse in the ______ and coincides with the ___ wave if the patient is on an ECG monitor.
S1 is best heard at the _APEX_ of the heart, where as S2 is loudest at the _BASE_ of the heart. S1 coincides with the pulse in the _CAROTID_ and coincides with the _R_ wave if the patient is on an ECG monitor.
123
Tough, fibrous, double-walled sac that surrounds and protects the heart.
a. Pericardial fluid
b. Ventricle
c. Endocardium
d. Myocardium
e. Pericardium
f. Atrium
e. Pericardium
124
Thin layer of endothelial tissue that lines the inner surface of the heart chambers and valves
a. Pericardial fluid
b. Ventricle
c. Endocardium
d. Myocardium
e. Pericardium
f. Atrium
c. Endocardium
125
Reservoid for holding blood
a. Pericardial fluid
b. Ventricle
c. Endocardium
d. Myocardium
e. Pericardium
f. Atrium
f. Atrium
126
Ensures smooth, friction-free movement of the heart muscle
a. Pericardial fluid
b. Ventricle
c. Endocardium
d. Myocardium
e. Pericardium
f. Atrium
a. Pericardial fluid
127
Muscular pumping chamber
a. Pericardial fluid
b. Ventricle
c. Endocardium
d. Myocardium
e. Pericardium
f. Atrium
b. Ventricle
128
Muscular wall of the heart
a. Pericardial fluid
b. Ventricle
c. Endocardium
d. Myocardium
e. Pericardium
f. Atrium
d. Myocardium
