Chapter 20:Heart and Neck Vessels Flashcards
1
Q
where is the heart and greater vessels located
A
mediastinum
2
Q
precordium
A
are on the anterior chest overlying the heart and greater vessels
3
Q
venae cavae
A
return unoxygenated venous blood to the right side to the heart
4
Q
pulmonary artery
A
leave the right ventricle, bifurcates, and carries the venous blood to the lungs
5
Q
pulmonary vein
A
returns the freshly oxygenated blood to the left side of the heart
6
Q
aorta
A
carrys blood out to the body
7
Q
pericardium
A
tough, fibrous, double walled sac that protects the heart
8
Q
myocardium
A
muscular wall of the heart
- does the pumping
9
Q
endocardium
A
the thin layer of endothelial tissue that lines the inner surface of the heart chambers and valves
10
Q
right AV valve
A
tricuspid valve
11
Q
left AV valve
A
mitral valve
12
Q
right side semilunar valve
A
pulmoric valve
13
Q
left side semilunar valve
A
aortic valve
14
Q
what happens in diastole
A
the ventricles relax and fill
- 2/3 of the cycle
15
Q
wat happens during systole
A
- hearts contraction
- blood is pumped from the ventricles and fills pulmonary and systemic arteries
1/3 of cycle
16
Q
what is the first diastolic phase
A
early or protodiastolic filling
17
Q
what is the active filling phase called
A
presystole or atrial systole
18
Q
isometric contractions
A
- all four ventricles closed
- contraction across a closed system works to build pressure inside the ventricles to a high level
19
Q
S1 sounds heard
A
closure of the mitral valve can be heard just before tricuspid valve closure
20
Q
S2 sounds heard
A
aortic valve closure occurs slightly before pulmonic valve closure
21
Q
where can the S1 sound be heard the loudest
A
apex
22
Q
where is the S2 sound heard the loudest
A
at the base
23
Q
S3 soundswhich 3 conditions result in a murmur
A
- increases in velocity of blood flow
- decreases in viscosity of blood
- structural defects in the valves
24
Q
what are the 4 characteristics of heart sounds
A
- frequency (pitch): high or low pitch
- intensity (loudness): loud or soft
- Duration: very shorrt
4. timing : systole or diastole
25
SA node is known as the
pacemaker
26
p wave
depolarization of the ventricles
27
P-R interval
interval from the begining of the P wave to the beggining of the QRS complex
- time required for atrial depolarizartion plus time for impulse to travel to the AV node the the ventricles
28
QRS complex
depolarization of the ventricles
29
T wave
repolarization of the ventricles
30
Co formula
CO=SVxRate
31
preload
- venous return that builds during diastole
- lenght to which the ventricular muscle is stretched at the end of diastole just before contraction
32
Afterload
- opposing pressure that the ventricle must generate to open the aortic valve against the higher aortic pressure
33
internal jugular vein location
lies deep and medial to the sternomastoid muscle
- not visable
34
external jugular vein location
lies lateral to the sternomastoid muscle above the clavical
- more superficial
35
A wave
- RA contracts
- tricuspid opens
36
X descent
- RA relaxes. starts to fill
- tricuspid closes
37
V wave
- RA filling
- tricuspid closed
38
Y descent
RA emptied
- tricuspid opens
39
blood volume increased by ____% during pregnancy
30-40%
40
pulse rate increases _____ during pregnancy
10-15 beats per minute
41
paroxysmal nocturnal dyspnea
- occurs with heart fialure
42
orthopnea
- need to assume a more upright position to breath
43
how to asses orthopnea
note the number of pillows used to sleep
44
Subjective data assesments
- chest pain
- dyspnea
- orthopnea
- cough
- fatigue
- cyanosis or pallor
- edema
- nocturia
- cardiac history
- family cardiac history
45
cyanosis or pallor occurs with
MI
46
hemoptysis often occurs as a side effect od
mitral stenosis
47
paroxysmal nocturnal dysnea occurs as a side effect of
heart failure
48
edema is dependent when caused by
heart failure
49
risk factors for CAD
- elevated cholesterol levels
- hypertension
- glucose levels obove 11.1
- known diabetes
- obesity
- cigareete smoking
sedentary lifestyle
50
how to asses for heart disease in infants
note fatigue during feeding
51
regional cardiovascular assesment should be preformed in what order
1. pulse and blood pressure
2. extremeties
3. neck vessels
- precordium
52
bruit
blowing swishing sound indicating blood flow turbulance
- not usually present
53
you should austclate the carotid artery for sings of
bruit
54
what heart murmer can radiate to the carotid artery
aortic stenosis
55
carotid sinus hypersensitivity
- pressure over the carotid sinus leads to a decrease in HR and BP
- may occur in adults with hypertension or occulsion
56
abnormal finding during palpation of the pericordium
a thrill
- palpable vibration
- signifies turbulent blood flow and accompanies loud murmurs
57
should you precuss the pericordium
no
58
second righ tinterspace
aortic valve area
59
second left interspace
pulmonic valve area
60
fifth interspace at left lower sternal border
tricuspid valve area
61
fifth interspace at around left midclavicular line
mitral valve area
62
normal pulse
60-100 BPM
63
sinus arrhythmias
- occurs mostly in young adults and children
- rhythm varies with patients breathing (increases during inspiration and slows with expiration)
64
pulse deficit
-signals weak contraction of the ventricles
- occurs with artial fibrilation, premature beats, and heart failure
65
how to asses for pulse deficit
auscultating the apical pulse while simultaneously palpating radial pulse
66
S1 valves
closure of AV valves
67
S2 valves
closure of the semilunar valves
68
early systolic murmur sounds
Lshshshs(S1) Dup (S2) Lshshs (s1) Dup (s2)
69
midsystolic murmur
LubshshsDub LubshshshDub
70
late systolic murmur
Lub shshshp. Lub shshshp
71
holosystolic murmurs
shshshshshsh shshshshs
72
Loudness: grade 1
barely audible, only heard in a quite room and then with difficulty
73
Loudness: grade 2
clearly audible but faint
74
Loudness: grade 3
moderately loud; easy to hear
75
loudness: grade 4
loud, associated with a thrill palpable on the chest wall
76
Loudness: grade 5
very liud, heard with one corner of the stethoscope lifted off the chest; associated with a thrill
77
Loudness: grade 6
loudest; still heard with entire stepthoscope lifted off the chest wall; associated with a thrill
78
murmur of mitral stenosis is
rumbeling
79
murmur of aortic stenosis is
hearsh
80
innocent murmurs
have no valvar or other pathological cause
- like fiddle strings
81
functional murmurs
caused by increased blood flow in the heart
82
venous hum
- common in healthy children and has no pathologic significance
- turbulance of blood flow in the jugular venous sytem
83
orthostatic blood pressure
sudden drop in blood pressure when sitting or standing
84
S3 is associated with
heart failure
85
fixed split
is unaffected by respiration; split is always there
86
paradoxical split
the soudns fuse on inspiration and split on expiration
87
midsystolic click
- associated with mitral valve prolapse
- most common extra sound
88
right side of the heart
- receives blood from superior and inferior vena cava
- pumps blood through pulmonary arteries to pulmonary circulation
89
left side of the heart
- receives blood from the pulmonary veins
- pumps blood through aorta into systemic circulation
90
s3 sound
- after S2 - early diastolic
- blood entering the ventricles during early ventricle filling
- quiet, low pitched
- best heard at the apex, with bell
91
S4 sound
- before S1, late diastolic
- atria contract, push blood into resistant ventricle
- quiet, low pitched
- best heard at the apex with bell
- pathologic
92
Internal jugular vein location
- lower, more lateral, under or behing the sternomastoid muscle
93
Internal jugular vein quality
diffuse; 2 visable waves per cycle
94
Internal jugular vein respiration
varies with respiration
95
Internal jugular vein palpuability
none
96
Internal jugular vein pressure
light pressue obliderates
97
Internal jugular vein position of patient
levels drop and disappear when sitting
98
Carotid artery location
higher; medial to sternomastoid
99
carotid artery quality
brisk, localized, one waver per cycle
100
carotid artery respiration
does not cary
101
carotid artery palpuability
yes
102
carotid artery pressure
no change
103
carotid artery position of patient
unaffected
104
carotid artery expected findings
- no bruits
- smooth contour
- 2+ amplitude bilaterally
105
expected internal jugular measurement
<3cm
106
unilateral distention of the jugular vein is indicative of
aneurysm
107
fully distended jugular vein is indicative of
heart failure
