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NURS252 > Chapter 20:Heart and Neck Vessels > Flashcards

Chapter 20:Heart and Neck Vessels Flashcards

1
Q

where is the heart and greater vessels located

A

mediastinum

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2
Q

precordium

A

are on the anterior chest overlying the heart and greater vessels

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3
Q

venae cavae

A

return unoxygenated venous blood to the right side to the heart

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4
Q

pulmonary artery

A

leave the right ventricle, bifurcates, and carries the venous blood to the lungs

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5
Q

pulmonary vein

A

returns the freshly oxygenated blood to the left side of the heart

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6
Q

aorta

A

carrys blood out to the body

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7
Q

pericardium

A

tough, fibrous, double walled sac that protects the heart

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8
Q

myocardium

A

muscular wall of the heart
- does the pumping

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9
Q

endocardium

A

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

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10
Q

right AV valve

A

tricuspid valve

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11
Q

left AV valve

A

mitral valve

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12
Q

right side semilunar valve

A

pulmoric valve

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13
Q

left side semilunar valve

A

aortic valve

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14
Q

what happens in diastole

A

the ventricles relax and fill
- 2/3 of the cycle

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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
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16
Q

what is the first diastolic phase

A

early or protodiastolic filling

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17
Q

what is the active filling phase called

A

presystole or atrial systole

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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
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19
Q

S1 sounds heard

A

closure of the mitral valve can be heard just before tricuspid valve closure

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20
Q

S2 sounds heard

A

aortic valve closure occurs slightly before pulmonic valve closure

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21
Q

where can the S1 sound be heard the loudest

A

apex

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22
Q

where is the S2 sound heard the loudest

A

at the base

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23
Q

S3 soundswhich 3 conditions result in a murmur

A
  1. increases in velocity of blood flow
  2. decreases in viscosity of blood
  3. structural defects in the valves
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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
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25
Q

SA node is known as the

A

pacemaker

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26
Q

p wave

A

depolarization of the ventricles

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27
Q

P-R interval

A

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

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28
Q

QRS complex

A

depolarization of the ventricles

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29
Q

T wave

A

repolarization of the ventricles

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30
Q

Co formula

A

CO=SVxRate

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31
Q

preload

A
  • venous return that builds during diastole
  • lenght to which the ventricular muscle is stretched at the end of diastole just before contraction
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32
Q

Afterload

A
  • opposing pressure that the ventricle must generate to open the aortic valve against the higher aortic pressure
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33
Q

internal jugular vein location

A

lies deep and medial to the sternomastoid muscle
- not visable

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34
Q

external jugular vein location

A

lies lateral to the sternomastoid muscle above the clavical
- more superficial

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35
Q

A wave

A
  • RA contracts
  • tricuspid opens
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36
Q

X descent

A
  • RA relaxes. starts to fill
  • tricuspid closes
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37
Q

V wave

A
  • RA filling
  • tricuspid closed
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38
Q

Y descent

A

RA emptied
- tricuspid opens

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39
Q

blood volume increased by ____% during pregnancy

A

30-40%

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40
Q

pulse rate increases _____ during pregnancy

A

10-15 beats per minute

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41
Q

paroxysmal nocturnal dyspnea

A
  • occurs with heart fialure
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42
Q

orthopnea

A
  • need to assume a more upright position to breath
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43
Q

how to asses orthopnea

A

note the number of pillows used to sleep

44
Q

Subjective data assesments

A
  • chest pain
  • dyspnea
  • orthopnea
  • cough
  • fatigue
  • cyanosis or pallor
  • edema
  • nocturia
  • cardiac history
  • family cardiac history
45
Q

cyanosis or pallor occurs with

A

MI

46
Q

hemoptysis often occurs as a side effect od

A

mitral stenosis

47
Q

paroxysmal nocturnal dysnea occurs as a side effect of

A

heart failure

48
Q

edema is dependent when caused by

A

heart failure

49
Q

risk factors for CAD

A
  • elevated cholesterol levels
  • hypertension
  • glucose levels obove 11.1
  • known diabetes
  • obesity
  • cigareete smoking
    sedentary lifestyle
50
Q

how to asses for heart disease in infants

A

note fatigue during feeding

51
Q

regional cardiovascular assesment should be preformed in what order

A
  1. pulse and blood pressure
  2. extremeties
  3. neck vessels
    - precordium
52
Q

bruit

A

blowing swishing sound indicating blood flow turbulance
- not usually present

53
Q

you should austclate the carotid artery for sings of

A

bruit

54
Q

what heart murmer can radiate to the carotid artery

A

aortic stenosis

55
Q

carotid sinus hypersensitivity

A
  • pressure over the carotid sinus leads to a decrease in HR and BP
  • may occur in adults with hypertension or occulsion
56
Q

abnormal finding during palpation of the pericordium

A

a thrill
- palpable vibration
- signifies turbulent blood flow and accompanies loud murmurs

57
Q

should you precuss the pericordium

A

no

58
Q

second righ tinterspace

A

aortic valve area

59
Q

second left interspace

A

pulmonic valve area

60
Q

fifth interspace at left lower sternal border

A

tricuspid valve area

61
Q

fifth interspace at around left midclavicular line

A

mitral valve area

62
Q

normal pulse

A

60-100 BPM

63
Q

sinus arrhythmias

A
  • occurs mostly in young adults and children
  • rhythm varies with patients breathing (increases during inspiration and slows with expiration)
64
Q

pulse deficit

A

-signals weak contraction of the ventricles
- occurs with artial fibrilation, premature beats, and heart failure

65
Q

how to asses for pulse deficit

A

auscultating the apical pulse while simultaneously palpating radial pulse

66
Q

S1 valves

A

closure of AV valves

67
Q

S2 valves

A

closure of the semilunar valves

68
Q

early systolic murmur sounds

A

Lshshshs(S1) Dup (S2) Lshshs (s1) Dup (s2)

69
Q

midsystolic murmur

A

LubshshsDub LubshshshDub

70
Q

late systolic murmur

A

Lub shshshp. Lub shshshp

71
Q

holosystolic murmurs

A

shshshshshsh shshshshs

72
Q

Loudness: grade 1

A

barely audible, only heard in a quite room and then with difficulty

73
Q

Loudness: grade 2

A

clearly audible but faint

74
Q

Loudness: grade 3

A

moderately loud; easy to hear

75
Q

loudness: grade 4

A

loud, associated with a thrill palpable on the chest wall

76
Q

Loudness: grade 5

A

very liud, heard with one corner of the stethoscope lifted off the chest; associated with a thrill

77
Q

Loudness: grade 6

A

loudest; still heard with entire stepthoscope lifted off the chest wall; associated with a thrill

78
Q

murmur of mitral stenosis is

A

rumbeling

79
Q

murmur of aortic stenosis is

A

hearsh

80
Q

innocent murmurs

A

have no valvar or other pathological cause
- like fiddle strings

81
Q

functional murmurs

A

caused by increased blood flow in the heart

82
Q

venous hum

A
  • common in healthy children and has no pathologic significance
  • turbulance of blood flow in the jugular venous sytem
83
Q

orthostatic blood pressure

A

sudden drop in blood pressure when sitting or standing

84
Q

S3 is associated with

A

heart failure

85
Q

fixed split

A

is unaffected by respiration; split is always there

86
Q

paradoxical split

A

the soudns fuse on inspiration and split on expiration

87
Q

midsystolic click

A
  • associated with mitral valve prolapse
  • most common extra sound
88
Q

right side of the heart

A
  • receives blood from superior and inferior vena cava
  • pumps blood through pulmonary arteries to pulmonary circulation
89
Q

left side of the heart

A
  • receives blood from the pulmonary veins
  • pumps blood through aorta into systemic circulation
90
Q

s3 sound

A
  • after S2 - early diastolic
  • blood entering the ventricles during early ventricle filling
  • quiet, low pitched
  • best heard at the apex, with bell
91
Q

S4 sound

A
  • before S1, late diastolic
  • atria contract, push blood into resistant ventricle
  • quiet, low pitched
  • best heard at the apex with bell
  • pathologic
92
Q

Internal jugular vein location

A
  • lower, more lateral, under or behing the sternomastoid muscle
93
Q

Internal jugular vein quality

A

diffuse; 2 visable waves per cycle

94
Q

Internal jugular vein respiration

A

varies with respiration

95
Q

Internal jugular vein palpuability

A

none

96
Q

Internal jugular vein pressure

A

light pressue obliderates

97
Q

Internal jugular vein position of patient

A

levels drop and disappear when sitting

98
Q

Carotid artery location

A

higher; medial to sternomastoid

99
Q

carotid artery quality

A

brisk, localized, one waver per cycle

100
Q

carotid artery respiration

A

does not cary

101
Q

carotid artery palpuability

A

yes

102
Q

carotid artery pressure

A

no change

103
Q

carotid artery position of patient

A

unaffected

104
Q

carotid artery expected findings

A
  • no bruits
  • smooth contour
  • 2+ amplitude bilaterally
105
Q

expected internal jugular measurement

A

<3cm

106
Q

unilateral distention of the jugular vein is indicative of

A

aneurysm

107
Q

fully distended jugular vein is indicative of

A

heart failure

NURS252 (21 decks)

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