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Health Assessment for Nurses > Chapter 20- Heart and Neck Vessels > Flashcards

Chapter 20- Heart and Neck Vessels Flashcards

1
Q

Area in anterior chest overlying heart and great vessels

A

Precordium

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2
Q

How many chambers does the heart have?

A

4

2 ventricles, 2 atria

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3
Q

Major arteries and veins connected to the heart

A

Great vessels

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4
Q

Blood vessels arranged in 2 continuous loops:

A

Pulmonary circulation and systemic circulation

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5
Q

3 layers of the heart wall:

A

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

Myocardium: muscular wall of heart; does the pumping

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

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6
Q

Heart has how many pump systems?

A

2

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7
Q

Thin-walled reservoir for holding blood.

A

Atrium

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8
Q

Thick-walled, muscular pumping chamber

A

Ventricle

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9
Q

Valves are___.

A

unidirectional. and they open/close passively in response to pressure gradients in moving blood.

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10
Q

4 valves in heart:

A 
2 atrioventricular (AV) valves
2 semilunar (SL) valves
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11
Q

What are the names of the 2 AV valves that seperate the atria and ventricles:

A

Triscupid valve: right AV valve

Bicuspid or mitral valve: left AV valve

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12
Q

AV valves open during ____.

A

diastole. during the hearts filling phase to allow ventricles to fill with blood.

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13
Q

AV valves close during ___.

A

Systole (pumping phase) to prevent regurgitation of blood back up into atria.

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14
Q

SL valves have __ cusps that look like half moons.

A

3

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15
Q

SL valve in right side of heart

A

Pulmonic valve

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16
Q

SL valve in left side of heart

A

Aortic valve

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17
Q

__ valves are present between vena cava and right atrium, or between pulmonary veins and left atrium.

A

NONE, 0.

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18
Q

Abnormally high pressure in ___ side of heart gives a patient symptoms of pulmonary congestion.

A

Left

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19
Q

Abnormally high pressure in ___ side of heart shows in neck veins and abdomen.

A

Right

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20
Q

___ blood drains into vena cava, following route of venous blood.

A

Unoxygenated

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21
Q

Blood goes from liver to ___ through inferior vena cava.

A

Right atrium

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22
Q

From RV, venous blood flows through ___ to pulmonary artery.

A

Pulmonic valve

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23
Q

__ oxygenate blood.

A

Lungs

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24
Q

From LA, arterial blood travels through __ valve to the __.

A

mitral

Left Ventricle

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25
Q

LV delivers blood to the ___.

A

Aorta.

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26
Q

Aorta delivers ___ blood to body.

A

oxygenated

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27
Q

__ is continuous loop; moving by continuous shifting pressure gradients.

A

Circulation

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28
Q

ventricles relax and fill with blood; 2/3 of cardiac cycle

A

Diastole

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29
Q

protodiastolic filling is the ___, where blood puts rapidly into the ventricles.

A

first/early passive phase

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30
Q

Presystole or atrial systole is also called the ___. this is when the atria contracts and pushes the last amount of blood into the ventricles.

A

atrial kick.

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31
Q

hearts contraction, blood pumped from ventricles fills pulmonary and systemic arteries; 1/3 of cardiac cycle

A

Systole

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32
Q

Atrial systole occurs during __.

A

ventricular diastole

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33
Q

For a brief moment, all four valves are ___ and ventricular walls undergo ___ and ___.

A

Closed
Isometric Contraction
Isometric Relaxation

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34
Q

This contraction against closed system works to build high level pressure in ventricles.

A

Isometric Contraction

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35
Q

All four valves closed and ventricles relax.

A

Isometric relaxation

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36
Q

Same events occur on __ sides of the heart. __ side requires lower pressure and sequence occurs slightly later because less energy is needed to pump blood to its destination.

A

Both

Right

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37
Q

Occurs with closure of AV valves- signals beginning of systole

Mitral component of first sound (M1) slightly preceded tricuspid component (T1)

A

First heart sound (S1)

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38
Q

Occurs with the closure of semilunar valves- signals end of systole

Aortic component of second sound (A2) slightly precedes pulmonic component (P2).

S2 loudest at base.

A

Second heart sound (S2)

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39
Q

The volume of right and left ventricular systole is just about equal, but this can be effect by respiration. consider the phrase:

A

MoRe to the Right heart, Less to the Left

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40
Q

Occurs when ventricles resistant to filling during early rapid filling phase (protodiastole)

Occurs immediately after S2, when AC valves open and atrial blood first pours into ventricles.

A

Extra heart sounds (third heart sound S3)

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41
Q

Occurs at end of diastole, at presystole, when ventricle resistant to filling phase (protodiastole)

Occurs just before S1

A

Fourth heart sound (S4)

Extra heart sound

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42
Q

Gentle, blowing, swooshing sound that can be heard on the chest wall

Conditions that create turbulent blood flow and collision currents

A

Murmurs

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43
Q

What conditions can result in murmurs?

A

Velocity of blood increases

Viscosity of blood decreases

Structural defects in the valves or openings occur in the chambers

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44
Q

Characteristics of sound:

A

Frequency or pitch: high to low

Intensity or loudness: loud or soft

Duration: very short for heart sounds; silent periods are longer

Timing: systole or diastole

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45
Q

Heart has a unique ability : ___.

A

Automaticity

46
Q

Automaticity in the heart:

A

It can contract by itself, independent of any signals or stimulation from body

Contracts in response to an electrical current conveyed by a conduction system

Specialized cells in Sinoatrial (SA) node, near superior vena cava initiate an electric impulse

Because SA node has intrinsic rhythm, it is called the pacemaker.

47
Q

Electrocardiograph (ECG): the waves are labeled ___. and what does each do?

A

PQRST

P wave- depolarization of atria

PR interval- from beginning of P wave to the beginning of the QRS complex (time needed for atrial depolarization)

QRS complex- time necessary for atrial depolarization plus time for impulse to travel through AV node to ventricles (depolarization of ventricles)

T wave- Repolarization of ventricles

48
Q

Cardiac output in an adult:

A

4-6L of blood per minute throughout the body

49
Q

Cardiac output equation

A

CO= HR x SV

cardiac output = number of beats per minute (heart rate) x volume of blood in each systole (strove volume)

50
Q

venous return that builds during diastole

A

Preload

51
Q

opposing pressure ventricle must generate to open aortic valve against higher aortic pressure

(resistance against which ventricle must pump its blood)

A

After load

52
Q

Carotid artery’s pulse— characteristics of its wave form:

A

Smooth rapid upstroke

Summit rounded and smooth

Downstroke more gradual and has a dicrotic notch caused by close of aortic valve.

53
Q

Jugular Venous empties __ blood into superior vena cava.

A

unoxygenated

54
Q

Jugular Pulse: 5 components

A

A wave reflects atrial contraction.
C wave (ventricular contraction) is backflips from bulging upward of triscuspid valve when it closes at beginning of ventricular systole.
X wave descent shows atrial relaxation when right ventricle contracts during systole.

V wave occurs with passive atrial right because of increasing volume in right atria.

Y descent reflects passive ventricular filling when triscuspid valve open and blood flows from RA TO RV

55
Q

Fetal heartbeat begins to beat after __ weeks’ of gestation.

A

3

56
Q

Blood volume increase by ___ to ___ during pregnancy.

A

30% to 40%

57
Q

The cardiovascular system consists of :

A

the heart and the blood vessels

58
Q

The ___ and ___ return unoxygenated venous blood to the right side of the heart.

A

superior and inferior vena cava

59
Q

The ___ leave the RV, bifurcated, and carries the venous blood to the lungs.

A

Pulmonary artery

60
Q

The ____ returns the freshly oxygenated blood to the left side of the heart, and the ___ carries it out to the body.

A

Pulmonary veins

aorta

61
Q

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

A

The pericardium

62
Q

The ___ side of the heart pumps blood into the lungs.

A

Right

63
Q

The __ side of the heart pumps blood into the body.

A

Left

64
Q

Each side of the heart had an ___ and a ___.

A

atrium and ventricle

65
Q

The four chambers are separated by swinging-door-like structures called ___ , whose main purpose is to prevent back flow of blood

A

Valves

66
Q

The valves thin leaflets are anchored by collagenous fibers, called ____ , to papillary muscles embedded in the ventricle floor.

A

Chordae Tendinae

67
Q

The SL valves open during ___ when blood ejects from the heart.

A

Pumping (systole)

68
Q

The rhythmic movement of blood through the heart

A

Cardiac Cycle

69
Q

Where is S1 loudest?

A

At the apex

70
Q

The ___ component of the first sound slightly preceded the triscuspid component, but you usually hear these two components fused as one sound.

A

M1- mitral component

71
Q

The ___ component of the second sound slightly precedes the pulmonic component.

A

Aortic component - A2

72
Q

S2 is loudest at ___.

A

The base

73
Q

The pacemaker of the heart

A

SA node

74
Q

__ events slightly precede __ events in heart.

A

Electrical

Mechanical

75
Q

The heart can alter its CO to adapt to __ needs of the body.

A

metabolic

76
Q

__ and __ can affect hearts ability to increase CO.

A

preload and afterload

77
Q

According to Frank-Starling law:

A

“great the stretch, the stronger the hearts contraction”

78
Q

How many Jugular veins are present on each side of the neck?

A

2

79
Q

I’m pregnant women, despite the increased cardiac output, arterial BO ___ in pregnancy as a result of peripheral vasodilation.

A

decreases

80
Q

__ and __ of lungs at birth produced circulatory changes

A

Inflation, aeration

81
Q

Increase in systolic BP due to thickening and stiffening of the arteries

A

Isolated systolic HTN

82
Q

Pressure/pulse changes with Aging:

A

Left ventricular wall becomes thicker but the overall size of the heart does not change.

pulse pressure increases

no change in resting heart rate or CO at rest

Ability of heart augment cardiac output with excerise is decreased

83
Q

The presence of supraventricukar and ventricular dysrhythmias ___ with age.

A

increase

84
Q

___ beats are common in aging people; although these are usually a symptomatic in healthy older people, they may compromise cardiac output and BP when disease is present.

A

Ectopic

85
Q

___ may not be tolerated as well in older people.

A

Tachydysrhythmias

86
Q

Electrocardiogram changes:

A

Prolonged P-T interval and prolonged Q-T interval, but the QRS interval is unchanged.

Left axis deviation form age/related mild LV hypertrophy and fibrosis in left bundle branch

Increased incidence of bundle branch book

87
Q

___ most common underlying cause of death globally

A

CVD

88
Q

Culture and Geneteics. CVD Risk factors:

A 
High BP
smoking
Serum Cholestrol
Physical Activity
Sex and Gender Differences
89
Q

Dyspnea

A

Difficulty breathing

90
Q

To evaluate the carotid arteries, the person can be ___

A

sitting up

91
Q

To access the jugular veins and the precordium, the person should be ___.

A

Supine with the head and chest elevated between 30-45 degrees

92
Q

When performing a regional CV assessment use this order:

A

Pulse and BP
Extremities
Neck Vessels
Precordium

93
Q

Palpating carotid artery:

A

Only one at a time to avoid compromising arterial blood to the brain

Feel contour and amplitude of pulse, normal strength 2+

findings should be same bilaterally

94
Q

Auscultate the carotid artery:

A

Assess for prescence of carotid bruit
- avoid compressing the artery which can create an artificial bruit

Keep neck in neutral position and lightly apply stethoscope at
- angle of jaw, midcervical area, and base of neck

95
Q

From the jugular veins you can assess the ____, and thus judge the hearts efficiency as a pump and the intravascular volume status.

A

Central venous pressure (CVP)

96
Q

How should a person be when inspecting jugular venous pulse?

A

Supine anywhere from a 30-45 degree angle, wherever you can best see pulsations.

97
Q

Characteristics of jugular versus carotid pulsations:

A

differentiate between: location, quality, respiration, palpable, pressure, and position of patient

98
Q

Identify auscultatory areas associated with valves. Sound radiates with blood flow direction; valve areas are:

A

Second right interspace: aortic valve area

Second left interspace: pulmonic valve area

Left lower sternal border: tricuspid valve area

Fifth interspace at around left midclavicular line: mitral valve area

99
Q

Precordium Auscultation. Identify ___ and ___. and listen for ___ and ___.

A

S1 and S2
extra heart sounds; describe them
murmurs; describe them

100
Q

Heart rate may range from ___ to ___ beats per minute immediately after birth.

A

100 to 180

101
Q

murmurs in the immediate newborn ___ necessarily indicate congenital heart disease seen due to shunt closure.

A

do not

102
Q

Heart Failure symptoms:

A

Dilated pupils, skin pale/gray/ or cuantoic, dyspnea, orthopnea, crackles (wheeze), cough, decreased BP, nausea/vomiting, ascites, dependent pitting edema, anxiety, falling O2 saturation, confusion, jugular vein distention, infarct, fatigue, S3 gallop (tachycardia), enlarged spleen and liver, decreased urine output, cool moist skin, and weak pulse.

103
Q

signs and symptoms of heart failure come from :

A
  1. the hearts inability to pump enough blood to meet the metabolic demands of the body
  2. the kidneys compensatory mechanisms of abnormal retention of sodium and water to compensate for the decreased cardiac output.
104
Q

the heart cannot contract properly

A

systolic dysfunction

105
Q

a failure of the heart to fully relax between heartbeats

A

diastolic dysfunction

106
Q

S1 sound

A

loud
faint
varying intensity
split

107
Q

S2 sound

A

Accentuated
Diminished
Normal splitting
- fixed split, paradoxical split, and wide split

108
Q

What abnormal sounds are these: Ejection click, aortic prosthetic valve sounds, and midsystolic click

A

systolic

109
Q

What abnormal sounds are these: opening snap, mitral prosthetic valve sound, third heart sound, fourth heart sound, summation sound, and pericardial friction rub.

A

Diastolic

110
Q

Persistence of the channel joining left pulmonary artery to aorta

A

Patent Ductus Arteriosus

111
Q

Severe narrowing of descending aorta, usually at the junction of the ductus arteriosus and the aortic arch, just distal to the origin of the left subclavian artery.

A

Coarctation of the Aorta

Health Assessment for Nurses (13 decks)

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