Chapter 9: Cardiovascular Flashcards
Right ventricle
occupies most of anterior chest wall
PMI
left ventricle-5th interspace 7-9 cm lateral to midsternal line
left ventricle
behind rv and left
Heart sounds
S1 is atrioventricular valves: mitral and tricuspid
S2 is aortic and pulmonic valves
S1 usually louder at apex (lowest portion)
S2 usually louder at base (top)
split heart sounds S1
s1 split into mitral M1 (louder) and tricuspid T1 softer.
split heart sounds S2
Left side events occur first. right pressures lower than left. if split-first av closure then pv. S2 is A2P2
heart murmur
turbulent blood flow in heart
types of murmurs
- innocent-w/o any detectable physiologic or structural abnormalities
- physiologic: from changes in body metabolism such as fever
- pathologic: from a structural abnormality in the heart or great vessels
Position aids to identify MVP
squatting increases ventricular filling time and helps identify MVP by delaying the click and murmur
Standing reverses this.
Valsalva also does the same
stenotic
abnormally narrowed valvular orifice obstructing flow
regurg
valve fails to close allowing blood to leak backward
Grading murmurs
- very faint- may not be heard unless listener active
- quiet-heard immediately after placing steth on chest
- mod loud
- +thrill; loud
- +thrill; very loud; may be heard with steth partly off chest
- +thrill; may be heard w/o steth
JNC7
normal <130/80
thrills
humming vibrations
bruits
murmur like sound over vascular-aortic valve may radiate to the neck and sound like carotid bruit
