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Health Assessment > Exam 1: Respiratory and Cardiac Assessment > Flashcards

Exam 1: Respiratory and Cardiac Assessment Flashcards

1
Q

Tracheal bifurcation

A

located below Angle of Louis or T4-T5

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2
Q

lung fissures

A

separate the different lobes of the lungs

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3
Q

Anterior posterior (AP) diameter of chest

A

Refers to the shape of the chest; AP should be less than transverse

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4
Q

resonance

A

refers to percussion tone over chest wall; low-pitched, clear, hollow sounds that predominates in health lung tissue

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5
Q

barrel chest

A

AP=T, ribs are more horizontal
seen with pulmonary disease like COPD where the ribs become fixed in inspiratory position due to air trapping

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6
Q

Clubbing of the nails

A

change in normal configuration of distal phalanx due to growth of vascular connective tissue or respiratory disease (chronic hypoxia)

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7
Q

Subjective data to collect for respiratory assessment

A

cough
SOB
chest pain w/ breath
hx of resp infections
smoking hx
environmental exposure
patient-centered care (maintenance)

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8
Q

stridor

A

inspiratory wheeze audible w/o stethoscope caused by obstruction

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9
Q

characteristics of sputum

A

white/clear - colds/bronchitis
yellow/green - bacterial infection
pink/frothy - fluid in pleural cavity

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10
Q

bronchial breath sounds

A

normal breath sounds heard over the trachea and larynx
loud and high pitched

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11
Q

bronchovesicular breath sounds

A

normal breath sounds heard over major bronchi; posterior, between scapular; anterior, around sternum in 1st and 2nd ICS

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12
Q

vesicular breath sounds

A

normal breath sounds heard over peripheral lung fields
soft and low pitched

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13
Q

crackles (rales)

A

adventitious BS crackling, popping sound

suggest secretions in periphery

usually on inspiration

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14
Q

rhonchi

A

adventitious BS sonorous bubbling sound

usually expiratory, but may be inspiratory

suggests secretions in large airways

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15
Q

wheeze

A

adventitious BS whistle-like sound

suggest narrowed airways from secretions, etc.

inspiratory or expiratory

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16
Q

friction rub

A

cracking/grating sound secondary to pleural irritation or inflammation

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17
Q

absent breath sounds

A

seen w/ pneumothorax, obstruction, mass, etc.

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18
Q

tripod position

A

leaning forward to aid recruitment of abdominal, intercostal and neck (accessory) muscles with breathing

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19
Q

accessory muscles

A

trapezius, sternocleidomastoid & scalenus muscles that enlarge (hypertrophy) with chronic respiratory disease

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20
Q

pursed lip breathing

A

prolonged expiratory phase and resistance to outflow allows alveoli to remain open longer

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21
Q

pneumothorax

A

air in pleural space
absent BS
trachea shifts from midline
uneven expansion
hyper-resonant percussion

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22
Q

lobar pneumonia

A

a serious infection in which the air sacs fill with pus and other liquid
dull percussion over area of PNA
expect rhonchi and rales
pg 443

23
Q

precordium

A

area around the heart on the anterior chest

24
Q

myocardium

A

muscles of the heart

25
Q

endocardium

A

the thin, smooth membrane which lines the inside of the chambers of the heart and forms the surface of the valves

26
Q

pericardium

A

the membrane enclosing the heart, consisting of an outer fibrous layer and an inner double layer of serous membrane
reduces friction

27
Q

AV valves

A

atrioventricular valves - separate the atria from the ventricles

tricuspid & mitral

28
Q

SL valves

A

Semilunar valves - separate the chambers of the heart from the great vessels

pulmonic & aortic

29
Q

peripheral vessels

A

jugular veins (ext & int)
carotid artery

30
Q

direction of blood through the heart

A

Simplified:

Vena cava
Right atrium
Tricuspid valve
Right ventricle
Pulmonary valve
Pulmonary arteries
LUNGS
Pulmonary veins
Left atrium
Mitral valve
Left ventricles
Aortic valve
Aorta

31
Q

heart failure (pg 487?)

A

L-sided - volume can’t get out, so back up into lungs. Pulm HTN. Increased hydrostatic pressure in the lungs and pulmonary capillaries. (Cough, SOB, increased WOB, pulm edema)

R-sided - hepatomegaly, JVD, dependent pedal edema
Increased hydrostatic pressure in the systemic capillaries.

32
Q

ventricular dilation

A

volume overload

Dilated cardiomyopathy (DCM) is a condition in which the left ventricle, the heart’s main pumping chamber, is enlarged (dilated). As the chamber gets bigger, its thick muscular wall stretches, becoming thinner and weaker. This affects the heart’s ability to pump enough oxygen-rich blood to the rest of the body

33
Q

ventricular hypertrophy

A

pressure overload

thickening and stiffening of the ventricle walls (typically HTN) and leads to the heart not being able to pump blood effectively

34
Q

cardiac risk factors

A

high cholesterol
smoking
physical inactivity
obesity
HTN
DM
age (65+) and gender (male)
heredity

35
Q

apical impulse

A

4-5th ICS, L MCL

36
Q

thrills

A

palpable vibration that signifies turbulent blood flow, associated with murmurs

37
Q

“A Point To Memorize”

A

Aortic valve (2 ics (R) SB)
Pulmonic (2 ics (L) SB)
Tricuspid (4 ics (L) SB)
Mitral (5 ics (L) MCL)

not anatomic area of valve, but where heard best

38
Q

S1

A

Heart sounds associated with closure of the mitral and tricuspid valves. Loudest at apex.
Beginning of ventricular systole
“LUB”

39
Q

S2

A

Heart sound associated with closure of the pulmonic and aortic valve. Loudest at base.
Beginning of ventricular diastole
“DUB”

40
Q

S3

A

Extra heart sound heard in early diastole
physiologic (young) vs pathologic (noncompliant ventricle w/fluid overload, high CO)

41
Q

S4

A

Extra heart sound heard in late diastole
“atrial kick”
inflow of blood vibrates valves and structures of wall
physiologic (middle age adults after exercise) vs pathologic (noncompliant ventricle or valve)

42
Q

Split S2

A

Occurs with asynchronous closure of the aortic and pulmonic valve
occurs with deep inspiration
“more to the right, less to the left”
more input to the R side of heart - less pressure intrathoracic, so more blood trapped in the lungs and less to the L side of heart, also septum bulges and L side can’t hold as much

delays pulm valve closure

aortic valve closes earlier

43
Q

Bruit

A

Turbulent blood flow (vessels) makes a swishing sound upon auscultation

44
Q

Murmur

A

Turbulent blood flow (heart) makes a swishing sound upon auscultation

innocent (young)
functional (pregnancy)
pathological (stenosed or loose valves)

45
Q

Pericardial friction rub

A

caused by inflammation of the pericardium
heard best at apical

46
Q

jugular vein distention

A

indicated R-sided heart failure

47
Q

diastole

A

tricuspid & mitral open
pulm & aorta closed
S2

48
Q

systole

A

tricuspid & mitral closed
pulm & aorta open
S1

49
Q

pulse deficit

A

if there is a lag b/t the apical pulse and carotid, subtract the 2 for a value
“difference b/t hearing and feeling”

50
Q

Split S1

A

Asynchronous closure of mitral & tricuspid valve
depolarization on the left is faster

51
Q

carotid

A

bruit in carotid indicative of plaque and blood moving through it

52
Q

Landmarks for right oblique fissure

A

T3 -> 5th rib mid-axillary -> 6th rib (R) MCL

53
Q

Landmarks for right horizontal fissure

A

5th rib mid-axillary -> 4th rib (R) SB

54
Q

Landmarks for left oblique fissure

A

T3 -> 5th mid-axillary -> 6th rib (L ) MCL

Health Assessment (6 decks)

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