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Advanced Health Assessment > Exam 3 > Flashcards

Exam 3 Flashcards

1
Q

What happens during contraction?

A

The Apex beats against the chest wall producing an apical impulse

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2
Q

Where is the apical impulse located?

A

Normally at the fifth intercostal space 7 to 9 cm from midsternal line

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3
Q

The heart is rotated so what side is anterior and what side is posterior

A

The right side is anterior in the left side is posterior

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4
Q

Atrium

A

Reservoir for holding blood

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5
Q

Ventricle

A

Muscular pumping chamber

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6
Q

Pericardium

A

Tough fibrous double walled sac that surrounds and protects the heart. It has two layers that contain a few milliliters of a serous pericardial fluid does ensure a smooth friction free movement of the heart muscle

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7
Q

Pericardium

A

Adherent to great vessels esophagus sternum and pleural and anchored to the diaphragm

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8
Q

Myocardium

A

Muscular wall of the heart it does pumping

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9
Q

Endocardium

A

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

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10
Q

And normally high pressures in the left side of the heart gives person symptoms of

A

Pulmonary congestion

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11
Q

Abnormally high pressures in right side of heart shows in

A

In neck veins and abdomen

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12
Q

During the pumping phase or systole what happens?

A

The AV valves close to prevent regurgitation of blood back up into atria

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13
Q

What happens when the AV valves open during hearts filling phase also known as diastoly

A

It allows the ventricles to fill with blood

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14
Q

How is diastole defined?

A

Ventricles relax and fill with blood this takes up to 2/3 of cardiac cycle

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15
Q

Systole

A

Hearts contraction, blood pumped from ventricles Phils pulmonary and systemic arteries, this is 1/3 of cardiac cycle

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16
Q

What are you hearing with the first heart sound S1

A

Closure of AV valves

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17
Q

What are you hearing when you hear the second heart sound S2

A

Closure of semi lunar valves and signals end of systole

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18
Q

Name five characteristics of the first heart sound

A

Onset of systole
Closure of mitral and tricuspid valves
High pitched
Heard loudest at the mitral an apical area

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19
Q

What are four characteristics of the second heart sound

A

Onset of diastole to end of diastole
Closure of aortic and pulmonic valves
High pitched
Heard loudest at base of heart

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20
Q

Murmur

A

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

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21
Q

Conditions resulting in murmur

A

Thyrotoxicosis- in exercise- velocity of blood increases
Anemia- velocity of blood decreases
Structural defects in valves, narrowed valve, incompetent valves
Unusual openings occur in chambers, dilated chamber, wall defect

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22
Q

Conduction

A

Automaticity- Unique ability of the heart to contract by itself in response to an electrical current conveyed by the conduction system

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23
Q

Sa node

A

Pacemaker; Discharges impulse between 60 to 100 bpm

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24
Q

P wave

A

Depolarization of atria

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25
Q

P-R interval

A

From beginning of P wave to beginning of QRS complex (Time necessary for atria depolarization plus time for impulse to travel through AV node to ventricles)

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26
Q

QRS complex

A

Depolarization of ventricles

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27
Q

T wave

A

Repolarization of ventricles

28
Q

How do you calculate cardiac output?

A

Cardiac output equals volume of blood in each systole or stroke volume times the number of beats per minute

29
Q

What are some hemodynamic changes with aging?



A

Overall size of heart does not increase with age but left ventricular wall in thickness increases
No change in Diastolic pressure occurs with age
A rising systolic pressure with a relatively constant diastolic pressure increases pulse pressure
No change in resting heart rate occurs with aging
Cardiac output at rest is not changed with aging
Decreased ability of hard to augment cardiac output with exercise

30
Q

Does the incident of coronary artery disease increase or decrease sharply with advanced age

A

Increases and accounts for about half of all deaths in older people

31
Q

An increase in physical activity of older adults is associated with reduced risks of death from what?

A

Cardiovascular disease and respiratory illness

32
Q

What are five major risk factors for heart disease and stroke

A

Hypertension, smoking, serum cholesterol, type two diabetes, obesity

33
Q

For a person middle age or older who is showing signs of cardiovascular disease auscultate each carotid artery for the presence of bruit. How do you perform this?

A

Lately apply Bell of stethoscope over carotid arteries at three levels
The angle of the jaw, mid cervical area, base of neck,

34
Q

How to estimate jugular venous pressure

A
35
Q

Precordium

A

Auscultation
Sound radiates with blood flow direction valves areas are:
Second right into space is the aortic valve area
Second left interspace: Pomonic valve area
Third left interspace: Erb’s point
Left lower sternal border: tricuspid valve area
Fifth interspace at around left midclsvicular line: mitral valve area

36
Q

Grade 1 murmur

A

Very faint, heard only after listener has tune in

37
Q

Grade 2 murmur

A

Quiet but hurt immediately after placing the stethoscope on the chest

38
Q

Grade 3 murmur

A

Moderately loud

39
Q

Grade 4 murmur

A

Loud, with palpable thrill

40
Q

Grade 5 murmur

A

Very loud, with thrill. May be heard when the stethoscope is partially off the chest

41
Q

Grade 6 murmur

A

Very loud with thrill. May be heard with stethoscope entirely off the chest

42
Q

Abnormal pulsation

A
43
Q

S3 and S4 heart sounds

A
44
Q

Portrait of heart failure

A 
Dilated pupils 
Skin is pale, cyanotic, gray 
Dyspnea 
Decreased BP 
nausea and vomiting 
Ascites 
Pitting edema 
Anxiety 
Jvd 
Fatigue 
S3 
DecreSed urine output 
Weak pulse
45
Q

+1 pitting edema

A

Mild petting, slight indentation, no perceptible swelling

46
Q

+2 pitting edema

A

Moderate pitting, indentation, no perceptible swelling

47
Q

+3 pitting edema

A

Deep pitting, indentation remains, legs look swollen.

48
Q

+4 pitting edema

A

Very deep pitting, indentation lasts a long time, leg very swollen.

49
Q

Manual compression test of varicose veins

A

While person is standing, test length of varicose being to determine whether its valves are competent then place one hand on lower part of varicose vein and compressed being with your other hand about 20 cm higher competent means present a wave transmission and your distal lower fingers will feel no change

50
Q

S1 you r first heart sounds is heard loudest at the??

A

Apical and mitral area

51
Q

Second heart sound is heard loudest at the ??

A

Base of the heart

52
Q

S3 can indicate

A

CHF

53
Q

S4 can indicate

A

Hypertrophy

54
Q

All people eat taco meat

A

Aortic pulmonic erbs tricuspid mitral

55
Q

During contraction, apex beats against chest wall, producing an apical impulse and is palpable

A

In most people normally at the fifth intercostal space 7-9cm from midsternal line

56
Q

Flow of blood?

Toilet paper my ass

A

Tricuspid pulmonic mitral aortic

57
Q

What organs are located in the right upper quadrant? 7

A

Liver, gallbladder, Duodenum, Head of pancreas, right kidney and adrenal gland, hepatic flexure of colon, and part of ascending and transverse colon

58
Q

What organs are located in the left upper quadrant? 7

A

Stomach, spleen, left lobe of liver, body of pancreas, left kidney and adrenal gland, splenic fixture of colon, and part of transverse and descending colon

59
Q

Which organs are located in the right lower quadrant? 5 

A

Second, appendix, right ovary and tube, right ureter, right spermatic cord

60
Q

What organs are located in the left lower quadrant? 5 

A

Part of the descending colon, Sigmoid colon, Leftover into, left your order, left spermatic cord

61
Q

Blumberg sign

A

Rebound tenderness, sign of peritoneal inflammation, present if the patient experiences sharp discomfort over the inflamed site when pressure is released

62
Q

Murphy’s sign

A

Inspiratory arrest, pain is present on deep inspiration when an inflamed gallbladder is palpated by pressing the fingers under the rib cage. Positive for cholecystitis

63
Q

Iliopsoas muscle test

A

Lift the supply in patient’s right leg straight up flexing at the hip then push down over the lower part of the right thigh as the person tries to hold the leg up. Positive for pain with appendicitis

64
Q

Obturator test

A

Lift a supply in patient’s right leg, flexing at the hip and 90° at the knee. Hold the ankle and rotate the leg internally and externally pain is a listed with appendicitis

65
Q

Rovsing’s sign

A

Press deeply and evenly in the left lower quadrant then quickly withdrawal fingers. Referred rebound pain in the right lower quadrant present with appendicitis

66
Q

Cutaneous hyperesthesia

A

Add a series of points down in the abdominal wall, gently pick up a fold of skin between your thumb and index finger, without pinching it. May accompany appendicitis

Advanced Health Assessment (4 decks)

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