HAPS--Cardiac Assessment Flashcards
Apex
the tip of the heart located to the left of midline
Base
posterior & to the right of the midline
Atrioventricular valves (A/V)
Tricuspic
Mitral (bicuspid)
Semilunar valves
Pulmonic
Aortic
Systole
contraction of the ventricles
S1
onset of systole = closure of mitral and tricuspid valves
Louder at the Apex
Diastole
relaxation of the ventricle
S2
onset of diastole = closure of aortic and pulmonic valves
Louder at the base
Insufficient valve
“Leaky”
Does not close completely
Stenotic
“Stiff”
Does not open completely
Blood Flow through Heart
R. Atrium > Tricuspid valve > Right ventricle > Pulmonic valve > Pulmonary artery > Lungs > Pumonary veins > Left atrium > Mitral valve > Left ventricle> Aortic valve> Aorta > BODY
Coronary Arteries (3 major vessels)
Left Anterior Descending artery
Left Circumflex artery
Right Coronary artery
blood supply of coronary arteries?
Coronary arteries receive their blood supply from the aorta and supply blood to the myocardium.
Automaticity:
Ability of pacemaker cells to initiate an impulse spontaneously and repetitively
The conduction tissue area with the highest rate of automaticity assumes the role of pacemaker, normally the SA node
Contractibility
The ability to respond to this impulse with pump action.
Autonomic Nervous System
Sympathetic
Parasympathetic
Sympathetic
Increase heart rate, speed of conduction and vigor of contraction
Parasympathetic
Decrease rate of firing of the SA node, speed of conduction and force of contraction
The Cardiac Assessment
History B/P Assessment Inspection Palpation & pulsation Auscultation
Preparation for Cardiac Assessment
: The client should be sitting up supine at a 30-45 degree angle
INSPECTION
General appearance: chest symmetry, skin color, hair pattern (on legs)
Peripheral and Central circulation (pulses)
Aortic pulsations
Capillary Refill
Edema Assessment
Palpate carotid artery
neck vessels
Palpate only one carotid artery at a time to avoid compromising arterial blood to brain
Feel amplitude of pulse
Findings should be same bilaterally
Auscultate the Carotids
Auscultate each carotid arteries for the presence of a bruit with your bell
This swishing sound indicates turbulence therefore… none should be present
If it is present, the patient is at risk for TIA, CVA.
It is present if the lumen is occluded by ½. After the lumen is 100% occluded, the bruit will disappear.
Observe for JVD
Have the client sitting 30 degree
Have them turn face away
Shine light
Pulsations should disappear after 45 degrees or is indicative of heart failure
Measuring JVP
Place one ruler vertically at the sternal angle.
Locate the pulsation and place another ruler at the level of the pulsation.
Line up the two rulers as a T.
Measure JVP at the level where the horizontal ruler intersects the vertical ruler.
Ideally the measurement should be less than 2 cm