Health assessment-test 2-heart and neck vessels

Question 1

Diastole

Answer 1

ventricles are relaxed

M/T vavles open; A/P valves close

Question 2

systole

Answer 2

ventricles contract;

M/T valves close; A/P valves open

Question 3

S1?

Answer 3

closure of the T/M valves; signals beginning of systole

LUB

Question 4

S2?

Answer 4

closure of A/P valves

DUB

Question 5

S3?

Answer 5

extra heart sound; ventricular filling creates vibrations that can be heard over chest

Question 6

S4?

Answer 6

extra heart sound; end of diastole; atria contract and push blood in a noncompliant ventricle which creates vibrations

Question 7

preload

Answer 7

venous return that builds during diastole (length the ventricular muscle is stretched at the end of diastole just before contraction)

Question 8

afterload

Answer 8

opposing pressure the ventricle must generate to open the aortic valve against the higher aortic pressure; resistance against which the ventricle must pump its blood

Question 9

point of maximal impulse (PMI)
Where is it?
what size is it normally?
Where is it when heart is enlarged?

Answer 9

usually in the 4th or 5th ICS near (or medial to) the midclavicular line
about the size of a dime (1 x 2 cm)
displaced to the left when heart is enlarged

Question 10

cardiac thrill

Answer 10

feel a thrill

turbulent flow across a valve

Question 11

heaves

Answer 11

aka lift
sustained forceful thrusting of the ventricle during systole
occurs with ventricular hypertrophy as a result of increased workload

Question 12

murmurs

Answer 12

gentle blowing, swooshing sound that can be heard on the chest wall; turbulent blood flow
causes: velocity of blood increases,
viscosity of blood decreases (anemia),
structural defects in the valves

Question 13

When can you best hear a high pitch murmur?

Answer 13

when patient is leaning forward

Question 14

summarize heart failure symptoms

Answer 14

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