Heart

Question 1

The ____ is highly complex, consisting of the heart and a closed system of blood vessels.

Answer 1

cardiovascular system

Question 2

The _____ is a hollow, muscular, four-chambered (left and right atria, and left and right ventricles) organ located in the middle of the thoracic cavity between the lungs in the space called the .

Answer 2

heart, mediastenum

Question 3

The anterior chest area that overties the heart and great vessels is called the

Answer 3

precordium

Question 4

The right side of the heart pumps blood to the lungs for gas exchange (______) by removing CO2 from blood and replenishing oxygen supply.

Answer 4

pulmonary circulation

Question 5

It occurs between alveoli and the blood of lungs; the left side of the heart pumps blood to all other parts of the body (_____).

Answer 5

systemic circulation

Question 6

The large veins and arteries leading directly to and away from the heart referred to

Answer 6

great vessels.

Question 7

called chordae tendineae, anchor the AV valve flaps to papillary muscles within the ventricles.

Answer 7

Collagen fibers

Question 8

The right and left sides of the heart are separated by a partition called the

Answer 8

septum

Question 9

The ___ receive blood returning to the heart and pump blood into the ventricles. The ____pump blood out of the heart.

Answer 9

thin-walled atria, thicker-walled ventricles

Question 10

is a tough, inextensible, loose-fitting, fibroserous sac that attaches to the great vessels and surrounds the heart.

Answer 10

pericardium

Question 11

serous membrane lining, the _____, secretes a small amount of pericardial fluid that allows for smooth, friction-free movement of the heart.

Answer 11

parietal pericardium

Question 12

This same type of serous membrane covers the outer surface of the heart and is known as the .

Answer 12

epicardium

Question 13

is the thickest layer of the heart, made up of contractile cardiac muscle cells.

Answer 13

myocardium

Question 14

is a thin layer of endothelial tissue that forms the innermost layer of the heart and is continuous with the endothelial lining of blood vessels

Answer 14

The endocardium

Question 15

have a unique inherent ability. They can spontaneously generate an electrical impulse and conduct it through the heart.

Answer 15

Cardiac muscle cells

Question 16

The generation and conduction of electrical impulses by specialized sections of the myocardium regulate the events associated with the filling and emptying of the cardiac chambers. The process is called the

Answer 16

cardiac cycle

Question 17

is located on the posterior wall of the right atrium near the junction of the superior and inferior vena cava. The ____, with inherent rhythmicity, generates impulses (at a rate of 60–100 per minute) that are conducted over both atria, causing them to contract simultaneously and send blood into the ventricles.

Answer 17

The sinoatrial (SA) node (or sinus node)

Question 18

The current, initiated by the SA node, is conducted across the atria to the ____ located in the lower interatrial septum. The __ node slightly delays incoming electrical impulses from the atria and then relays the impulse to the AV bundle (bundle of His) in the upper interventricular septum.

Answer 18

atrioventricular (AV) node

Question 19

The electrical impulse then travels down the right and left bundle branches and the ____ in the myocardium of both ventricles, causing them to contract almost simultaneously.

Answer 19

Purkinje Fibers

Question 20

Although the SA node functions as the “_____,” this activity shifts to other areas of the conduction system, such as the Bundle of His (with an inherent discharge of 40–60 per minute), if the SA node cannot function.

Answer 20

pacemaker of the heart

Question 21

The cardiac cycle has two phases: diastole (relaxation of the ventricles, known as ___) and systole (contraction of the ventricles, known as ____)

Answer 21

filling, emptying

Question 22

This valve closure also prevents blood from flowing backward (a process known as ___) into the atria during ventricular contraction.

Answer 22

regurgitation

Question 23

S1 sound is louder than an S2 . This occurs when the mitral valve is wide open and closes quickly. UHyperkinetic states in which blood velocity increases such as fever, anemia, and hyperthyroidism UMitral stenosis in which the leaflets are still mobile but increased ventricular pressure is needed to close the valve

Answer 23

Accentuated S1

Question 24

Sometimes the S1 sound is softer than the S2 sound. This occurs when the mitral valve is not fully open at the time of ventricular contraction and valve closing. Examples include: UDelayed conduction from the atria to the ventricles as in first-degree heart block, which allows the mitral valve to drift closed before ventricular contraction closes it UMitral insufficiency in which extreme calcification of the valve limits mobility UDelayed or diminished ventricular contraction arising from forceful atrial contraction into a noncompliant ventricle, as in severe pulmonary or systemic hypertension

Answer 24

Diminished S1

Question 25

This occurs when the left and right ventricles contract at different times (asynchronous ventricular contraction). Examples include: UConduction delaying the cardiac impulse to one of the ventricles, as in bundle branch block UVentricular ectopy in which the impulse starts in one ventricle, contracting it first, and then spreading to the second ventricle

Answer 25

Split S1

Question 26

This occurs when the mitral valve is in different positions when contraction occurs. Examples include: URhythms in which the atria and ventricles are beating independently of each other UTotally irregular rhythm such as atrial fibrillation

Answer 26

Varying S1

Question 27

S2 is louder than S1 . This occurs in conditions in which the aortic or pulmonic valve has a higher closing pressure. Examples include: UIncreased pressure in the aorta from exercise, excitement, or systemic hypertension (a booming S2 is heard with systemic hypertension) UIncreased pressure in the pulmonary vasculature, which may occur with mitral stenosis or congestive heart failure UCalcification of the semilunar valve, in which the valve is still mobile, as in pulmonic or aortic stenosis

Answer 27

accentuated S2

Question 28

S2 is softer than S1 . This occurs in conditions in which the aortic or pulmonic valves have decreased mobility. Examples include: UDecreased systemic blood pressure, which weakens the valves, as in shock UAortic or pulmonic stenosis, in which the valves are thickened and calcified, with decreased mobility

Answer 28

A diminished S2

Question 29

can be heard over the second or third left intercostal space. It is usually heard best during inspiration and disappears during expiration. Over the aortic area and apex, the pulmonic component of S2 is usually too faint to be heard and S2 is a single sound resulting from aortic valve closure. In some clients, S2 may not become single on expiration unless the client sits up. Splitting that does not disappear during expiration is suggestive of heart disease.

Answer 29

Normal (Physiologic) Split S2

Question 30

This is an increase in the usual splitting that persists throughout the entire respiratory cycle and widens on expiration. It occurs when there is delayed electrical activation of the right ventricle. An example: URight bundle branch block, which delays pulmonic valve closing

Answer 30

Wide Split S2

Question 31

This is a wide splitting that does not vary with respiration. It occurs when there is delayed closure of one of the valves. An example: UAtrial septal defect and right ventricular failure, which delay pulmonic valve closing

Answer 31

Fixed Split S2

Question 32

S2 that appears on expiration and disappears on inspiration— also known as paradoxical split. It occurs when closure of the aortic valve is abnormally delayed, causing A2 to follow P2 in expiration. Normal inspiratory delay of P2 makes the split disappear during inspiration. An example: Left bundle branch block

Answer 32

Reversed Split S2

Question 33

S3 is often termed ____, and S4 is called ___

Answer 33

ventricular gallop, atrial gallop

Question 34

is the amount of blood pumped by the ventricles during a given period of time (usually 1 minute)

Answer 34

Cardiac output (CO)

Question 35

is the amount of blood pumped from the heart with each contraction (stroke volume from the left ventricle is usually 70 mL)

Answer 35

Stroke volume

Question 36

An inspiratory increase in venous pressure, called ____, may occur in clients with severe constrictive pericarditis.

Answer 36

Kussmaul’s sign

Question 37

S3 and S4 pathologic sounds together create a quadruple rhythm, which is called a

Answer 37

summation gallop