Heart Flashcards
What occurs in ventricular contraction?
The left ventricle’s contraction and thrust result in the apical impulse usually felt in the fifth left intercostal space at the midclavicular line, but can be obscured by obesity, large breasts, or muscularity.
What is the precordium?
The area of the chest overlying the heart is the precordium. Because of the heart’s conelike shape, the broader upper portion is called the base, and the narrower lower tip of the heart is the apex.
What is the difference between the atria and ventricles?
The atria are small thin-walled structures acting primarily as reservoirs for blood returning to the heart from the veins throughout the body. The ventricles are large thick-walled chambers that pump blood to the lungs and throughout the body.
When what valve closes does the S1 and S2 sound occur?
Mitral and tricuspid valve closure produces S1 heart sound and aortic and pulmonic valve closure causes the S2 heart sound.
What occurs in the infant heart that is different from the adult?
The right ventricle pumps blood through the patent ductus arteriosus rather than into the lungs.
The changes at birth include the closure of the ductus arteriosus, usually within 24-48 hours.
The heart lies more horizontally in the chest in infants and young children. As a result, the apex of the heart rides higher, sometimes well into the fourth intercostal space.
What are common symptoms of chest pain in older adults?
FATIGUE, confusion, dizziness, syncope, palpitations, coughing/wheezing, SOB, and leg edema.
What does an apical impulse that is more forceful and widely distributed mean?
An apical impulse that is more forceful and widely distributed, fills systole, or is displaced laterally and downward may indicate increased cardiac output or left ventricular hypertrophy.
What is a thrill and where is it felt in the heart?
A fine, palpable, rushing vibration is known as a thrill and this can be felt over the base of the heart in the area of the right or left second intercostal space.
What are the three different positions that a patient can be in when auscultating the heart?
Patient sitting up and leaning slightly forward
Patient supine
Patient left lateral recumbent
What are the different intensities of heart murmurs?
Grade I: Barely audible in quiet room
Grade II: Quiet but clearly audible
Grade III: Moderately loud
Grade IV: Loud, associated with a thrill
Grade V: Very loud, thrill easily palpable
Grade VI: Very loud, audible with stethoscope not in contact with chest, thrill palpable and visible
What are common rhythm disturbances to be aware of?
A heart rate that is irregular but occurs in a repeated pattern may indicate a sinus arrythmia (a cyclic variation of the HR characterized by increased rate on inspiration and decreased rate on expiration).
An unpredictable, irregular rhythm may indicate heart disease or atrial fibrillation.
What is the FRAIL Scale?
The FRAIL scale identifies persons at risk for frailty.
Fatigue
Resistance (ability to climb one flight of stairs)
Ambulation (ability to walk one block)
Illnesses (> 5)
Loss of weight (>5%)
What are characteristics of left sided HF?
Cardiomegaly
Displaced/abnormal apical impulse
Tachycardia
Hypotension
Crackles on lung examination
SOB
What are characteristics of right sided HF?
Jugular venous distention
HTN
Edema
What is PDA?
Patent ductus arteriosus is failure of the ductus arteriosus to close after birth.
Subjective Data: Small shunt can be asymptomatic; larger one causes dyspnea on exertion.
Objective Data: Dilated and pulsatile neck vessels, Wide pulse pressure, Harsh, loud continuous murmur heard at the first to third intercostal spaces with a machine-like quality.
