Heart <3 Flashcards
what are the HEART’s FUNCTIONS?
- aids to CIRCULATE BLOOD throughout the body & lungs through TWO SEPARATE CIRCULATIONS;
- body
- lungs
describe the LOCATION of the HEART
- located in the MEDIASTINUM
- left of the midline
- ABOVE the DIAPHRAGM
describe the CHAMBERS & VALVES of the heart
CHAMBERS:
- ATRIA
acting BLOOD RESERVOIRS for returning blood from veins
- VENTRICLES
acting as PUMPS to pump blood towards the lungs or body
VALVES:
- ATRIOVENTRICULAR VALVES
TRICUSPID & MITRAL VALVE
- SEMILUNAR VALVES
PULMONIC & AORTIC VALVE
how can we memorize the VALVE ORDER?
- “TRY PULLING MY ARM”
tricuspid
pulmonic
mitral
aortic
what are the THREE LAYERS OF THE HEART?
- PERICARDIUM
- EPICARDIUM
- MYOCARDIUM
- ENDOCARDIUM
epicardium
- thin outermost muscle layer—covers the heart surface
- extends into the great vessels
myocardium
- the THICK MUSCULAR MIDDLE LAYER
- important for the PUMPING of the heart
endocardium
- the innermost layer —lines the chambers of the heart & heart valves
- has SMALL MUSCLES that allows the OPENING & CLOSING of the valves
pericardium
- tough double walled fibrous sac that helps to ENCASE & PROTECT THE HEART
- has also some fluid;
- allows for LOW-FRICTION MOVEMENT
DESCRIBE the HEART CIRCULATION PROCESS
- have the SVC & IVC that are now returning DEOXYGENATED BLOOD
- enters into the RA
(flows though TRICUSPID VALVE) - enters into the RV
(flows through PULMONIC VALVE)
(flows into PULMONARY ARTERIES) - enters into LUNGS **pulmonary circulation to now OXYGENATE THE BLOOD
(flows into PULMONARY VEINS) - enters into LEFT ATRIUM that now have OXYGENATED BLOOD
(flows through MITRAL VALVE) - enters into LEFT VENTRICLE
(flows through AORTIC VALVE - enters into AORTA which then delivers OXYGENATED BLOOD TOWARDS THE BODY
definition of the cardiac cycle
the FILLING & EMPTYING of the heart’s chamber
what are the TWO PHASES OF THE CARDIAC CYCLE?
- consists of DIASTOLE & SYSTOLE
DIASTOLE:
where the heart is at rest; and we have the FILLING OF THE HEART
- where the VENTRICLES DILATE
- drawing BLOOD from the ATRIA»_space; VENTRICLES
SYSTOLE:
where the heart is contracting; and we have the EMPTYING OF THE HEART
- where the VENTRICLES CONTRACT
- LV»_space; AORTA
- RV»_space; PULMONARY ARTERY
what considerations to observe for HISTORY OF PRESENT ILLNESS?
- does the patient have chest pain or dyspnea?
- any coughing/dyspnea/orthopnea?
- edema/nocturia? (due to possible poor circulation–more fluid build-up in the bladder)
- tobacco use?
- past surgeries/family history?
what are some RISK FACTORS for heart disease?
can depend on MANY FACTORS;
- pt’s own PERSONAL HABITS
- tobacco use
- substance use
- nutrition status/diet/weight
- amount of exercise
- medications
definition of HYPERTENSION
- can be referred to as HTN, HBP
- the force of blood flowing
through your blood vessels, is
consistently too high. - can be a big factor in developing HEART ATTACK, STROKE, other threats
what are the NORMAL & HYPERTENSIVE FINDINGS for BP?
NORMAL:
less than 120/less than 80
ELEVATED:
120-129/less than 80
HBP STAGE 1:
130-139/80-89
HBP STAGE 2:
140-149/90+
HYPERTENSIVE CRISIS:
180+/120+
definition of a HEART ATTACK
occurs when the oxygen is not PROPERLY SUPPLIED to the heart
common symptoms of HEART ATTACK
can vary;
- chest pain/discomfort
- SOB
- pain in arms/back/shoulders/jaw
- lightheadedness
**can BE DIFFERENT FOR WOMEN
- some may think it was just chest pain or tightness
- have tightness of the JAW *referred pain
what are part of the PHYSICAL EXAM are used during heart examination?
- INSPECTION
- PALPATION
- AUSCULTATION
precordium
- the area of the chest that overlies the heart
what do we INSPECT FOR heart & neck vessel assessment?
- looking for our APICAL IMPULSE/PMI **point of maximal pulse
- any abnormal PULSATIONS, HEAVES, or LIFTS
- observe JUGULAR VENOUS PRESSURE/PULSE
- any DISTENSION in the NECK VESSELS
what do we PALPATE FOR? for heart & neck vessel assessment
- again looking and feeling for the APICAL IMPULSE
- PMI, HEAVES, LIFTS, THRILLS
- can also palpate the CAROTID ARTERIES
(**ALWAYS PALPATE ONLY ONE SIDE AT A TIME–can suffocate patient if palpating both arteries at the same time)
difference between THRILLS & BRUIT?
THRILLS are for PALPATION–give a sense of VIBRATION
- can be an indication of TURBULENCE in blood flow
BRUITS are for AUSCULTATION–give off a RUSHING SOUND
- can be an indication of blood rushing around a BLOCKAGE
what is a HEAVE/LIFT?
this is where the heart is beating so hard–fingers start moving up from the vibrations giving off
a sustained, abnormal outward movement of the precordium that can be felt or seen
how do we palpate the PERICORDIUM?
- always using the PALMAR ASPECT OF THE FOUR FINGERS to feel for any pulsations/vibrations/thrills
what are the NORMAL & EXTRA HEART SOUNDS & ABNORMAL HEART SOUNDS?
NORMAL HEART SOUNDS:
typically consist of our “lub dub” S1, S2
typically consist of S3, S4
ABNORMAL HEART SOUNDS:
consist of heart murmurs, gallops, mitral snaps, ejection clicks, friction rubs
why could a heart be having an IRREGULAR RHYTHM
- can be an indication of SINUS ARRHYTHMIA or a variation in HR
what is S1? what does “LUB” indicate?
indication of the ATRIOVENTRICULAR VALVES CLOSING
- **this is where we have VENTRICULAR CONTRACTION
- the AV VALVES CLOSE in order to prevent BACKFLOW of that BLOOD
- = FIRST HEART SOUND (S1) “LUB”
what is S2? what does “DUB” stand for?
- this is where our SEMILUNAR VALVES are closing
-
= SECOND HEART SOUND (S2) “DUB”
- A2 [AORTIC VALVE CLOSING]
- P2 [PULMONIC VALVE CLOSING]
what is the step-by-step process of auscultating the heart ?
- want to lie the pt. onto a SUPINE POSITION
- listening in a SYSTEMIC MANNER–from the base moving down to the apex
- identifying each heart sound separately
- turning on the LEFT SIDE – allows to hear murmurs & S3 more easily
what are the FIVE AREAS OF AUSCULTATING THE HEART?
- AORTIC AREA
- PULMONIC AREA
- ERB’S POINT
- TRICUSPID AREA
- MITRAL AREA
**APE TO MAN !! :D
aortic valve area location
the SECOND RIGHT INTERCOSTAL SPACE at the RIGHT STERNAL BORDER
pulmonic valve area location
the SECOND LEFT INTERCOSTAL SPACE at the LEFT STERNAL BORDER
erb’s point/second pulmonic area location
the THIRD LEFT INTERCOSTAL SPACE at the LEFT STERNAL BORDER
tricuspid area location
the FOURTH LEFT INTERCOSTAL SPACE at the LOWER LEFT STERNAL BORDER
mitral / apical area
at the APEX OF THE HEART in the FIFTH LEFT INTERCOSTAL SPACE at the MIDCLAVICULAR LINE
definition of HEART MURMURS
turbulent blood flow with a swooshing or blowing sound during auscultation
what are the CONDITIONS that contribute to heart murmurs?
- INCREASED BLOOD VELOCITY
- STRUCTURAL VALVE DEFECTS
- VALVE MALFUNCTION
- ABNORMAL CHAMBER OPENINGS
how do we assess for EXTRA HEART SOUNDS?
- better to switch to the BELL and auscultate within the areas
- use of a LEFT LATERAL POSITION
definition of S3
a ventricular filling sound
occurring in early diastole with rapid filling
definition of S4
late ventricular filling sound
occurring with atrial contraction; often heard in late diastole
definition of HEART FAILURE
- the heart is not PUMPING WELL
- used to describe when a HEART CANNOT KEEP UP with its work load
- not ENOUGH OXYGEN SUPPLYING THE HEART NEEDS
congestive heart failure
- type of HEART FAILURE that requires seeking timely medical attention
- indication of plenty of FLUID BACKUP within the HEART
- heart begins to work MORE HARD TO KEEP UP WITH HEART DEMANDS, since the heart is a MUSCLE = increase of MUSCLE MASS OCCURS **CARDIOMEGALIA
- this decreases the amount of EFFICIENCY
common symptoms of heart failure
- greater enlargement of the heart
- narrowing of heart BV
- fatigue
- SOB
- can affect both sides of the heart; affects the left side first more often
cyanosis
- characteristic of CONGENITAL HEART DEFECTS that allow the mixture of ARTERIAL & VENOUS BLOOD
- prevents BLOOD FLOW to the lungs
splitting
- occurs when the mitral & tricuspid valves / pulmonic & aortic valves do NOT CLOSE SIMULTANEOUSLY
- often more heart and easy to detect in younger patients
angina pectoris
- often described as a CHOKING OR PRESSURE SENSATION
- can sometimes radiate towards the JAW and down to the LEFT/RIGHT ARM
- often begins from too much activity, eating, cold exposure
