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Health Assessment > Heart and blood vessels > Flashcards

Heart and blood vessels Flashcards

1
Q

DC: Infants: how is fetal blood rerouted to maternal supply

A

Two thirds is shunted through an opening in the atrial septum, foramen ovale into the left side of the heart-> pumped into aorta

Rest of oxygenated blood is pumped by the right side of the heart out through the pulmonary arteries, detoured through ductus arterioles to the aorta

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2
Q

DC:Infants: When does the mass of the left ventricle surpass the right reaching a 2:1 ratio

A

By 1 years old

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3
Q

DC: infants: Heart position

A

heart is more horizontal, apex is higher located at fourth intercostal space.
Reaches adult position at 7 years old

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4
Q

DC: Aging adults: hemodynamic changes

A

Increase in systolic BP
- thickening and stiffening of large arteries–> collagen and calcium deposits in vessel & loss of elastic fibers

  • Stiffening (arteriosclerosis) creates and increase in pulse wave velocity bc less compliant arteries can’t store blood volume
  • Size of heart does not increase
  • Left ventricles does enlarge though
  • Diastolic BP may decrease after 6th decade
  • Rise of systolic and decline in diastolic= larger pulse pressure
  • No change in resting heart rate, or CO
  • Decreased ability of heart to augment CO with exercise
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5
Q

Non-cardiac factors that affect exercise performance in aging adult

A

Decrease in skeletal muscle performance
Increase in muscular fatigue
Increased sense of dyspnea

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6
Q

DC: Aging adult: Dysrhythmias

A

PSVT, ventricular dysrhythmias increases
Ectopic beats
-Tachydysrythmias less tolerated d/t thicker less compliant myocardium, and shortened diastole

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7
Q

DC: Aging adult ECG changes

A

Prolonged PR, QT intervals
QRS is unchanged
Left axis deviation from age related mild LV hypertrophy and fibrosis in LBB
Increased risk of BB block

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8
Q

Leading cause of death in those over 65 years?

A

CVD

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9
Q

Stage 1 hypertension

A

Systolic > 140 mmhg

Diastolic>90 mmhg

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10
Q

Factors that play a significant role in acquisition of heart disease

A 
Obesity
Alcohol use
Smoking
Lack of exercise 
Diet
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11
Q

Which racial group has highest prevalence of HTN

A

Blacks

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12
Q

Leading cause of death of women

A

CVD

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13
Q

Chest pain signifies

A
  • Angina- decreased blood flow to coronary arteries

- May have pulmonary, GI, musculoskeletal origin

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14
Q

Paroxysmal nocturnal dyspnea

A

Occurs with heart failure
Lying down increases volume of intrathoracic blood, and weakened heart cannot accommodate the increased load

Typically the person wakes up w/ 2 hours

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15
Q

Hemoptysis

A

Occurs with pulmonary disorders and mitral stenosis

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16
Q

Prodromal symptom in women for MI

A

Unusual fatigue

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17
Q

Fatigue from reduced CO

A

worse in the evening

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18
Q

Fatigue from anxiety

A

Worse in morning or all day

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19
Q

Cyanosis or pallor

A

occurs with MI, low CO as a result of decreased tissue perfusion

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20
Q

Cardiac edema

A

Worse in the evening and better in morning after elevating legs

B/L

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21
Q

Unilateral edema

A

Local vein occlusion or other problem

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22
Q

Risk factors for CAD

A 
Cholesterol
Elevate BP
Blood glucsose> 100 mg/dl
DM
Hormonal replacement (collect length in assessment)
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23
Q

Vitamin D deficiency increases risk for?

A 
HTN
CVD
Diabetes
Metabolic syndrome
LV hypertrophy
Chronic vascular inflammation
24
Q

Carotid sinus hypersensitivity

A

Pressure over the carotid sinus leads to a decrease hr, decreased bp, and cerebral ischemia w/ syncope

25
Q

Carotid sinus hypersensitivy causes

A

HTN or occlusion of the carotid artery

26
Q

Central Venous Pressure

A

Assessment of jugular vein pressure and therefore the heart’s efficiency as a pump and intravascular volume status

27
Q

how should you stand for testing CVP?

A

On patient’s right side

28
Q

What should occur to jugular veins when a person is raised from supine to a 45 degree angle?

A

The external jugular veins should flatten and disappear

29
Q

Where can you inspect the internal jugular veins?

A

Suprasternal notch or around the origin of sternocleidomastoid

30
Q

Estimating the Jugular Venous Pressure

A

Normal is 2cm or less

State person’s angle at which jugular pulsations stop

31
Q

What should you perform when venous pressure is elevated or if you suspect heart failure?

A

abdominojugular test (hepatojugular reflux)

32
Q

Abdominojuglar test results

A

4 cm or greater indicates heart failure

33
Q

Heave or lift indicates?

A

ventricular hypertrophy as a result of increased workload

It is a sustained forceful thrusting of ventricles during systole

34
Q

What states cause an increase in CO that increases apical pulse amplitude and duration?

A

Anxiety, fever, hyperthyroidism, anemia

35
Q

How to perform an apical pulse?

A

Use one finger pad
Patient exhales and holds breath
Sustained impulse w/ increased force and duration but no change in location occurs with LV hypertrophy and no dilation (pressure overload)

36
Q

Carotid bruit

A

Audible when lumen is occluded to 1/2-1/3

37
Q

Thrill

A

Palpable vibration
Signifies turbulent blood flow and can help locate the origin of murmurs

Absence of thrill does not rule out murmurs
Accentuated 1st and 2nd heart sounds also may cause abnormal pulsations

38
Q

Aortic valve area

A

Second right intercostal space

39
Q

Pulmonic valve area

A

Second left intercostal space

40
Q

Tricuspid valve area

A

Left lower sternal border

41
Q

Mitral valve area

A

5th intercostal space around left midclavicular space

42
Q

Pulse deficit

A

Auscultate the apical beat while simultaneously plating radial pulse

43
Q

Pulse deficit significance

A

Signals a weak contraction of the ventricles

Occurs w/ AFib, premature beats, and heart failure

44
Q

S1

A
  • Louder at the apex
  • Coincides with the carotid artery pulse
  • Coincides with the R wave
  • Caused by closure of the AV valves and signals beginning of systole
  • Audible in any position, and inspiration and expiration
45
Q

Split S1

A

associated with closure of the semilunar valves

46
Q

Split S2

A

Normal phenomenon that occurs toward the end of inspiration in some people

Only heart in the pulmonic valve area at second left intercostal space

47
Q

Do the aortic and pulmonic valves close at the same time?

A

No, aortic closes 0.06 seconds before pulmonic

48
Q

S3

A

ventricular gallop occurs with heart failure and volume overload

49
Q

S4

A

atrial gallop occurs with CAD

50
Q

mid systolic gap occurs with

A

mitral valve prolapse

most common extra sound

51
Q

Murmur

A

blowing sound

52
Q

What characteristics to document a murmur

A

Timing- systole or diastole
Loudness- 6 different grades
Pitch- high, medium, low
Pattern- grow louder w/ cardiac cycle or tapers etc
Quality- musical, blowing, harsh, rumbling
Location- Where it is best heard
Radiation
Posture- some enhance or disappear w/ different positions

53
Q

Innocent murmurs

A

Indicates no valvar problems

  • Soft (grade 2)
  • midsystolic
  • short
  • cresendo-descendo
  • Vibratory or musical
  • heard in 2nd-3rd intercostal space
  • Disappears with sitting
54
Q

Functional murmur

A

Caused by increase blood flow in the heart

  • anemia
  • pregnancy
  • fever
  • hyperthryodism
55
Q

How do childhood murmurs sound

A

Louder than adults d/t smaller chest and increase in blood velocity

56
Q

S3 and S4 murmur of mitral stenosis

A

May only be heard on left side

57
Q

Diastolic murmer of aortic regurgitation

A

May only be heard when person is leaning forward

Health Assessment (12 decks)

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