Heart and neck vessels

Question 1

What is the order of blood flow?

Answer 1

Superior/inferior vena cava bring blood to RA to RV to pulmonary artery to lungs to pulmonary vein to LA to LV to aorta and then it goes to rest of the body.

Question 2

What is pericardium, myocardium, and endocardium?

Answer 2

Pericardium- tough/fibrous wall that surround and protects the heart, divided into fibrous and serous layers (serous divided into parietal and visceral), there’s also serous fluid surrounding heart

Myocardium- muscular wall of heart, thicker on left side

Endocardium- think layer of endothelial tissue that lines inner surface of heart

Question 3

What are the types of heart valves?

Answer 3

Atrioventricular (tricuspid on the right and mitral is on the left, they open with diastole and close with systole). Semilunar (pulmonic is on the right and aortic is on the left, open with systole).

Question 4

What are the 4 heart chambers?

Answer 4

RA- receives de O2 blood from body
RV- contracts to send de O2 blood to lungs
LA- receives O2 blood from lungs
LV- contracts to send O2 blood to body

Question 5

Where is top and apex of the heart located?

Answer 5

Base of heart is at the top and apex is lower and a bit to left side. Heart is like inverted triangle.

Question 6

What is the heart sounds 1+2?

Answer 6

S1- AV valves close, lub
S2- SL valves close, dup

Question 7

What are S3/S4 and murmurs?

Answer 7

S3/S4 caused by turbulent blood flow and resistant ventricles. S3 is after S2 and S4 is right before S1. Murmurs sound like blowing/clicking. They are r/t elicits/viscosity of blood or valve wall defects.

Question 8

What is the SA node and AV node?

Answer 8

SA node- pacemaker of heart, 60-100 beats/min
AV node- 40 to 60 beats/minute

Question 9

What is cardiac output?

Answer 9

Volume of blood in each systole times rate. SV x HR.

Question 10

What are preload and afterload?

Answer 10

P- length which ventricular muscle is stretched at end of diastole before contraction

A- ongoing pressure that ventricle must generate to open aortic valve for ejection

Question 11

Which valves are found the loudest at the base of heart?

Answer 11

Aortic and pulmonic valve.

Question 12

What is the purpose of superior/inferior vena cava, veins, and arteries?

Answer 12

S/I vena cava return deoxygenated blood to the heart. Veins carry deoxygenated blood and arteries carry oxygenated blood.

Question 13

What is a myocardial infarction?

Answer 13

Heart attack. Angina (chest pain) can be a symptom.

Question 14

What is subjective data of heart/neck vessels?

Answer 14

Chest pain, dyspnea (SOB), orthopnea (need to sit up to breathe with pillows), cough, fatigue, cyanosis/pallor, edema, nocturnal (awaken at night to go pee), cardiac hx, family cardiac hx, and personal habits.

Question 15

What are the 6 grades for heart sound loudness?

Answer 15

1- barely audible
2- audible but faint
3- moderate loud
4- loud, palpable thrill on chest wall
5- very loud, has thrill
6- loudest, heard with no stethoscope, has thrill

Question 16

What is the location of the different valves?

Answer 16

apt M 2255. Aortic valves located at 2nd intercostal space on the right. Pulmonic valve located at 2nd intercostal space on left sternal border. Tricuspid valve located at 5th intercostal space at left lower sternal border. Mitral valve is located at 5th intercostal space at left midclavicular line.

Question 17

What is diastole and systole?

Answer 17

Diastole is ventricles relaxed and filling. Systole is heart contracting/blood pumped/ pressure is raised.

Question 18

When palpating the apical pulse what do we notice?

Answer 18

Duration (short), location, size (1-2 cm), amplitude (short tap).

Question 19

When is S1 louder than S2?

Answer 19

At the apex. S2 is louder than S1 at the base.

Question 20

What is a split S2?

Answer 20

Effect of respiration. Causes delayed pulmonary valve closure. T-dup. Separation of 2 valves that happens in inspiration.

Question 21

What is it called when 70 patients has swelling in ankles and has jugular venous pulsations 5 cm above sternal angle?

Answer 21

Increased pressure on right side of heart

Question 22

Major risk factors for heart disease?

Answer 22

Smoking, hypertension, high cholesterol, obesity, and diabetes.

Question 23

Where to listen for S3/S4 and for murmurs?

Answer 23

S3/S4- listen at apex of heart with bell and patient in left lateral position
Murmurs- listen at based of heart with diaphragm with patient sitting up/lean forward slightly