Heart and Neck vessels Flashcards

1
Q

What are the layers of the heart?

A

Pericardium (sac), Myocardium (muscle), Endocardium (lining)

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2
Q

Which valves open during systole?

A

The atrioventricular valves (AV)

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3
Q

Which valves open during systole?

A

The semilunar valves (SL)

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4
Q

Which valves are a part of the atrioventricular valves?

A

The tricuspid and the mitral valves

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5
Q

Which valves are a part of the semilunar valves?

A

The pulmonic and the aortic valves

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6
Q

Which medications should you ask about?

A

heart meds, BP meds, diuretics, statins, aspirin, anticoagulants, alcohol, street drugs

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7
Q

When does cardiac edema worsen?

A

worsens in the evening and better in the morning (cardiac edema is bilateral)

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8
Q

What is atherosclerosis?

A

Build up of fatty plaques in the arteries

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9
Q

What is arteriosclerosis?

A

Blood vessels grow more rigid/stiff (lose elasticity)

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10
Q

How does arteriosclerosis affect blood pressure?

A

Increases systolic pressure

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11
Q

What are arteriosclerosis and atherosclerosis both associated with?

A

PAD

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12
Q

How should you position patient for assessment of heart and neck vessels?

A

sitting up or supine with HOB elevated

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13
Q

How do you prepare for assessment

A

warm, quiet room, drape chest of females, stand on right side of patient

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14
Q

what equipment is needed?

A

stethoscope, penlight, and sphygmomanometer

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15
Q

What do you need to inspect?

A

the general appearance of precordium, point of maximal impulse (PMI), lift, heave and thrust

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16
Q

What angles should you check jugular vein distention?

A

at 45 and 90 degrees

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17
Q

What are the expected finding of jugular vein distention?

A

flat at 45 and 90 degrees

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18
Q

What sites should you auscultate?

A

Aortic, Pulmonic, Erbs, Tricuspid, and Mitral

19
Q

What is an unexpected finding during auscultation?

A

Thrill

20
Q

Which pulse should you check?

A

Carotid pulses (palpate one at a time)

21
Q

where is aortic valve located?

A

2nd right ICS

22
Q

where is the pulmonic valve?

A

2nd left ICS

23
Q

Where is the tricuspid valve?

A

left 4th ICS

24
Q

Where is Erbs point?

A

left 3rd ICS

25
Q

Where is mitral/apex?

A

left 5th ICS

26
Q

What should you auscultate for?

A

Apical pulse, heart sounds, carotid arteries, BP

27
Q

What should you do if the apical pulse is irregular?

A

check pulse deficit (apical-radial)

28
Q

Where do you find the apical pulse?

A

5th ICS MCL

29
Q

In what positions should your patient be when checking BP?

A

Supine, sitting, standing Right and left

30
Q

What should you assess for when checking BP?

A

orthostatic hypotension

31
Q

With what part of stethoscope should you listen to heart sounds?

A

Both diaphragm and bell

32
Q

What should you identify during cardiac auscultation?

A

S1 and S2

33
Q

What are the positions patient should be in during auscultation of heart?

A

Sitting, supine, and left lateral recumbent

34
Q

If the patient is on the left lateral recumbent position, which side will you be standing during auscultation

A

On the right side

35
Q

Heart sounds: what does S1 mean?

A

“lub”: beginning of systole

36
Q

Heart sounds: What does S2 mean?

A

“dub” end of systole, beginning of diastole

37
Q

what does S3 mean?

A

occurs during diastolic filling phase immediately after S2 “lub-dub-dub”

38
Q

What does S4 mean?

A

heard late in diastole immediately before S1 “lub-lub-dub”

39
Q

What does hearing a murmur mean?

A

turbulent blood flow

40
Q

What are the three areas you auscultate for carotid arteries

A

angle of jaw, mid clavicular, base of neck

41
Q

What does bruit indicate?

A

Indicates turbulent blood flow through narrowed vessel

42
Q

What is an expected finding during auscultation of carotid arteries?

A

No bruit heard

43
Q

What should you instruct your patient to do during auscultation of carotid arteries?

A

Inhale, exhale and hold (in order to listen for bruit)

44
Q
A