Heart and Neck vessels Flashcards
What are the layers of the heart?
Pericardium (sac), Myocardium (muscle), Endocardium (lining)
Which valves open during systole?
The atrioventricular valves (AV)
Which valves open during systole?
The semilunar valves (SL)
Which valves are a part of the atrioventricular valves?
The tricuspid and the mitral valves
Which valves are a part of the semilunar valves?
The pulmonic and the aortic valves
Which medications should you ask about?
heart meds, BP meds, diuretics, statins, aspirin, anticoagulants, alcohol, street drugs
When does cardiac edema worsen?
worsens in the evening and better in the morning (cardiac edema is bilateral)
What is atherosclerosis?
Build up of fatty plaques in the arteries
What is arteriosclerosis?
Blood vessels grow more rigid/stiff (lose elasticity)
How does arteriosclerosis affect blood pressure?
Increases systolic pressure
What are arteriosclerosis and atherosclerosis both associated with?
PAD
How should you position patient for assessment of heart and neck vessels?
sitting up or supine with HOB elevated
How do you prepare for assessment
warm, quiet room, drape chest of females, stand on right side of patient
what equipment is needed?
stethoscope, penlight, and sphygmomanometer
What do you need to inspect?
the general appearance of precordium, point of maximal impulse (PMI), lift, heave and thrust
What angles should you check jugular vein distention?
at 45 and 90 degrees
What are the expected finding of jugular vein distention?
flat at 45 and 90 degrees
What sites should you auscultate?
Aortic, Pulmonic, Erbs, Tricuspid, and Mitral
What is an unexpected finding during auscultation?
Thrill
Which pulse should you check?
Carotid pulses (palpate one at a time)
where is aortic valve located?
2nd right ICS
where is the pulmonic valve?
2nd left ICS
Where is the tricuspid valve?
left 4th ICS
Where is Erbs point?
left 3rd ICS
Where is mitral/apex?
left 5th ICS
What should you auscultate for?
Apical pulse, heart sounds, carotid arteries, BP
What should you do if the apical pulse is irregular?
check pulse deficit (apical-radial)
Where do you find the apical pulse?
5th ICS MCL
In what positions should your patient be when checking BP?
Supine, sitting, standing Right and left
What should you assess for when checking BP?
orthostatic hypotension
With what part of stethoscope should you listen to heart sounds?
Both diaphragm and bell
What should you identify during cardiac auscultation?
S1 and S2
What are the positions patient should be in during auscultation of heart?
Sitting, supine, and left lateral recumbent
If the patient is on the left lateral recumbent position, which side will you be standing during auscultation
On the right side
Heart sounds: what does S1 mean?
“lub”: beginning of systole
Heart sounds: What does S2 mean?
“dub” end of systole, beginning of diastole
what does S3 mean?
occurs during diastolic filling phase immediately after S2 “lub-dub-dub”
What does S4 mean?
heard late in diastole immediately before S1 “lub-lub-dub”
What does hearing a murmur mean?
turbulent blood flow
What are the three areas you auscultate for carotid arteries
angle of jaw, mid clavicular, base of neck
What does bruit indicate?
Indicates turbulent blood flow through narrowed vessel
What is an expected finding during auscultation of carotid arteries?
No bruit heard
What should you instruct your patient to do during auscultation of carotid arteries?
Inhale, exhale and hold (in order to listen for bruit)
