Heart and Neck Vessels: Ch 19 Flashcards
Precordium
Is the areas on the anterior chest directly overlaying the heart and great vessels
Mediastinum
Middle third of the thoracic cage, ❤️ and great vessels are located here
“Point of maximum impulse”, mitral- is located where?
4th or 5th intercostal space
What are the great vessels?
Superior and inferior vena cava Pulmonary artery Pulmonary vein Aorta Jugular veins Carotid arteries
Heart wall
3 layers
1- pericardium: tough-double walled sac that surrounds and protects the heart
2- myocardium: muscular wall of the heart, does the pumping
3- endocardium: thin layer of endothelial tissue that lines the inner surface of the ❤️ chambers and valves
Heart chambers
Atria- right and left (top)
Ventricles- right and left (bottom)
Base of the heart is located where?
Top right side
Where is the apex of the heart located?
Bottom left of the heart where it forms a V
Atrioventricular Valves
(AV)
Separate the atria and the ventricles
- tricuspid: right side, 3 flaps
- mitral/bicuspid: left side, 2 flaps
Types of heart valves
Atrioventricular (AV)
Semilunar (SL)
Semilunar valves (SL) Blood travels thru these valves from the ventricles to "leave" the body
Pulmonic: left side-blood leaves right ventricle thru valve to pulmonary artery
Aortic: right side, blood leaves left ventricle thru valve to aorta- to systemic circulation
Cardiac cycle
Diastole- the ventricles relax and fill with blood (2/3 of cycle)
Systole- the heart contracts/ejects the blood from ventricles to pulmonary and aortic artery (1/3 of cycle)
Diastole- AV valves are open
Systole- AV valves close- aortic valve open
Diastole- AV valves open
Which heart sound signals the end of diastole and the beginning of systole?
S1
Which heart sound signals the end of systole, start of diastole/and the beginning of the cycle again?
S2
S1
First heart sound, occurs with the closure of the AV valves and shanks the end of diastole and the beginning of systole
** heard loudest at Apex
S2
Second heart sound, occurs with the closure of the pulmonary and aortic (SL) valves and the end of systole/beginning of cycle again
**heard loudest at the base (top right)
Extra heart sounds “diastolic filling sounds”
S3: occurs after s2, during. Diastolic filling
-usually hear w/ MI, CHF, CAD, 80% of pregnant women
S4: occurs at the end of distill and presystole when the ventricle is reactance to filling
-can be normal in athlete and elderly people
Aortic cyanosis- HTN, CAD
Neck vessels
Carotid arteries: palpate pulse and grade (0-3+)
Jugular veins- no palpate, observe for pulsation by suprasternal notch
- internal: can’t hear, used to give IV
- external: right JVD is direct reflection of the heart, assess for CHF, men may stick out, WT lifters
When/how is JVD best assessed?
When the person is lying down
The engorged vein will run across the SCM muscle
-if the vein remains enlarged when the pt sits up the patient is + for JVD
Carotid artery is located..
In the groove between the trachea and the SCM muscle
JVD
CHF, edema in extremities: check for JVD
More visible on the right
Yes- vein will remain enlarged when sitting up
No- vein will flatten when sitting up
❤️ anatomy
The heart extends from the 2nd-5th intercostal and from the right border of the sternum to the left midclavicular line.
Subjective data: health history
Chest pain: MI, angina?* start intervention early
*dyspnea: sob, labored breathing, PND at night
*orthopnea: trouble breathing lying down
Cough, fatigue, cyanosis
Cardiac history: HTN, ⬆️ LDL= high risk for MI
Personal habits
*cultural considerations
Heart disease and stroke is higher among which population?
Black adults versus any population
