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Health Assessment- NUR 202 > Heart and Neck Vessels: Ch 19 > Flashcards

Heart and Neck Vessels: Ch 19 Flashcards

1
Q

Precordium

A

Is the areas on the anterior chest directly overlaying the heart and great vessels

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2
Q

Mediastinum

A

Middle third of the thoracic cage, ❤️ and great vessels are located here

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3
Q

“Point of maximum impulse”, mitral- is located where?

A

4th or 5th intercostal space

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4
Q

What are the great vessels?

A 
Superior and inferior vena cava 
Pulmonary artery 
Pulmonary vein 
Aorta 
Jugular veins 
Carotid arteries
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5
Q

Heart wall

3 layers

A

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

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6
Q

Heart chambers

A

Atria- right and left (top)

Ventricles- right and left (bottom)

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7
Q

Base of the heart is located where?

A

Top right side

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8
Q

Where is the apex of the heart located?

A

Bottom left of the heart where it forms a V

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9
Q

Atrioventricular Valves
(AV)
Separate the atria and the ventricles

A
  • tricuspid: right side, 3 flaps

- mitral/bicuspid: left side, 2 flaps

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10
Q

Types of heart valves

A

Atrioventricular (AV)

Semilunar (SL)

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11
Q 
Semilunar valves (SL) 
Blood travels thru these valves from the ventricles  to "leave" the body
A

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

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12
Q

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)

A

Diastole- AV valves are open

Systole- AV valves close- aortic valve open

Diastole- AV valves open

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13
Q

Which heart sound signals the end of diastole and the beginning of systole?

A

S1

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14
Q

Which heart sound signals the end of systole, start of diastole/and the beginning of the cycle again?

A

S2

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15
Q

S1

A

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

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16
Q

S2

A

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)

17
Q

Extra heart sounds “diastolic filling sounds”

A

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

18
Q

Neck vessels

A

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
19
Q

When/how is JVD best assessed?

A

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

20
Q

Carotid artery is located..

A

In the groove between the trachea and the SCM muscle

21
Q

JVD

A

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

22
Q

❤️ anatomy

A

The heart extends from the 2nd-5th intercostal and from the right border of the sternum to the left midclavicular line.

23
Q

Subjective data: health history

A

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

24
Q

Heart disease and stroke is higher among which population?

A

Black adults versus any population

25
Q

What will occur with CHF?

A

Edema

Nocturia

26
Q

Objective data: the physical exam

A

Carotid arteries: palpate 1 at a time, auscultate for bruit with bell

Jugular veins- inspect, check for JVD
Precordium- inspect, palpate the apical pulse, palpate across precordium, outline of cardiac borders

27
Q

Instructions for patient when listening for a bruit?

A

Take a deep breath in

Blow it out and hold it

28
Q

The first heart sound is produced by…?

A

The closure of the AV valves

29
Q

When auscultating heart sounds the appropriate position for the patient is…?

A

Recumbent position

-Layin down

30
Q

A bruit is caused by?

A

Turbulent blow flow thru the carotid artery

31
Q

Auscultation 👂🏻of the heart sounds

A

Aortic area: 2nd intercostal space-R
Pulmonic area: 2nd intercostal space-L
Erbs point: 3rd intercostal space-L
Tricuspid area: 5th intercostal space-L but more midline
Mitral area: 4th or 5th (usually 5th, mid claviciular line)-L

32
Q

Apical pulse: “PMI”, mitral/apical=apical pulse

-4th or 5th intercostal space

A

Note the rate and rhythm

-sinus arrhythmia: most common and easiest treated (Afib)

33
Q

Pulse deficit

A

Listen to the apical pulse and palpate the radial pulse at the same time!
Apical-130
Radial-115
PD-15
Peripheral pulse may/may not be a reliable area

34
Q

Have patient lay on what side to listen to apex?

A

Left- it brings the heart closer to the chest wall

35
Q

If a patient has a fistula in the right arm and you need their BP what do you do?

A

Take it in the left arm

-never do BP in an arm with a fistula

36
Q

Abnormal findings-diastolic extra sounds

A
  • 3rd heart sound
  • 4th heart sound
  • precordial friction rub- inflammation of the pericardium, high pitched sound, “sand paper”

Health Assessment- NUR 202 (11 decks)

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