Heart & Neck Flashcards
Where is S1 heard?
Explain S1
Over all precordium, but loudest at apex
Sound from closure of AV valves and beginning of systole
Where is S2 heard?
Explain S2
Heard all over precordium, but loudest at base
Sound of closure of semilunar valves and end of systole
What are abnormal heart sounds?
S3
S4
Murmurs
Explain S3
Abnormal extra heart sound
Occurs when ventricles are resistant to filling during early rapid filling phase (protodiastole)
Late sound
Immediately after S2, when AV valves open and atrial blood first pours into ventricles
“Kentucky”
Explain S4
Abnormal extra heart sound
Occurs at end of diastole (presystole) when ventricles are resistant to filling
Atria contract and push blood into noncompliant ventricle
Vibrations
Just before S1-Early sound
“Tennessee”
Explain murmurs
Abnormal extra heart sound
Gentle swooshing sound heard on chest wall- turbulent blood flow
Explain the murmur scale
1/6: Can’t hear it- use echocardiogram
2/6: Can hear if room is completely silent
3/6: Can hear faintly
4/6: Louder
5/6: Loud!
6/6: L O U D
What kind of things cause heart murmurs?
Increased blood velocity
Decreased blood viscocity
Valve defect
Heart chamber or wall openings: ASD, VSD
Explain the hemodynamic changes with aging?
Increased systolic BP
Increased pulse pressure
Does resting heart rate or cardiac output change with age?
No
What is pulse pressure?
The difference between systolic and diastolic pressure
What are aging adults at an increased risk of? How can this be prevented?
Coronary Artery Disease
Hypertension
Heart Failure
Increase physical activity
What is the recommended lifestyle to prevent the risk of cardiovascular disease?
No smoking, obesity, physical activity at least once a week and a healthy diet
What are the risk factors to cardiovascular disease?
HNT
Smoking
High serum cholesterol
Physical activity
Sex/gender differences
What are some heart attack symptoms more common in women?
Profound fatigue
Shortness of breath
Flu-like discomfort
Epigastric pain
Feelings of indigestion/heartburn
Symptoms for days instead of sudden onset
What are 2 common medicinal treatments for chest pain/heart attacks?
Baby aspirin: chewed up for faster absorption, keeps blood cells from sticking together
Nitroglycerine: on/under tongue, dilates coronary arteries
How is fatigue related to heart attacks/heart disease?
Decreased blood flow to brain
Define:
Orthopnea
Nocturia
Orthopnea: can’t breathe when laying down- ask how many pillows they sleep with
Nocturia: getting up to pee at night
What are some personal habits that affect cardiac risk?
Nutrition
Smoking
Alcohol
Exercise
Drugs/medications
What kind of tone is best when asking questions about alcohol/nutrition/smoking?
Flat affect- non-reactive or judgemental
What position is best for carotid artery evaluation?
Sitting
What position is best for assessing jugular veins and precordium?
Supine with head and chest slightly elevated 30-45 degrees
Explain JVD assessment
Jugular Vein Distention- blood buildup causing a visible pulsation/bulging
Explain apical impulses
Pulsation on anterior chest from left ventricle rotating against chest wall during systole
not always visible
