Heart/neck vessels ch 19

Question 1

Precordium

Answer 1

anterior chest area directly overlying the heart and great vessels connected to heart.

Question 2

Mediastinum

Answer 2

houses the heart, between the lungs in the middle third of thoracic cage, from the 2nd to fifth intercostal space.

Question 3

Apex of the heart

Answer 3

the bottom/left area (left ventricle) which beats against chest wall during contraction.

Question 4

Base of the heart

Answer 4

the top, broad part of the heart

Question 5

Superior and Inferior vena cavas

Answer 5

largest veins in the body, return unoxygenated blood to the right atrium

Question 6

Pulmonary artery

Answer 6

carries unoxygenated blood, pumped from the right atrium, to the lungs

Question 7

Pulmonary veins

Answer 7

return newly oxygenated blood to left atrium of heart (from lungs)

Question 8

Aorta

Answer 8

largest artery in the body, carries oxygenated blood to systemic arteries.

Question 9

Pericardium

Answer 9

tough, fibrous, dbl-walled sac surrounding the heart. It contains pericardial fluid to ensure smooth contraction of the heart

Question 10

Myocardium

Answer 10

muscular, middle layer of heart responsible for contractions

Question 11

Endocardium

Answer 11

endothelial tissue lining the inner surface of heart.

Question 12

Tricuspid valve

Answer 12

the right atrioventricular valve; separates RA from RV. Closed during systole, open during diastole

Question 13

Mitral valve

Answer 13

bicuspid or Left AV valve; seperates LA from LV. Closed during systole, open during diastole.

Question 14

Chordae Tendinae

Answer 14

collagenous fibers on the papillary muscles that attach to the AV valves. Papillary muscles contract during systole to close valves.

Question 15

Semilunar Valves

Answer 15

valves that separate the ventricles and arteries.

Question 16

Pulmonic SL valve

Answer 16

between the right ventricle and pulmonary artery, Open during systole to allow blood flow to the lungs

Question 17

Aortic SL valve

Answer 17

seperates the left ventricle and the aorta. Opens during systole to allow systemic circulation.

Question 18

Diastole

Answer 18

2/3 of cardiac cycle. Where AV valves are open and ventricles are filling with blood.

Question 19

Atrial kick

Answer 19

presystole or atrial systole, occurs during ventricular diastole and is the active filling phase where atria contract to push about 25%/ last amt of blood into ventricles

Question 20

Systole

Answer 20

the contraction phase (1/3 of cardiac cycle) where the filled ventricles close the AV valves and then contract, causing the SL valves to open and eject blood into the arteries.

Question 21

S1 (sound)

Answer 21

1st Sound heard during the beginning of systole where the AV valves close as a result of high ventricular pressure. Heard loudest over apex

Question 22

Isometric contraction

Answer 22

the contraction of the ventricles when all valves are closed, causing a highly pressured, rapid ejection of blood into arteries

Question 23

S2 (sound)

Answer 23

2nd sound that signals the end of systole and heard when the semilunar valves close due to backflow of blood in the arteries. Heard loudest at the base.

Question 24

Isometric relaxation

Answer 24

The brief period upon diastole where all four valves are closed and atrial pressure is rising

Question 25

Split S2 (sound)

Answer 25

Where the aortic valve closes significantly earlier than the pulmonary valve and both distinct sounds are heard due to unequal stroke volume b/w ventricles caused by respiration.

Question 26

S3

Answer 26

occurs when the ventricles are resistant to filling during protodiastole and they vibrate

Question 27

S4

Answer 27

vibrations heard just before S1 due to resistant ventricular filling when the atria contract.

Question 28

Murmur

Answer 28

gentle blowing sound heard due to turbulent blood flow. Can be caused by increased viscosity, decreased viscosity of blood, or defective valves or unusual openings in the chambers.

Question 29

How are heart sounds further described?

Answer 29

by their frequency (high pitch/low pitch), Intensity (loud or soft), Duration, and Timing (systole or diastole)

Question 30

Describe the sequence of electrical current in the heart?

Answer 30

The SA node (pacemaker) initiates the impulse, then impulse moves across atria to AV node, then to the bundle of His, the R and L bundle branches, and then through the ventricles.

Question 31

Cardiac output= ?

Answer 31

Stroke volume SV X Heart rate HR

Question 32

List the changes of hemodynamics with the aging adult:

Answer 32

increase in systolic pressure due to arteriosclerosis, ventricular wall thickens to accomodate arteriosclerosis, ability to augment CO during exercise decreases.

Question 33

Angina

Answer 33

chest pain occurring when the hearts blood supply can’t keep up with metabolic demand.

Question 34

Associated symptoms of Angina?

Answer 34

diaphoresis, pallor, palpitations (skipped beats), dyspnea, fatigue, tachycardia

Question 35

Dyspnea on exertion

Answer 35

DOE, with this symptom state how much activity causes this.

Question 36

Paroxysmal nocturnal Dyspnea

Answer 36

PND, occurs with heart failure b/c lying down increases volume of intrathoracic blood and heart can’t accommodate.

Question 37

Hemoptysis

Answer 37

coughing up blood that usually indicates pulmonary condition but may be due to mitral stenosis

Question 38

Cardiac Edema

Answer 38

bilateral swelling first in the feet and legs. Usually worse at evening and is a sign of heart failure.

Question 39

Risk factors for CAD

Answer 39

elevated cholesterol lvls, elevated BP, BS lvls above 130mg/dL or diabetes mellitus, obesity, smoking, low activity level, postmenopausal hormone replacement therapy

Question 40

Carotid sinus hypersensitivity

Answer 40

where pressure over carotid sinus causes decreased HR and BP, and cerebral ischemia with syncope. occurs with hypertension or occlusion of the carotid artery

Question 41

The normal strength of the carotid pulse is?

Answer 41

2+ or moderate

Question 42

Bruit

Answer 42

blowing sound heard when auscultating carotid, indicating turbulent blood flow due to a local vascular cause such as atherosclerotic narrowing.

Question 43

Describe auscultation of the carotid?

Answer 43

done with bell of stethoscope over 3 areas: angle of lower jaw, midcervical area, base of the neck. Listen after person exhales a deep breath.

Question 44

Thrill

Answer 44

palpable vibration (purring) usually present with murmurs that indicates turbulent bl flow

Question 45

Left Ventricular Hypertrophy

Answer 45

Increased volume or thickened heart wall due to HTN, CAD, heart failure, and cardiomyopathy. A sustained impulse will be present.

Question 46

Pulse Deficit

Answer 46

Difference in apical and radial pulses that occurs with weak ventricular contractions as in heart failure, atrial fib, and premature beats.

Question 47

Pericardial friction rub

Answer 47

High-pitched, scrathy noise heard over precordium during systole and diastole. Best heard with pat sitting erect and stethoscope over apex.

Question 48

Murmur

Answer 48

blowing, swooshing sound that occurs with turbulent blood flow. Can be innocent, functional, or pathological

Question 49

Jugular Venous pressure

Answer 49

Central venous pressure (CVP). estimates right side heart function based on the level of pulsation of internal jugulars. note patients elevation and mx in cm.

Question 50

Summation Gallop

Answer 50

When both S3 and S4 sounds are heard as one prolonged, loud sound during cardiac stress periods.

Question 51

Sinus Arrhythmia

Answer 51

A change in rhythm of heart beats due to respiration. Beats increase during inspiration and decrease on expiration. Normal in young adults and children.

Question 52

apical impulse

Answer 52

pulsation created against chest wall as left ventricle rotates during systole. May or may not be seen.