Heart & Peripheral Vascular Flashcards
Cardiovascular consist of
Heart (muscular pump)
Blood vessels (tubes = arteries and veins)
Precordium
Area on anterior chest overlaying the mediastinum (heart & great vessels)
Heart => base? Apex?
Base: on top of the heart
Apex narrow bottom portion of the heart/point of heart
Position of heart?
2nd ICS- 5th ICS
Right sternal border to the left midclavicular line
Right side (heart) = Anterior
Left side (heart) = posterior
Right ventricles = behind sternum & anterior cardiac surface
Left ventricles (pump blood out) = posterior & at apex of heart
Layers of heart 3
Pericardium (sac filled with fluid)
Epicardium
Myocardium
Endocardium
Pericardium
Tough fibrous double wall sac, filled with pericardial fluid that decreases friction
Epicardium
Outermost layer of heart and innermost layer pericardium
Myocardium
Muscular wall, responsible for pumping
Endocardium
This layer of epithelial tissue that lines inner surface of heart & forms valves
Cardiac tamponade
Fluid build up = pericardial sac become inflamed & squeeze the heart & hear a granting rub
Med emergency, shock
Pericarditis
Inflammation of the pericardium (layer around heart & sac membrane)
Hear a rub as symptom
Endocarditis
Infection of the inner lining
Risk Factor = infection in blood (septicemia), use of contaminated needle, IV drug abuse, oral hygiene, artificial devices
Septum
Impermeable wall that separate the right & left sides of heart
Blood flow = Heat?
RA => Tricuspid valve => RV => Pulmonic valve => Lungs
LA => Mitral valve => LV => Aortic valve => aorta => body
Anatomy of pumps => Right vs Left
Right => pulmonary circulation
Left => systemic circulation
Importance of Valves
Keep the blood going in one direction = prevent back flow
When the valves become damaged = back flow
Associated to turbulence & called murmur cuz it can damage the heart & cardio system
Epitrochlear node location?
Elbow
What does Lymphatic do? /purpose
Lymph nodes => filter fluids (fluids & plasma protein =leak out) before returning to the blood stream
Part of the immune system function
What happens do lymph nodes during infection?
Nodes will be SWOLLEN/ enlarged/ tender downstream from infection
Semilunar valves
Separate ventricles
Pulmonic valve = RV & PA (pulmonary artery)
Aortic valve = LV & Aorta
Atrioventricular Valves
Tricuspid = separates RA from RV
Mitral/ bicuspid = separates LA from LV
No valves between
RA & Vena cava
LA & pulmonary veins
Diastole
Ventricles relaxed & blood flows into them
AV valves open
Pressure in atria higher than ventricles/blood pours into ventricles (early dia)
Presystole (atrial kick)
Atria contract to push last amount of blood into ventricles
Atrial kick = happens at the end of this cycle (atria contract & push left over blood)
Systole
Ventricular pressure higher than atrial
Closure of AV valves (tricuspid & mitral)
S1
Lub & mitral & tricuspid close => loudest at Apex of heart
S2
Dub => heard at Aortic & Pulmonic => Base of heart
S3
S3 => happens after S2 => Kentucky => heard when Wet (extra fluid, excess IV solution, fluid overload, pregnant, HF, CHF)
Come at the END
S4
Occurs before S1
Caused by rigid heart =>heart is inflexible
S4 =>S1 => S2 => S3
Pressure in the Right side of heart is
Lower than Left side
R less than L
Events occur __________ on Right side of heart
Slower => due to depolarization
Valves on Right side of heart_______
Close LATER than on the Left
Right side of heart____
Pressure Lower & Slower & R valves close later
Impulses start at
SA node
Sinoatrial node
Sinus node
Pacemaker of heart
SA node/Sinoatrial
Automaticity
Unique ability of cardiac tissue to contract by itself in response to electrical concurrent, auto response of heart
P QRS T
P => depolarization of Atria
QRS => depolarization of Ventricles
T => repolarization of Ventricles
A => V => V
D => D => R
Preload
Stretch (diastole) applied to ventricles
Volume of blood received by heart
After load
After load (squeeze) => resistance
The resistance the heart must overcome to eject/pump blood to body
Carotid artery
Carotid artery located between the trachea & sternocleidomastoid
Pulse coincides (يتزامن) with ventricular systole S1
Pressure on it can stimulate PNS => slow HR
Check one side only cuz May impact blood supply to brain
Jugular venous pulse
Blood coming from brain neck empty in superior vena cava
Jugular vine reflects =>activity on Right heart side
Jugular vines =>blood is blocked => cuz of edema/fluid overload => j vein widen & expands
Laying down flat (see it normal) / sitting up & distended (obvious => fluid overload)
Development issue Elderly
Systolic pressure (top#) go up/raise
Diastolic pressure (bottom#) go down
Widening (high) pulse pressure
Arterial insufficiency = Chronic
Chronic = gradual narrowing of vessels
1= Intermittent Claudication
2= Cool Pale Shiny skin
3= Decreased hair growth
4= Sores on the end of Toes, necrotic toes
Arterial insufficiency = Acute
Acute = Lost the ability to have circulation
1 = Throbbing pain
2 = Sudden onset
3 = 4 P = Pain Pallor Pulselessness Paresthesia Cool (legs, hands)
Veins = Chronic insufficiency
1 = Aching, dull, tired leg cuz of standing
2 = Edema +1 +4
3 = Varicosities
4 = Weeping Ulcers
5 = Brown / Hemosiderin discoloration
6 = Venous hum = turbulence sound
Veins = Acute insufficiency
DVT
1 = Warm Red Swollen
2 = Pain with Dorsiflexion = Homan’s sign
3 = Sudden onset
4 = Unilateral = one side
