Jarvis Chapter 19 Heart and Neck Vessels Flashcards
The venous return that builds during diastole. It’s the length to which the ventricular muscle is stretched at the end of diastole just before contraction.
Preload
All Heart Sounds are described by what?
- Frequency (pitch)
- Intensity (loudness)
- Duration
- Timing
The greater the stretch, the stronger is the heart’s contraction. This increased contractility results in an increased volume of blood ejected (Increased SV)
Frank-Starling Law
The opposing pressure the ventricle must generate to open the aortic valve against the higher aortic pressure. It’s the resistance against which the ventricle must pump its blood
Afterload
Risk Factors for CAD
- Elevated cholesterol
- Elevated B/P
- Blood sugar levels above 130mg/dl or know DM
- Obesity
- Cigarette smoking
- Low activity Level
- Length of any hormone replacement therapy for postmenopausal women
The Intensity of S1 depends on what factors?
- Position of AV valve at the start of systole
- Structure of the valve leaflets
- How quickly pressure rises in the ventricles
Patent Ductus Arteriosus (PDA)
Persistence of the channel joining left pulmonary artery to aorta. This is normal in the fetus and usually closes spontaneously within hours of birth
Atrial Septal Defect (ASD)
Abnormal opening in the atrial septum, resulting usually in left-to-right shunt and causing large increase in pulmonary blood flow
Ventricular Septal Defect (VSD)
Abnormal opening in the septum between the ventricles, usually in the subaortic area. The size and exact position vary considerably
Tetralogy of Fallot 4 components:
- RV outflow stenosis
- VSD
- RV hypertrophy
- Overriding aorta
Pulmonic Stenosis
Calcification of pulmonic valve restricts forward flow of blood
Mitral Regurgitation
Stream of blood regurgitates back into LA during systole through incompetent mitral valve. In diastole, blood passes back into LV again along with new flow; results in LV dilation and hypertrophy
Tricuspid Regurgitation
Backflow of blood through incompetent tricuspid valve into RA
Mitral Stenosis
Calcified mitral valve will not open properly, impedes forward flow of blood into LV during diastole. Results in LA enlarged and LA pressure increased
Pulmonic Regurgitation
Backflow of blood through incompetent pulmonic valve, from pulmonary artery to RV
Midsystolic Ejection Murmurs
Due to forward flow through SL valves
Pansystolic Regurgitant Murmurs
Due to backward flow of blood from area of higher pressure to one of lower pressure
Diastolic Rumbles of AV Valves
Filling murmurs at low pressures, best heard with bell lightly touching the skin
Early Diastolic Murmurs
Due to SL valve incompetence
Occurs with closure of the AV Valves and thus signals the beginning of systole. Loudest at the Apex of the Heart
1st Heart Sound (S1)
Occurs with the closure of the SL valves and signals the end of systole. Loudest at the Base of the Heart
2nd Heart Sound (S2)
Empty unoxygenated blood directly into the superior vena cava.
Jugular Veins
Give info about activity on the right side of the heart. Specifically, they reflect filling pressure and volume changes.
Jugular Veins
Occurs when the heart’s own blood supply cannot keep up with metabolic demand.
Angina
Clenched Fist
Angina key sign
- Elevated cholesterol
- Elevated B/P
- Blood sugar levels above 130mg/dl or know DM
- Obesity
- Cigarette smoking
- Low activity Level
- Length of any hormone replacement therapy for postmenopausal women
Risk Factors for CAD
Blowing, swishing sound indicating blood flow turbulence
Bruit
A sustained forceful thrusting of the ventricle during systole. It occurs with ventricular hypertrophy as a result of increased workload.
Heave (Lift)
A Palpable vibration. It feels like the throat of a purring cat. Signifies turbulent blood flow and accompanies loud murmurs.
Thrill
Varies with the person’s breathing, increasing at the peak of inspiration and slowing with expiration.
Sinus Arrhythmia
Occurs near term or when mother is lactating; it’s due to increased blood flow through the internal mammary artery
Mammary Souffle
- Position of AV valve at the start of systole
- Structure of the valve leaflets
- How quickly pressure rises in the ventricles
The Intensity of S1 depends on what factors?
Unoxygenated blood levels of the heart by the way of:
Pulmonary artery
An area on the anterior chest that overlays the heart and great vessels
Precordium
The amount of blood that is ejected during systole in a minute is describe as :
Cardiac Output
Systematic circulation is measure by?
Blood Pressure
Where oxygenated blood is recieve?
Right ventricle
Area that lies above the heart
Precordium
Bottom part of the heart
Apex
Upper part of the heart
Base
What is JVD?
Jugular vein distension
How do you assess JVD?
Have the patient lay supine in a 30-45 degree angle and observe
Purpose of the Heart
Deliver blood to the circulatory system
Upper chambers of the heart
Atria
Lower chamber of the Heart
Ventricles
From where the atria collect blood?
Circulatory system
Where the atria deliver the blood
Ventricles
Which muscular partition separate the heart into two functional units?
The septum
Which are the two majors structures of the heart?
The left and right ventricles.
Normal findings in aging adult
- Gradual rise in B/P
- The aorta stiffens, dilates, and elongates
- he chest often increases in anteroposterior diameter
- Systolic murmurs are common
Occurs with right ventricular hypertrophy, as found in pulmonic valve disease, pulmonic hypertension, and chronic lung disease.
Lift (heave)
A ______ in the second and third _____ interspaces occurs with severe aortic stenosis and systemic hypertension.
Thrill, right
A ______ in the second and third ______ interspaces occurs with pulmonic stenosis and pulmonic hypertension.
Thrill, Left
Calcification of aortic valve cusps restricts forward flow of blood during systole; LV hypertrophy develops.
Aortic Stenosis
Calcification of pulmonic valve restricts forward flow of blood.
Pulmonic stenosis
The first heart sound is produced by the
Closure of the AV valves
Which of the guideline may be used to identify which heart sound is S1?
S1 coincides with the carotid artery pulse.
Which cardiac alterations occurs during pregnancy
An increase in cardiac volume and a decrease in blood pressure
The leaflets of the tricuspid and mitral valves are anchored by __________________ to the _________________, which are embedded in the ventricular floor.
Chordae tendineae; papillary muscles
The ability of the heart to contract independently of any signals or stimulation is due to:
Automaticity
When auscultating the heart of a newborn within 24 hours after birth, the examiner hears a continuous sound that mimics the sound of a machine. This finding most likely indicates:
An expected sound caused by nonclosure of the ductus arteriosus.
A bruit heard while auscultating the carotid artery of a 65-year-old patient is caused by:
Turbulent blood flow through the carotid artery.
The jugular venous pressure is an indirect reflection of the:
Heart’s efficiency as a pump.
The semilunar valves separate the:
Ventricles from the arteries
