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AHA Quiz 2 > Module 8 - Cardiovascular Assessment > Flashcards

Module 8 - Cardiovascular Assessment Flashcards

1
Q

What is the function of the heart?

A

The heart is a muscular pump

  • Pumps blood to the lungs to become oxygenated
  • The oxygenated blood is then pumped to the organs of the body (skin, liver, kidney etc)
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2
Q

What does the cardiovascular system consist of?

A
  • Heart
  • Blood vessels
  • Precordium (area on the anterior chest overlying the heart and great veins)
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3
Q

What are the great vessels?

A

Major arteries and veins connecting to the heart

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4
Q

What is the mediastinum?

A

It is the location of the heart and the great vessels between the lungs in the thoracic cage

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5
Q

How many chambers does the heart contain?

A

4 chambers

  • Two Atriums
  • Two Ventricles
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6
Q

What are the 2 main continuous loops called? - For circulation

A
  • Pulmonary circulation

- System circulation

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7
Q

What is Pulmonary circulation?

A

Circulation of blood to the lungs to become oxygenated

  • Oxygenated blood travels via Pulmonary arteries
  • Oxygenated blood travels back via Pulmonary veins
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8
Q

What is Systemic circulation?

A

Circulation of blood to vital organs and other organs of the body

  • Oxygenated blood travels via systemic arteries to body
  • Returns unoxygenated to heart via system veins
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9
Q

What is the function of the Superior and Inferior venae cavae?

A

Return unoxygenated blood venous blood to the right side of the heart

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10
Q

What does the Pulmonary artery do?

A

Transports unoxygenated blood via the right ventricle and carries the unoxygenated (venous) blood to the lungs

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11
Q

What are the functions of the Pulmonary veins?

A

Return oxygenated blood to the left side of the heart (left atrium)

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12
Q

What is the function of the aorta?

A

Carries the blood out to the body via Systemic Circulation

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13
Q

What are the layers of the heart wall?

A
  • Pericardium (outside layer) - tough and fibrous - Protects the heart -contains pericardial fluid which prevents friction
  • Myocardium (middle layer) - muscle of the heart - pump
  • Endocardium (inner layer) - contains a thin layer of endothelial tissue that lines the surface of heart chambers/valves
  • Septum - separates the heart into right and left
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14
Q

How many valves does the heart have?

A

4

  • Pulmonic Valve
  • Aortic Valve
  • Tricuspid valve - right AV
  • Mitral valve (Bicuspid valve) - left AV
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15
Q

Name the two semi-lunar valves and their function

A
  • Pulmonic valve - right side
  • Aortic valve - left side
  • They open during pumping (systole) to allow blood to eject from the heart
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16
Q

What are the two phases and function of the cardiac cycle?

A

1) Diastolic - Ventricles relax and fill with blood

2) Systolic - Heart is contracted, blood pumps from ventricles and fills the pulmonary/aortic arteries

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17
Q

What is the structure and function of the peripheral vascular system?

A
  • Part of the circulatory system
  • Consists of veins and arteries not in the chest/abdomen ex) arms, legs, hands and feet
  • Peripheral arteries supply oxygenated blood to the body
  • Peripheral veins direct unoxygenated blood from capillaries to the heart
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18
Q

What is the structure of the lymphatic system?

A
  • Part of the circulatory system and immune system
  • Network of lymphatic vessels, lymphatic fluid ad lymphoid organs/tissues
  • Vessels carry lymph fluid towards the heart
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19
Q

What are the two main functions of the lymphatic system?

A

1) Providing a route for the surplus of blood back to the heart from the interstitial fluid
2) Immune defense - lymphocytes

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20
Q

Name the main organs that are part of the lymphatic system

A
  • Lymph nodes - highest concentration of lymphocytes
  • Spleen
  • Thymus
  • Tonsils
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21
Q

What is the function of the Spleen?

A
  • Filter and store blood
  • Recycles RBC’s - turns globin into amino acids and metabolizes heme into bilirubin (liver)
  • Contains antibodies to fight infection in its white pulp
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22
Q

What is the function of the Thymus?

A
  • Immunity

- Allows T cells to mature

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23
Q

What is the function of tonsils?

A

First line defense for immunity of ingested or inhaled pathogens
- Provide immune response against the common cold

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24
Q

Health History questions for Cardiac system

A
  • Chest pain - onset, location, character
  • Dyspnea (SOB) - onset, duration, interference
  • Orthopnea - pillows
  • Cough - duration, frequency, type (dry, hacking), position, treatment
  • Fatigue - onset
  • Cyanosis/pallor
  • Edema - onset, changes
  • Nocturia
  • Cardiac history
  • Family cardiac history
  • Personal habits (smoking, alcohol, diet, activity level)
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25
Q

Health history questions for the Peripheral and Lymphatic system

A
  • Leg pains/cramps - Pain assessment
  • Skin changes on arms/legs - temperature, ulcers, sores
  • Swelling in arms/legs - edema
  • Lymph node enlargement - swollen glands
  • Medications
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26
Q

What is isometric contraction?

A

Contraction to build high pressure inside the ventricles

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27
Q

What are the two normal heart sounds?

A

1) S1 - closure of AV valves - beginning of systole - loudest in apex
2) S2 - closure of semi-lunar valves - end of systole - loudest at base

“Lub-Dub” Sound

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28
Q

What are the four auscultating areas for listening to heart valves?

A
  • Aortic valve area - Second right intercoastal space - Base
  • Pulmonic valve area- Second left intercostal space
  • Tricusid valve area- Fifth intercostal space at left lower sternal border
  • Mitral valve area- Fifth interspace at around left midclavicular line - Apex
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29
Q

What should you note during auscultation of the heart (5)?

A

1) Rate and rhythm
2) Heart Valves - S1 and S2
3) Assess S1 and S2 - S1 is louder at apex and S2 is louder at base
4) Extra heart sounds
5) Murmurs

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30
Q

What is the normal range for heart rates?

A

60-100 bpm

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31
Q

What should you listen for when assessing for murmurs?

A
  • Timing
  • Loudness
  • Pitch
  • Pattern
  • Quality
  • Location
  • Radiation
32
Q

How would you palpate the Precordium?

A
  • Palmars of four fingers
  • Gently palpate over apex, left sternal border and base
  • Search for pulsations - if none are felt that is normal
  • If you feel a pulsation - note timing
33
Q

On inspection of the Precordium where would you see the Apical Impulse if noted?

A

When visible, it appears at the level of the 4th or 5th intercostal space at/or inside the midclavicular line - Apex

34
Q

How would you palpate an Apical Impulse?

A
  • One finger pad
  • “exhale and hold”
  • Roll client midway to the left
35
Q

What are the characteristics of sound (4)?

A

1) Frequency
2) Intensity
3) Duration
4) Timing

36
Q

How would you take an accurate Apical-Radial pulse?

A

Auscultate apical beat and simultaneously palpate the radial pulse

  • Two counts should be identical
  • When different subtract the radial rate from apical rate = pulse deficit
37
Q

What qualities are you looking for when recording a pulse?

A

1) Rate
2) Rhythm
3) Force
4) Quality

38
Q

What is a pulse deficit?

A
  • It signals a weak contraction of the ventricles

- Occurs with atrial fibrillation., premature beats and heart failure

39
Q

What is the significance of the Jugular Venous distention/pressure?

A
  • When the pressure inside the vena-cava increases and appears as a bulge running down the right side of a person’s neck
  • May indicate heart failure
    heart
40
Q

What is the location of the apical pulse?

A

Left center of the chest at the apex of the heart - 4th/5th intercostal

41
Q

What is the location of the cartoid pulse?

A
  • On the neck (either side) between trachea and sternomastoid muscle
  • Coincides with ventricle systole
  • Supplies blood to head, neck and face
42
Q

What is the location of the brachial pulse?

A
  • Pulse is found on the antecubital foca of elbow

- Brachial artery is the major artery in the arm and runs in the biceps-triceps of the upper arm

43
Q

What is the location of the radial pulse?

A

Lateral of the wrist under the base of the thumb

44
Q

What is the location of the femoral pulse?

A

Inner thigh - midway between symphysis pubis and anterior superior iliac spine, known as the “Femoral Triangle”

45
Q

What is the location of the popliteal pulse?

A

Back of knee - most difficult to find

46
Q

What is the location of the dorsalis pedis pulse?

A

Dorsum (top) of the foot

47
Q

What is the process of palpating the cervical lymph nodes?

A
  • Palpate one side at a time
  • Position client’s head forward
  • Palpate over carotid arteries
48
Q

What is the process of palpating the cervical lymph nodes?

A
  • Palpate one side at a time
  • Position client’s head forward - protruding nodes
  • Palpate over carotid arteries
49
Q

What is the process of palpating the axillary lymph nodes?

A

Palpating under the axilla palpating the tissue over the ribs - posterior and anterior of axilla

50
Q

What is the process of palpating the epitrochlear lymph nodes?

A
  • Cup clients elbow

- Palpate just above the elbow along inside of the arm

51
Q

What is the process of palpating the inguinal lymph nodes?

A
  • Palpate groin area

- Same as femoral pulse area - femoral triangle

52
Q

What is the significance of enlarged lymph nodes?

A

Inflammation has occurred due to immunity response against a pathogen that could cause infection

53
Q

Signs and Symptoms of enlarged lymph nodes

A
  • Swelling
  • Tenderness
  • Infection
54
Q

What is the edema rating scale?

A

1+ - Mild pitting, slight indentation, no swelling of the leg
2+ - Moderate pitting, indentation subsides rapidly
3+ - Deep pitting, indentation remains for a short time, swelling of leg
4+ - Very deep pitting, indentation lasts a long time, gross swelling and distortion of leg

55
Q

Normal findings for heart relating to sounds

A
  • Normal valve closures - S1 and S2

- Lub - dub sound

56
Q

Abnormal findings for the heart relating to sounds

A
  • Bruit
  • Murmurs
  • Arrhythmia
  • JVP
  • Variations of S1 and S2
  • Thrills (vibrations) on precordium
  • Heaves - lifting impulse on systole
57
Q

Normal findings for peripheral vascular system relating to pulse and palpation

A
  • Normal 2+ rate
  • Equal bilateral brachial pulse
  • Pulse tap for femoral pulse - should be felt
  • Capillary refill
58
Q

Abnormal findings for peripheral vascular system

A
  • Bruits
  • Full and bonding pulse (anemia, hyperthyroidism)
  • Weak/thready pulse
  • Deep muscle pain on palpation
  • Ulcers (diabetes, Ischemia, Stasis)
  • Edema
  • Varicose veins
  • Deep vein thromboses
  • Reynauds
  • Skin discolouration
  • Gangrene
59
Q

Normal findings for lymphatic system

A

Normal size, consistency, tenderness and locations of lymph nodes

60
Q

Abnormal findings for lymphatic system

A
  • Lymph edema
  • Cancer - Lymphoma
  • Chronic infection
61
Q

Abnormal sound variations of S1

A
  • Loud
  • Faint/diminished
  • Varying intensity
  • Split S1 (Mitral and Tricuspid heard separate)
62
Q

Abnormal sound variations of S2

A
  • Accentuated S2
  • Diminished S2
  • Splitting
  • Fixed split (right ventricle failure)
  • Wide split (Right bundle branch block)
  • Paradoxial Split (Left bundle branch block)
63
Q

What are some Vascular disorders?

A
  • Thrombosis – blood clots
  • Phlebitis – infection
  • DVT – Deep vein thrombosis
  • Venous Insufficiency - poor wound healing
64
Q

What is isometric/isovolumic relaxation?

A

All four valves are closed and ventricles are relaxed

65
Q

What are some diagnostic tests for the Cardiac system?

A
  • ECG (electrocardiogram)
  • ECHO (Echocardiogram)
  • Exercise Stress Test
  • Doppler
  • Cardiac Catheter
66
Q

What is an ECG?

A

Measures electrical impulses

67
Q

What does the P interval on the ECG represent?

A

Depolarization of the atria

68
Q

What does the QRS interval on the ECG represent?

A

Depolarization of the ventricles

69
Q

What does the T interval on the ECG represent?

A

Re-polarization of the ventricles

70
Q

How many liters of blood does the heart normally pump in an adult per minuet?

A

4-6 L

71
Q

What is Cardiac Output?

A

Stroke volume x Rate (CO= SV x Rate), the volume of blood pumped from the ventricles in a minuet

72
Q

What is Deep Vein Thrombosis (DVT)?

A

Peripheral vascular disorder and is a blood clot in the deep vein, usually in the legs

73
Q

What is Varicose veins?

A

Superficial large veins that are enlarged, twisted and have a blueish colour

74
Q

Signs and Symptoms of Heart Failure

A
  • Dyspnea
  • Decreased BP
  • Crackles
  • Cough
  • falling O2 sat
  • Weak Pulse
  • JVD
  • Fatigue
  • Dilated pupils
75
Q

What is Preload?

A

Venous return that builds during diastole - “blood coming back to fill the ventricles”

76
Q

What is Afterload?

A

Opposing pressure that is needed from the ventricle to open the aortic valve against the aortic pressure

AHA Quiz 2 (4 decks)

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