Perfusion Flashcards
What is the First heart sound (S1)? (the “lub”)
Closure of the AV valves (Mitral and Tricuspid), start of systole
What are the Auscultation site, position, and pitch for best hearing S1?
Apex with diaphragm, position does not affect the sound, high pitch
(S1 is start of systole)
Closure of the semilunar valves (Aortic and pulmonic).
End of systole, beginning of diastole.
Is what sound?
Second heart sound (S2), the “dub”
Measure of the pressure exerted by the blood as it flows through the arteries.
Arterial blood pressure
The highest pressure exerted against the arterial walls at the peak of ventricular contraction (systole)
Systolic blood pressure
The lowest pressure exerted during ventricle relaxation (diastole)
Diastolic blood pressure
The difference between the diastolic and systolic pressure
Pulse pressure
What is a normal blood pressure? (Not at risk for hypertension)
Systolic less than 120
Diastolic less than 80
What blood pressure levels classify a person as pre-hypertensive?
Systolic between 120-139
Diastolic between 80-89
What are the non-modifiable risk factors?
Age, gender, genetics, race
What are modifiable risk factors?
Smoking, high blood cholesterol, hypertension, physical inactivity, obesity and overweight, diabetes mellitus, stress
What blood pressure classifies someone with stage 1 Hypertension?
Systolic of 140-159
Or
Diastolic of 90-99
What would classify someone as having Stage 2 hypertension?
Systolic of 160 or higher
Or
Diastolic of 100 or higher
The opposing forces or impedance to bloodflow as the arterial channels become more and more distant from the heart is called
Peripheral vascular resistance
Peripheral vascular resistance is determined by what three factors?
- Blood viscosity- The thicker the blood the greater it’s resistance to moving and flowing
- Length of the vessel- The longer the vessel the greater the resistance to blood flow
- Diameter of the vessel- The smaller the diameter of the vessel the greater the friction against the walls of the vessel leading to greater impedance of blood flow
When is the third heart sound (S3) heard and what is it called?
May be heard in children, young adults, or pregnant females during the third trimester. It is heard after S2 and is called a ventricular gallop.
What causes a ventricular gallop? (S3)
When the AV valves open, bloodflow into the ventricles may cause vibrations, these vibrations create the S3 sound during diastole.
What is an atrial gallop?
The fourth heart sound (S4), May be heard in children, well conditioned athletes, and even healthy older adults without cardiac disease. The S4 sound is caused by atrial contraction and ejection of blood into the ventricles in late diastole. (Heard before S1)
Heart __________ are harsh, flowing sounds caused by disruption of blood flow into the heart, between the chambers of the heart, or from the heart into the pulmonary or aortic systems.
Murmurs
_________ and __________ may be heard in clients with valvular disease.
Clicks and snaps
What would you hear in a patient with mitral stenosis?
And opening snap during early diastole.
Side note: High pitch, best heard when sitting or supine position
auscultation site: third to fourth ICS, LSB with diaphragm
What type of aortic clicks might you hear during early systole at the second ICS and what would they mean?
Ejection clicks occur in damaged pulmonic and aortic valves.
Nonejection clicks are heard in prolapse of the mitral valve.
