Perfusion

Question 0

What is the First heart sound (S1)? (the “lub”)

Answer 0

Closure of the AV valves (Mitral and Tricuspid), start of systole

Question 1

What are the Auscultation site, position, and pitch for best hearing S1?

Answer 1

Apex with diaphragm, position does not affect the sound, high pitch
(S1 is start of systole)

Question 2

Closure of the semilunar valves (Aortic and pulmonic).
End of systole, beginning of diastole.
Is what sound?

Answer 2

Second heart sound (S2), the “dub”

Question 3

Measure of the pressure exerted by the blood as it flows through the arteries.

Answer 3

Arterial blood pressure

Question 4

The highest pressure exerted against the arterial walls at the peak of ventricular contraction (systole)

Answer 4

Systolic blood pressure

Question 5

The lowest pressure exerted during ventricle relaxation (diastole)

Answer 5

Diastolic blood pressure

Question 6

The difference between the diastolic and systolic pressure

Answer 6

Pulse pressure

Question 7

What is a normal blood pressure? (Not at risk for hypertension)

Answer 7

Systolic less than 120

Diastolic less than 80

Question 8

What blood pressure levels classify a person as pre-hypertensive?

Answer 8

Systolic between 120-139

Diastolic between 80-89

Question 9

What are the non-modifiable risk factors?

Answer 9

Age, gender, genetics, race

Question 10

What are modifiable risk factors?

Answer 10

Smoking, high blood cholesterol, hypertension, physical inactivity, obesity and overweight, diabetes mellitus, stress

Question 11

What blood pressure classifies someone with stage 1 Hypertension?

Answer 11

Systolic of 140-159
Or
Diastolic of 90-99

Question 12

What would classify someone as having Stage 2 hypertension?

Answer 12

Systolic of 160 or higher
Or
Diastolic of 100 or higher

Question 13

The opposing forces or impedance to bloodflow as the arterial channels become more and more distant from the heart is called

Answer 13

Peripheral vascular resistance

Question 14

Peripheral vascular resistance is determined by what three factors?

Answer 14

1. Blood viscosity- The thicker the blood the greater it’s resistance to moving and flowing
2. Length of the vessel- The longer the vessel the greater the resistance to blood flow
3. 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

Question 15

When is the third heart sound (S3) heard and what is it called?

Answer 15

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.

Question 16

What causes a ventricular gallop? (S3)

Answer 16

When the AV valves open, bloodflow into the ventricles may cause vibrations, these vibrations create the S3 sound during diastole.

Question 17

What is an atrial gallop?

Answer 17

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)

Question 18

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.

Answer 18

Murmurs

Question 19

_________ and __________ may be heard in clients with valvular disease.

Answer 19

Clicks and snaps

Question 20

What would you hear in a patient with mitral stenosis?

Answer 20

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

Question 21

What type of aortic clicks might you hear during early systole at the second ICS and what would they mean?

Answer 21

Ejection clicks occur in damaged pulmonic and aortic valves.
Nonejection clicks are heard in prolapse of the mitral valve.