Test2-Heart and Neck Vessels-MJ Flashcards
What does APETM (all physicians eagerly take money) stand for?
It is the acronym for the way to listen to the heart sounds:
Atrial, Pulmonary, Erbs, Tricuspid, Mitral
What is the basic blood flow in the heart?
*this is a real simple answer, not the complicated one
R.Atrium–>R.Ventricle –>Lungs–>L.Atrium
–>L.Ventricle–>Body–>Back to R.Atrium
S1= closer of ____ valves
AV valves
S2= closer of ___ valves
Semilunar valves
Is S1 systolic or diastolic?
Systolic
Is S2 systolic or diastolic?
Diastolic
Where is the S1 sound heard best?
This is the systolic sound; it is heard best at the apex of heart
Where is the S2 sound heard best?
This is the diastolic sound; it is loudest at base of the heart
Why do we listen for S1S2 sounds at Erbs Point?
Erbs point is in the middle of where it is heard best for systolic and diastolic, this is the best place to hear both of them equally loud
Define: turbulent blood flow
Murmur
What are the normal heart sounds?
S1S2
What are the extra heart sounds?
S3S4
What is a murmur?
Turbulent blood flow
What is a bruit?
Anywhere else in the body (outside the heart) where there is turbulent blood flow
Can you feel a bruit?
No
Is a bruit a low or high pitched sound? So what side of the stethoscope would you use?
Bruit are LOW pitched, so you use the bell of the stethoscope
Can you feel a thrill?
Yes
What is a thrill?
Turbulent blood flow you can feel
For a friction rub: How would you be able to tell the difference between a friction rub that is in the lungs vs. in the heart?
Ask them to old their breath; if you can still hear it when they are holding their breath, that means the friction rub is in the heart
When you see/feel heaves and lifts, what does that tell you?
The heart is having to work very hard
What does it mean when you have a pulse deficit?
There is a difference in the HR monitor pulse and the manual pulse
What type of patient might you see a pulse deficit in?
Patients who have A-Fib
What is syncope?
Fainting
What is the inspection sequence for the heart and neck?
Inspection
Palpation
Percussion
Auscultation
What are the two main things you look for during inspection?
- Apical impulse
- Heaves/lifts
Inspection: Who can you see apical impulses in better?
Children
Inspection: When do heaves/lifts occur?
Ventricular hypertrophy
Heaves/lifts: Where is the right ventricular seen?
Sternal boarder
Heaves/lifts: Where is the left ventricular seen?
At the apex
What are the 3 main areas for palpation?
Carotid arteries
Apical impulse
Precordium
How do you palpate the carotid arteries?
- Avoid excessive pressure
- Only palpate one at a time
- Note couture and amplitude
- Both sides should be equal
How do you palpate the apical impulse?
- Use one finger pad
- Asks patients to exhale and hold
- May need to roll client to the LEFT
What are the four apical pulse findings?
Location
Size: 1X2 cm
Amplitude: Short, mental tap
Duration
The apical pulse can be difficult to find. 25-40% of adults you can’t find it when they are in a supine position. What position can you move them to so that you can feel it better. This increases the chances of finding it to 50-73%.
Left lateral position
What other types of patients may have “difficult to find” apical pulses?
Obese patients and those with thick chest walls
How do you palpate the precordium?
Use palmar aspect of 4 fingers
What do you palpate for the precordium?
Apex
Left sternal boarder
Base
What do we do for percussion when checking the heart and neck?
Nothing
What do we auscultate for the heart and neck?
Heart and caarotid arteries
What are the 5 steps to heart auscultation?
- Start with diaphragm
- Note regularity of rhythm
- Identify S1 and S2
- Listen for extra heart sounds and murmurs
- Repeat with the bell
What type of clients would need to have the carotid arteries auscultated?
Clients with CAD risk factors
For carotid artery auscultation, when would a bruit be heard?
When 1/2 to 2/3 of the artery is occluded; the bruit will fade after it is stopped being occluded
How do you auscultate the carotid artery?
- Keep neck in neutral position
- Lightly apply the bell over:
- angle of jaw
- Midcervical area
- Base of neck
