Test2-Heart Notes from Mrs. Scoby-MJ Flashcards
What does the right side of the heart deal with?
Pulmonary circulation
What does the left side of the heart deal with?
Systemic circulation
What side works harder and why?
Systemic side (so left side), this is the side the pumps all the blood around the body
What are the 4 chambers of the heart?
Right atrium (Pulmonary) Right ventricle (pulmonary) Left atrium (systemic) Left ventricle (systemic)
What are the different vessels of the heart?
Superior and Inferior vena cava Pulmonary artery Pulmonary veins Aorta Tricuspid valve (AV valve) Bicuspid (mitral/AV valve) Pulmonic valve Aortic valve
What is the shape of the heart..as in where is the apex and base located?
Apex is the inferior end
Base is at the top (so superior)
During S1, what is happening to the ventricles and valves?
Ventricles contract (squeeze) AV close (refilling)
During S2, what is happening to the ventricles and valves?
Atrias contract (squeeze) Semi-lunar valves close (refilling)
Where can S3 sounds be heard?
Renal failure, CHF, fluid overload, and pregnant women
*Think S3, need to pee (not literal, but makes you think lots of fluid)
Where can S4 sounds be heard?
Cardiomegaly and CAD
What happens during a split S1?
AV valves don’t close at exactly the same time
What happens during a split S2?
Semilunar valves don’t close at exactly the same time
What is the flow of blood?
Superior and inferior vena cava--> RA--> Tricuspid valve (AV valve)--> RV--> Pulmonic Valve (semilunar)--> Pulmonary artery--> Lungs--> Pulmonary veins--> Left atrium--> Bicuspid valve (AV valve/mitral)--> Left ventricle--> Aortic Valve (semilunar)--> Aorta--> Body
What is it called when there is that last 25% of blood the needs to get out of the atrium so it contracts a little to push all the blood in?
Atrial kick
What are murmurs?
A turbulent sound of blood going through the vessels
Are all murmurs pathologic?
No; some are physiologic
What are the two kinds of murmurs?
Systolic and diastolic
What are the systolic murmurs?
Mitral regurgitation
Physiologic murmur
Aortic stenosis (stiff)
Mitral valve prolapse
What are the diastolic murmurs?
Aortic regurgitation
Mitral stenosis
Out of the systolic and diastolic murmurs, which one is more of a big deal?
Diastolic
What is a barely audible murmur?
2
What is a loud murmur?
6
Does the pulmonary or systemic side work harder?
Systemic–stronger because pushing against blood pressure and delivers blood through the rest of the body
Do the vessels that dump blood into the right atrium have any valves/doors to enter/exit? What does this mean?
No; once it is in it is going to the right atrium and if the right atrium is blocked up, problems may occur
What would happen if the right atrium is blocked up and the blood backs up into the superior vena cava?
JVD (jugular vein distention)
What would happen if the right atrium is blocked up and the blood backs up into the inferior vena cava?
Lower extremity swelling
What is the only artery in the body that carries deoxygenated blood?
Pulmonary artery
Do pulmonary veins hold oxygenated blood?
Yes
What is the “workhorse of the heart”?
Left ventricle
What is the atrial kick?
Last 25% of the valve emptying to fully empty
Is this a systolic or diastolic murmur: Physiological murmur
Systolic
Is this a systolic or diastolic murmur:
Aortic regurgitation
Diastolic
Is this a systolic or diastolic murmur:
Mitral regurgitation
Systolic
Is this a systolic or diastolic murmur:
Mitral valve prolapse
Systolic
Is this a systolic or diastolic murmur:
Mitral stenosis
Diastolic
Is this a systolic or diastolic murmur:
Aortic stenosis
Systolic
During inspection, what do we look for?
Inspect the precordium (the area covering the heart and vessels: front of chest)
What do you look for during inspection of the chest area?
Deformities
Scars (previous surgeries)
Heaves/lifts (actually seeing the heart beat through the skin)
Shape of chest
When you auscultate, what is the order you go from start to finish?
Aortic area Pulmonic area Erbs point Tricuspid Mitral
From start to finish use the diaphragm, then go back up backwards listening in the same locations using the bell of the stethoscope
Where do you find the aortic area?
Right chest wall
Second intercostal space
Right sternal border
Where do you find the pulmonic area?
Left sternal border
2nd intercostal space
Where do you find Erbs point?
3rd intercostal space
Left sternal border
What is the significance of Erbs point?
This is where you hear S1 and S2 at the same volume (the apical pulse)
Where do you find the tricuspid area?
5th intercostal space
Left sternal border
Where do you find the mitral area?
5th intercostal space, mid-clavicular line
What is PMI and why is it important?
Point of maximal intensity; if this is far to the outside there is possibly an enlarged heart. This can also be seen in pregnancy since the entire diaphragm is pushed up
QUIZ: Doc picked up a chart and wrote they had aortic stenosis. What kind of murmur is this?
Systolic
QUIZ: If a patient has mitral regurgitation, what kind of murmur is this? Where do you listen?
Systolic; mitral area (5th intercostal space, mid-clavicular line)
*Can also listen under left axilla
QUIZ: What is the strongest side of the heart and why?
Left side; it has to pump harder
QUIZ: When there is fluid overload in the right atria, where does all the blood go?
Back up into the superior (JVT) &/or inferior vena cava (swelling in lower extremities [legs])
QUIZ: When ausculating a patients chest, what landmarks need to be identified?
Sternal notch
Angle of louis
2nd intercostal space
QUIZ: What is happening to the ventricles and valves in S1?
Ventricle contraction
AV valves closing
QUIZ: What is happening to the atria and valves in S2?
Atria contracting
Semilunar valves closing
QUIZ: Where is the PMI?
5th intercostal space on the left
