Test2-Heart Notes from Mrs. Scoby-MJ

Question 1

What does the right side of the heart deal with?

Answer 1

Pulmonary circulation

Question 2

What does the left side of the heart deal with?

Answer 2

Systemic circulation

Question 3

What side works harder and why?

Answer 3

Systemic side (so left side), this is the side the pumps all the blood around the body

Question 4

What are the 4 chambers of the heart?

Answer 4

Right atrium (Pulmonary)
Right ventricle (pulmonary)
Left atrium (systemic)
Left ventricle (systemic)

Question 5

What are the different vessels of the heart?

Answer 5

Superior and Inferior vena cava
Pulmonary artery
Pulmonary veins
Aorta
Tricuspid valve (AV valve)
Bicuspid (mitral/AV valve)
Pulmonic valve
Aortic valve

Question 6

What is the shape of the heart..as in where is the apex and base located?

Answer 6

Apex is the inferior end

Base is at the top (so superior)

Question 7

During S1, what is happening to the ventricles and valves?

Answer 7

Ventricles contract (squeeze)
AV close (refilling)

Question 8

During S2, what is happening to the ventricles and valves?

Answer 8

Atrias contract (squeeze)
Semi-lunar valves close (refilling)

Question 9

Where can S3 sounds be heard?

Answer 9

Renal failure, CHF, fluid overload, and pregnant women

*Think S3, need to pee (not literal, but makes you think lots of fluid)

Question 10

Where can S4 sounds be heard?

Answer 10

Cardiomegaly and CAD

Question 11

What happens during a split S1?

Answer 11

AV valves don’t close at exactly the same time

Question 12

What happens during a split S2?

Answer 12

Semilunar valves don’t close at exactly the same time

Question 13

What is the flow of blood?

Answer 13

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

Question 14

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?

Answer 14

Atrial kick

Question 15

What are murmurs?

Answer 15

A turbulent sound of blood going through the vessels

Question 16

Are all murmurs pathologic?

Answer 16

No; some are physiologic

Question 17

What are the two kinds of murmurs?

Answer 17

Systolic and diastolic

Question 18

What are the systolic murmurs?

Answer 18

Mitral regurgitation
Physiologic murmur
Aortic stenosis (stiff)
Mitral valve prolapse

Question 19

What are the diastolic murmurs?

Answer 19

Aortic regurgitation

Mitral stenosis

Question 20

Out of the systolic and diastolic murmurs, which one is more of a big deal?

Answer 20

Diastolic

Question 21

What is a barely audible murmur?

Answer 21

2

Question 22

What is a loud murmur?

Answer 22

6

Question 23

Does the pulmonary or systemic side work harder?

Answer 23

Systemic–stronger because pushing against blood pressure and delivers blood through the rest of the body

Question 24

Do the vessels that dump blood into the right atrium have any valves/doors to enter/exit? What does this mean?

Answer 24

No; once it is in it is going to the right atrium and if the right atrium is blocked up, problems may occur

Question 25

What would happen if the right atrium is blocked up and the blood backs up into the superior vena cava?

Answer 25

JVD (jugular vein distention)

Question 26

What would happen if the right atrium is blocked up and the blood backs up into the inferior vena cava?

Answer 26

Lower extremity swelling

Question 27

What is the only artery in the body that carries deoxygenated blood?

Answer 27

Pulmonary artery

Question 28

Do pulmonary veins hold oxygenated blood?

Answer 28

Yes

Question 29

What is the "workhorse of the heart"?

Answer 29

Left ventricle

Question 30

What is the atrial kick?

Answer 30

Last 25% of the valve emptying to fully empty

Question 31

Is this a systolic or diastolic murmur: Physiological murmur

Answer 31

Systolic

Question 32

Is this a systolic or diastolic murmur: | Aortic regurgitation

Answer 32

Diastolic

Question 33

Is this a systolic or diastolic murmur: | Mitral regurgitation

Answer 33

Systolic

Question 34

Is this a systolic or diastolic murmur: | Mitral valve prolapse

Answer 34

Systolic

Question 35

Is this a systolic or diastolic murmur: | Mitral stenosis

Answer 35

Diastolic

Question 36

Is this a systolic or diastolic murmur: | Aortic stenosis

Answer 36

Systolic

Question 37

During inspection, what do we look for?

Answer 37

Inspect the precordium (the area covering the heart and vessels: front of chest)

Question 38

What do you look for during inspection of the chest area?

Answer 38

Deformities Scars (previous surgeries) Heaves/lifts (actually seeing the heart beat through the skin) Shape of chest

Question 39

When you auscultate, what is the order you go from start to finish?

Answer 39

``` 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

Question 40

Where do you find the aortic area?

Answer 40

Right chest wall Second intercostal space Right sternal border

Question 41

Where do you find the pulmonic area?

Answer 41

Left sternal border | 2nd intercostal space

Question 42

Where do you find Erbs point?

Answer 42

3rd intercostal space | Left sternal border

Question 43

What is the significance of Erbs point?

Answer 43

This is where you hear S1 and S2 at the same volume (the apical pulse)

Question 44

Where do you find the tricuspid area?

Answer 44

5th intercostal space | Left sternal border

Question 45

Where do you find the mitral area?

Answer 45

5th intercostal space, mid-clavicular line

Question 46

What is PMI and why is it important?

Answer 46

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

Question 47

QUIZ: Doc picked up a chart and wrote they had aortic stenosis. What kind of murmur is this?

Answer 47

Systolic

Question 48

QUIZ: If a patient has mitral regurgitation, what kind of murmur is this? Where do you listen?

Answer 48

Systolic; mitral area (5th intercostal space, mid-clavicular line) *Can also listen under left axilla

Question 49

QUIZ: What is the strongest side of the heart and why?

Answer 49

Left side; it has to pump harder

Question 50

QUIZ: When there is fluid overload in the right atria, where does all the blood go?

Answer 50

Back up into the superior (JVT) &/or inferior vena cava (swelling in lower extremities [legs])

Question 51

QUIZ: When ausculating a patients chest, what landmarks need to be identified?

Answer 51

Sternal notch Angle of louis 2nd intercostal space

Question 52

QUIZ: What is happening to the ventricles and valves in S1?

Answer 52

Ventricle contraction | AV valves closing

Question 53

QUIZ: What is happening to the atria and valves in S2?

Answer 53

Atria contracting | Semilunar valves closing

Question 54

QUIZ: Where is the PMI?

Answer 54

5th intercostal space on the left