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Advanced Health Assessment > The Heart > Flashcards

The Heart Flashcards

1
Q

Where is the SA node located?

A

At the juncture of the superior vena cava and the right atrium

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2
Q

What occurs to the impulse once it gets to the AV node?

A

It is slowed before being transmitted to the bundle of his and parking fibers

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3
Q

How od cardiac impulses spread?

A

From endocardium to epicardium

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4
Q

At what level does the SNS enter for cardiac innervation?

A

T1-T5

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5
Q

What cranial nerve innervated the heart causing PSNS responses?

A

Vagus nerve

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6
Q

What chamber of the heart is most anterior?

A

Right ventricle

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7
Q

What is left ventricular apex called and where is it located?

A

Point of Maximal Impulse (PMI) fifth intercostal space midclavicular line

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8
Q

What are the only normal sounds that should be heard when auscultating the heart?

A

Only the closing of the heart valves

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9
Q

What produces the first heart sound (S1)?

A

Closing of the AV valves
Tricuspid
Mitral

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10
Q

What produces the second heart sound (S2)?

A

Closing of the semilunar valves
Aortic
Pulmonic

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11
Q

When can opening valves be heard?

A

When they are damaged

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12
Q

When is an opening snap heard versus an ejection click?

A

AV valve = opening snap

Semilunar valve = ejection click

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13
Q

What is the time between the closure of the AV valves and the opening of the semilunar valves?

A

Isovolumic contraction

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14
Q

What is the time between the opening and the closing of the semilunar valves?

A

The systolic period of ejection

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15
Q

What is the S2 heart sound split into?

A

A2

P2

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16
Q

What is the time between the closure of the semilunar valves and the opening of the AV valves?

A

Isovolumic relaxation

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17
Q

When does rapid filling of the ventricle occur?

A

When the AV valves open, 80% filling occurs at this point

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18
Q

When is S3 heard if present?

A

After S2 (Kentucky)

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19
Q

What population is S3 heart sound normal?

A

Children and young adults

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20
Q

What can a S3 heart sound indicate in adults greater than the age of 30?

A

Volume overload to the ventricles
Valvular regurgitation
CHF

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21
Q

When might a S4 heart sound be heard?

A

Prior to S1 (Tennessee)

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22
Q

What populations might a S4 heart sound be considered a normal finding?

A

Children and young adults

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23
Q

If a S4 heart sound is heard in an individual over the age of 30 what pathology is suspected?

A

It is indicative of a noncompliant or stiff ventricle

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24
Q

Where is S1 heard the best?

A

At the apex of the heart

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25
Q

Where might splitting of S1 be heard?

A

The tricuspid areas

26
Q

Where is S2 heard the best?

A

At the base of the heart

27
Q

How does inspiration affect the distance between A2 and P2?

A

The split is widened during inspiration

28
Q

What does the dicrotic notch represent?

A

The closure of the aortic valve

29
Q

What measures the lateral pressure exerted by a column of blood against the arterial wall?

A

Arterial blood pressure

30
Q

What determines blood pressure?

A

The volume ejected
Distensibility
Viscosity of blood
Pressure in vessels after last ejection

31
Q

In a healthy adult, which extremity is BP higher?

A

SPB in legs is 15-20mmHg greater than in the arms

32
Q

What is the difference between the systolic pressure and the diastolic pressure?

A

The pulse pressure

33
Q

How much is a normal pulse pressure?

A

There is normally a 10mmHg decrease in SBP during quiet inspiration

34
Q

What is the most common cause of right sided heart failure?

A

Left sided heart failure

35
Q

What causes angina?

A

Consequence of hypoxia of the myocardium resulting from an imbalance of coronary supply and myocardial demand

36
Q

What are four types of syncope?

A

Postural
Vasovagal
Carotid sinus
Posttussive

37
Q

What is xanthomata and what pathology is it indicative of?

A

Stony hard slightly yellowish masses, hypercholesterolemia

38
Q

What is Lichtstein’s sign and what pathology is indicated?

A

Ear lobe creases seen in patients with CAD/CHF

39
Q

What is considered normal BP?

A

Systolic: less than 120
Diastolic: less than 80

40
Q

What is considered preHTN BP?

A

Systolic: 120-139
Diastolic: 80-89

41
Q

What is considered stage one HTN?

A

Systolic: 140-159
Diastolic: 90-99

42
Q

What is considered stage 2 HTN?

A

Systolic: greater than 160
Diastolic: greater than 100

43
Q

How can jugular venous pressure be estimated?

A

Adding 5cmH2O to the amount calculated above the sternal angle
Measure 3cmH2O + 5 = 8cmH2O estimated JVP

44
Q

Where is the cardiac rate typically assessed?

A

Radial pulse

45
Q

What sound is typically heard before the carotid pulse is felt?

A

S1

46
Q

Typically what is the size of the PMI?

A

2-3cm in diameter

47
Q

When might a thrill be felt?

A

Indicates a large murmur is present

48
Q

What heart sounds are heard better with the diaphragm of the stethoscope?

A

High pitched sounds such as:
Valve closure
Systolic events
Regurgitant murmurs

49
Q

What sounds are typically heard better with the bell of the stethoscope?

A

Low pitched sounds such as:
Gallop rhythms
Murmur AV stenosis

50
Q

What are the five auscultatory areas of the heart?

A 
Aortic
Pulmonic
Erb's point
Tricuspid
Mitral
51
Q

Where is the aortic heart sound located?

A

Right side, second intercostal space, at the sternal border

52
Q

Where is the pulmonic heart sound located?

A

Left side, second intercostal space, at the sternal border

53
Q

Where is Erb’s point located?

A

Left side, third intercostal space, sternal border

54
Q

Where is the tricuspid heart sound located?

A

Left side, fourth intercostal space, sternal border

55
Q

Where is the mitral heart sound located?

A

Left side, fifth intercostal space mid-clavicular line

56
Q

When is splitting of S2 beast heard?

A

During inspiration at the pulmonic area

57
Q

At what grade murmur does a thrill become apparent?

A

Grade IV

58
Q

What would make the mitral component of S1 louder?

A

A faster rate of rise of left ventricular pressure and increased contractility

59
Q

What would make S1 as a whole louder?

A

Stiffened AV valves

60
Q

What would increase the intensity of S2?

A

Increased SBP

61
Q

How does fibrosis affect AV valves versus semilunar valves?

A

Semilunar valves are morphologically different fibrosis does not cause an increase in intensity as in closure of the AV valve

Advanced Health Assessment (7 decks)

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