Wk 3 Heart And Peripheral Vascular Flashcards by Jade Ring

Which part of the heart is the apex?
Base?

Apex = bottom
Base = Top

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Heart wall layers from inner

Endocardium
Myocardium
Pericardium

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Atrioventricular valves

Semilunar valves

Tricuspid/ mitral

Pulmonic / aortic

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Question: What is the “S1” heart sound?

Answer: “first heart sound” or “lub,” marks the beginning of systole and is associated with the closure of the atrioventricular (AV) valves.

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Which valves are responsible for the “S1” heart sound?

Closure of the AV valves, specifically the Mitral valve and the Tricuspid valve.

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The 2nd heart sound

Which valves closure is responsible

Sound made

Pulmonic and aortic

Dubb

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1st heart sound

What makes the noise

Where can we ausculate

Bicuspid (Mitral) & Tricuspid

Tricuspid = 4th intercostal space,Left side, sternal border

Mitral (bicuspid) = 5th intercostal space, left side, midcavicular

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3rd heart sound

Describe sound

Cause

Who it maybe normal for

Lub du bub

Rapid filling of the ventricles

<40

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4th heart sound

Describe

Cause / disease associated

Be lub duplicate

Stuff ventricle due to Hypertension

Ventricle cannot fill properly and thus has a reduced volume of blood to expel

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With pericarditis, there is often an abnormal heart sound called _________. This sound is created when the inflamed pericardial layers rub against each other

pericardial friction rub

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Murmur

An extra noise heard when examining the heart.

Maybe innocent or caused by heart disease

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Stenosis is…

When a valve doesn’t open properly

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Regurgitation is….

When a valve doesn’t close properly

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How is the Jugglar veins “Pulse” felt as….

A wave

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A stool softener may be given to a heart attack victim

True or False

True

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With heart failure there maybe Cyanosis & Pallor

Which is Chronic and which is Acute

Cyanosis= Acute
Pallor = Chronic

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Where is edema usually first seen

Legs

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Qualify edema

1+ ….
2+ ….
3 + ……

1+ = 2mm
2+ = 4mm
3+ = 6mm

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Nocturia is often seen with heart or lung problems

Heart

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High BP, Smoking, High LDL, obesity, DM are all risk factors for…

Cardiac problems

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Give examples of Primary & Secondary prevention for heart problems

Primary. Exercise, Healthy Diet, No smoking/ Drinking

Secondary: Screening for hypertension

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Objective Data: Physical Exam

Palpate the carotid arteries…..

How?

One at a time

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Objective Data: Physical Exam

When auscultating the Carotid artery with the Bell, what abnormal sound are you looking for.

Describe it / what is its cause

Bruit

Swishing sound.

Narrowing of artery

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early systole, and is loudest near the apex of the heart. Describes this heart sound

S¹

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Carotid Doppler to estimate if it is narrowed. If so...

Stent is placed inside the artery

Inspect Jugglar vein for...... Which is associated with Heart Failure

Distention

This lung sound is associated with Heart Failure

Fine crackles

AFib causes _____ solution is to give an anticoagulant What can happen if not treated

Clots Stroke

Any rare findings what is the first thing to do in an assessment

POLDCARTS History of Present Illness

FAST is for which disease

Stroke Face, arms, speech, time

Sever valve disease is....

A murmur

Which is the best posistion to hear S³ (Kentucky)

Left lateral

Give a reason valves may not close properly

Stiffening from Old Age

Arteriosclerosis

Loss of flexibility

Atherosclerosis is a type of arteriosclerosis Describe Atherosclerosis

Plaque build up

Lymph nodes get smaller or larger with age

Smaller

Modeling

Spotty skin

Edema +1 pitting (2mm) is a ___% increase of fluid

What is the maximum level of edema that is so sever it doesn't have pitting

Brawny Edema

A positive Allen's test signifies what

The paitent has sufficient blood supply to upper extremities

When auscultating a AV shunt or fistula access for Bruit & Thrill. These are normal/ healthy findings? Yes or No

Yes

Arteriovenous fistula

An abnormal connection between an artery and a vein. Arteriovenous (AV) fistulas usually occur in the legs.

An AV fistula is a connection that's made between an artery and a vein for....

dialysis access

Bruit is this type of sound

Swishing

Thrill can be inspected how?

Palpate. Palmer surface of hand and feel vibrations

Is lack of popteal pulse normal If you use a doppler to find this pulse, how do you chart this?

Yes Positive with doppler

Pulsus bigeminus is.....

cardiovascular phenomenon characterized by groups of two heartbeats close together followed by a longer pause

Raynauds Syndrome is an autoimmune disease that reacts to____ Treat with steroids

Cold weather

#1 cause of preventable death in hospitals....

Pulmonary embolism from DVT

Leathery skin, swelling lower legs, Nee varicose veins, statis ulcer... Describe this disease

Chronic Venus Disease

To help Venus disease place legs in this posistion

Elevated

To help Arterial Disease put legs in this position

Dangling

An Unna boot is a compression dressing made by wrapping layers of gauze around your leg and foot. The Unna boot is used for (Venus Status Ulcers or peripheral Artery Disease) The compression of the dressing helps improve blood flow in your lower leg.

Venus Status Ulcers

Use a unaboot for (Venus or Artery)

Venus

Venus ablation seals veins from the inside to improve blood flow from these two vein disease

from varicose veins or chronic venous insufficiency

Perferial Artery Disease PAD lower extremity problem. Poor wound healing, burning/ tingling, cramps, slow nail growth and Claudication Describe teachings to help

Beware falls, injury to foot, wear shoes

Rubor

Flushed Red

Claudication, Pain with exercise, low pulses, Thin shiny hairless skin, Cool Temps, ulcers on pressure points in feet Describes (Arterial or Venus)

Arterial

Pain increases when legs dependent, lower extremities edema, Brown discoloration of skin, Ankel Ulcerations, Skin temp normal, Pulse present but difficult to palpate due to edema (Arterial or Venus)

Venous

Activation of the sympathetic nervous system (increases/ decreases) heart rate, (constricts / dilates) blood vessels, and (diminish / enhance) the force of heart contractions

Increase Constricts Enhances

parasympathetic nervous system (slows/ speeds up) the heart rate, (dilates/ constricts) blood vessels, and (reduces/ increases) the force of heart contractions.

Slows Dilates Reduces

Often referred to as "lub," S1 is the sound of the closing of the ________ valves (tricuspid and mitral) at the beginning of ventricular (systole / diastole) It marks the start of ventricular contraction and the ejection of blood into the _______ & _______circulation.

atrioventricular Systole pulmonary and systemic

is an extra heart sound that occurs during early diastole, typically associated with rapid filling of the ventricles. can be a sign of heart conditions like ______ & ________

S3 heart failure or volume overload

extra heart sound that occurs in late diastole It is sometimes called an "atrial gallop" and is associated with stiff or non-compliant ventricles. Can be a sign of these diseases

S4 hypertensive heart disease or ventricular hypertrophy

Edema swelling occurs when there is an excess of ______

interstitial fluid

Often referred to as "dub," S2 is the sound of the closing of the_____ valves (aortic and pulmonic) at the end of ventricular systole. It marks the end of ventricular contraction and the closure of the valves to prevent blood from flowing back into the ventricles.

Semilunar

Negative allen's test is associated with (veins / arteries) and reduced blood flow.

Arteries

Apex (Bottom) of the heart this is heard better

S¹

Base (Top) of heart this is heard better

S²

membranous partition between two body cavities or two parts of an organ, especially that between the lungs.

mediastinum

membranous partition between two body cavities or two parts of an organ, especially that between the lungs.

mediastinum

The cordiatendian attach to ______ helping to prevent leakage through the AV valves during systole.

Papillary muscles

MI could make the chordate tendonia not open and close valves properly. Which sound would this be heard as

Murmur

S³ has this "state" sound S⁴... Correct

S³ Kentucky S⁴ Tennessee

A murmur is .... Correct

When a valve doesn't open or close properly

Afterload =

Blood pressure

Preload =

Amount of fluid

Does dehydration make heart rate go (up / down)

Parasympathetic involves the stimulation of the ____ nerve which makes heart rate / Blood pressure (increase/ decrease)

Vagus Decrease

Valsalva maneuver stimulates _____ nerve and decreases heart rate / BP Valsalva maneuver is similar to the force used when deficating True or False

Vagus True

A paitent has pallor associated with anemia Will heart rate be (elevated / decreased)

Elevated In attempt to move more blood around

With nocturia the Sympathetic Nervous System is decreased which releases

Water and sodium

Fine crackles associated with Heart Failure is AKA

Rales

Endocarditis: An infection of the heart's inner lining, usually involving the heart valves How does this infection usually occur Causes this type of atypical heart sound

Central Line Catheter Murmur

____ sound occurs when the atria contract, forcing blood into non-compliant ventricle

S⁴

Lymphatic nodes should be smaller than

1cm

Which have valves (veins/ arteries)

Veins

Pulse 0 1 2 3 4 Correct

0 absent 1 weak 2 normal 3 Bounding 4. Increased

When do we do Allen's test

When drawing arterial blood

Difference between a fistula and a shunt.

Fistula uses graft material to attach an artery to a vein Shunt connects them without the graft material

Manual compression test is for... 1. Compress vein 2. Feel for wave A. No wave felt B. Wave felt No wave

Vein function A. No wave felt = Competent valve B. Wave felt = incompetent valve

Homan's sign: Test for what Supine, flex foot towards tibia, PAIN = (possible disease)

Valves in veins not functioning Deep vein thrombosis Tendinitis Muscle injury

Pulse amplitude 1+ 2+ 3+ 4+

1+ = Weak Thready 2+ = Normal 3+ = Full 4 + = Bounding

Problems with lymph nodes can cause this. Unilateral, near lymph nodes

Lymphedema

Raynaud’s syndrome is an autoimmune disorder that is aggrevated by the cold. What kind of symptom does it present

Decreased circulation in hands / fingers

Swollen and red leg is associated with this disease

DVT

Does DVT always have swelling and redness associated with it?

No, sometimes only a fever is present

Symptoms: Arterial or Venous Claudication (Pain, commonly in the legs, caused by too little blood flow, usually during exercise)

Arterial

Symptom: Arterial or Venous Pain increases when legs are dependent (standing or sitting)

Venous

Symptom: Arterial or Venous Pain with exercise or at rest

Arterial

Symptom: Arterial or Venous Lower extremity edema

Venous

Symptom: Arterial or Venous Lower or absent pulse

Arterial

Symptom: Arterial or Venous Brown discoloration of skin

Venous

Symptom: Arterial or Venous Thin, shiny, hairless skin

Arterial

Symptom: Arterial or Venous Ankle ulcerations

Venous

Symptom: Arterial or Venous Cool skin temperature

Arterial

Symptom: Arterial or Venous Skin temperature normal

Venous

Symptom: Arterial or Venous on pressure points of feet

Arterial

Symptom: Arterial or Venous Pulse present but difficult to palpate due to edema

Venous

What do compression socks / unaboots do to venous return?

Increases it

In arterial disease Foot elevated = (Pallor/ Rubor) Foot Dependent = (Pallor/ Rubor)

Foot elevated = Pallor Foot Dependent = Rubor

Lub de bub is the sound associated with this extra heart sound

S³ (Kentucky)

Extra heart sound Results from increased atrial pressure leading to increased flow rates. CHF MOST COMMON CAUSE OF THIS EXTRA HEART SOUND

S³

Extra heart sound Low frequency sound in presystolic portion of diastole Belub dup

S⁴

Starling law: The more the heart is filled during diastole the more forcefully it contracts Is associated with (Afterload / Preload)

Preload

Stimulates Adrenal Medulla to secrete Catecholamines to interact with adrenergic receptors in heart and blood vessels (Sympathetic/ Parasympathetic)

Sympathetic

______ represents ventricular filling, and ____ represents ventricular contraction/ejection

Diastole / systole

Carotid artery pulse coincides with (S¹ or S²)

S¹

Harsh, blowing, musical, rumbling describe the quality of which heart sound

Murmur

Ejection murmur (due to blood flow through a narrowed vessel or irregular valve) Regurgitation murmurs happen when

Systolic murmur

These murmurs happen when the heart muscle relaxes between beats Due to narrowing (stenosis) of the mitral or Tricuspid valve Or Regurgitation of the aortic or pulmonary arteries

Diastolic

Murmurs caused by valvular defects Midsystolic ejection murmurs

Semilunar valves stenosis Aortic & pulmonic

Murmurs caused by valvular defects Diastolic rumbles of av valves

Av valves stenosis

Murmurs caused by valvular defects Pansystolic regurgitation murmurs

Semilunar Valve regurgitation

Murmurs caused by valvular defects Early diastolic murmurs

Semilunar Valve regurgitation Aortic & Pulmonic

Diaphragmatic excursion less than 3-5 cm may indicate which diseases

Pneumonia Pneumothorax

Bronchial vesicular sound heard over

Tracheal, high pitched, loud

Brochvesicular heard where

1 & 2nd ICS at sternal boarder Post: to T4 Medium intensity

Vesicular sounds are heard in most of the lung fields True or False

True

Which condition is associated with Marfans syndrome

Pectus excavatum

Pleural Rub Because these sounds occur whenever the patient's chest wall moves, they appearon inspiration and expiration Name diseases associated with it

pneumonia, pulmonary embolism, and pleurisy

rhonchi aka wheezes are (Continuous/ Discontinuous)

Continous

A (positive / negative) Allen's test is when the blood returns in less than 6 seconds. It is a good sign

Positive

Stethoscope Use Diaphragm (Wide Part) is used to listen to (Low / High) Pitched sounds (S1,S2,S3,S4) Bell (small part) is used to listen to (Low / High) pitched sounds (S1,S2,S3,S4)

Diaphragm = High Pitched S1 & S2 Bell = Low S3, S4