Cardiovascular system Flashcards Preview

Clinical Methods Final > Cardiovascular system > Flashcards

Flashcards in Cardiovascular system Deck (54):
1

where is the base of the heart

right ventricle meets pulmonary artery superiorly

2

where is the point of maximal impulse (PMI) ?

apex of the heart

3

trace the flow of blood through the heart

superior VC > right atrium > tricuspid valve > right ventricle > pulmonary valve > pulmonary artery> lungs> pulmonary veins > left atrium > mitral valve > Left ventricle > aortic valve > aorta

4

what are the positions of the valves during sytole?

aortic valve = open
mitral valve = closed

5

what are the positions of the valves during diastole?

aortic valve = closed
mitral valve = open

6

what produces heart sound S1?

closing of mitral valve (listen with diaphragm)

7

what produces heart sound S2?

closing of aorta valve (listen with diaphragm)

8

what does heart sound S3 represent?

S3 gallop (listen with bell)
rapid deceleration of column of blood against ventricular wall

9

what does heart sound S4

usually happens just before S1 (listen with bell)
marks atrial contraction

10

what causes splitting of S2?

occurs with inspiration
aortic valve and pulmonic valve closure

11

What causes the "harsh" sounding heart murmur?

a stenotic valve
abnormally narrow valvular oriface
(i.e. aortic stenosis)

12

Where is the mital valve heard best?

cardiac apex (5th intercostal space)

13

where is the tricuspid valve heard best?

LLSB (lower left substernal border)

14

where is the pulmonic valve heard best?

Left 2nd & 3 rd intercostal space (close to sternum)

15

where is the aortic valve heard best?

Right 2nd intercostal space

16

Which node has a delay in conduction?

AV node

17

the p wave is associated with what?

atrial depolarization

18

the QRS complex is associated with what?

ventricular depolarization
heart sound S1 (R wave)
left ventricular end diastolic volume

19

the T wave is associated with what

ventricular repolarization
end of T wave (S2 sound)
left ventricular end systolic volume

20

what is the Q wave?

1st downward deflection
septal depolarization

21

what is the R wave?

ventricular depolarization

22

define cardiac output

volume of blood ejected each ventricle in 1 min

23

define stroke volume

volume of blood ejected with each heartbeat

24

define preload

the load that stretches the cardiac muscle before contraction.
volume of blood in the RV at end of diastole

25

the following increase preload

1. inspiration
2. increase volume
3. CHF

26

the following decrease preload

1. exhalation
2. decreased LV output
3. pooling of blood (cap. bed/venous system)

27

define myocardial contractility

refers to the ability of the cardiac muscle, when given a load, to shorten

28

what increase myocardial contractility

stimulation from sympathetic nervous system

29

What decreases myocardial contractility

impaired blood flow (O2 delivery) to myocardium

30

what is afterload?

degree of vascular resistance (tone in walls of artial system) to ventricular contraction

31

what is arterial pulse?

pressure wave felt on exam by the contraction of the LV ejecting a volume of blood into the aorta then into arterial system

32

what is true of jugular venous pressure?

1. height in venous column of blood in the internal jugular vein
2. reflects R. atrial pressure
3. clinical indicator right hear dynamics
4. measured on right side, more direct path to right atrium

33

how is JVP (jugular venous pressure) measured?

1) make patient comfortable. Raise head slightly (pillow) to relax the sternomastoid ms.
2)Raise head of bead (HOB) of exam table to 30 degrees and turn patients head away from side inspected.
3)Examine both sides of neck. Identify external jugular vein (EJ) then find the internal jugular pulsations.
4) Raise or lower the HOB until oscillations of IJV are seen in the lower half of the neck.
5) Focus on the right internal jugular vein. Look for pulsations in the suprasternal notch.
6) Identify the highest point of pulsation in the right IJV. Extend card horizontally and ruler vertically from sternal angle and form a right angle. Distance on ruler in cm=JVP

34

what is paroxysmal nocturnal dyspnea?

suddent dyspnea or orthopnea that awakens pt. feel like they need to open a window to get air

35

what are some indicationos of obstructive sleep apnea?

snoring
sleepy during day
complete obstruction of airway more than 10 seconds while sleeping

36

what are non modifiable risk factors for cardiac disease?

age
gender
heredity

37

how far do you inflate the cuff for B/P?

30 mmHg

38

what is a thrill

palpable humming virbration

39

what is a bruit

murmur like sound in vasculature, use diaphragm of stethoscope

40

True or false. Brachial arteries reflect aortic pulsations more accurately

False. carotid artery. brachial when carotid occluded

41

PMI is how big in diameter? and last how long?

a. 2.5 cm
b. first 2/3 of systole

42

Which part of stethoscope do you use to hear high pitch sound? low pitch?

High - diaphragm
low - bell

43

what is true of S1

is first heart sound
hear mostly the mitral valve;
Heard best near heart’s apex over the mitral area with diaphragm

44

What is true of S2

second heart sound
Long diastolic intervals separates one pair from another
Heard best near heart’s base, over pulmonic area

45

what is true of S3

Heard best with bell over mitral area
May be seen in anemia, fever, pregnancy, thyrotoxicosis

46

What is true of S4q

Heard best with the bell near heart’s apex, over the mitral area
non-compliant left ventricle

47

What are the murmur grades?

I – very faint
II – quiet but heard immediately
III – moderately loud
IV – loud with a palpable thrill
V – very loud, thrill, heard with stethoscope partly off the chest
VI – very loud, thrill, heard with stethoscope entirely off the chest

48

Mid-systolic ejection murmur, heard best over aortic area, crescendo/decrescendo, radiates to neck

aortic stenosis

49

Mid-systolic click, heard best over mitral area

mitral valve prolapse

50

valve is unable to contain blood within the ventricle during systole, S1 may be decreased heard best over apex, radiates to left axilla

mitral regurg - pansystolic (holosystolic)

51

valve fails to close completely during systole, heard best over lower left sternal border

tricuspic regurg - pansystolic

52

what is true of aortic regurg

Leaflets of aortic valve fail to close – volume overload in LV
Heard best in aortic area with patient sitting and leaning forward
May be caused by rheumatic heart disease, congenital bicuspid valves, Marfan’s syndrome, aortic dissection, syphilis

53

what is true of mitral stenosis

Leaflets of valve have become thick, stiff, and distorted because of rheumatic fever
Heard best at apex and using bell
Mainly rheumatic in origin

54

What are the murmur intensisty grades

I – very faint
II – quiet but heard immediately
III – moderately loud
IV – loud with a palpable thrill
V – very loud, thrill, heard with stethoscope partly off the chest
VI – very loud, thrill, heard with stethoscope entirely off the chest