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Assessment > Ch 19 Heart & Neck Vessels > Flashcards

Ch 19 Heart & Neck Vessels Flashcards

1
Q

Acute chest pain that occurs when myocardial demand exceeds its oxygen supply

A

Angina pectoris

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2
Q

Incompetent aortic valve that allows backward flow of blood into left ventricle during diastole (aortic insufficiency)

A

Aortic regurgitation

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3
Q

Calcification of aortic valve cusps that restrict forward flow of blood during systole

A

Aortic stenosis

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4
Q

The left semilunar valve separating the left ventricle and the aorta

A

Aortic valve

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5
Q

Tip of the heart pointing down toward the 5th intercostal space

A

Apex of the heart

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6
Q

When the apex beats against the chest wall
Pulsation created as the left ventricle rotates against the chest wall during systole, normally at the 5th left intercostal space in the midclavicular line (point of maximal impulse or PMI)

A

Apical pulse

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7
Q

Broader area of heart’s outline located at the 3rd right and left intercostal space

A

Base of the heart

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8
Q

Cup shaped end piece used for soft, low pitched heart sounds

A

Bell of the stethoscope

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9
Q

Slow heart rate, less than 50 beats per minute in the adult

A

Bradycardia

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10
Q

Bulbous enlargement of distal phalanges of fingers and toes that occurs with chronic cyanotic heart and lung conditions

A

Clubbing

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11
Q

Severe narrowing of the descending aorta, a congenital heart defect

A

Coarctation of aorta

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12
Q

Right ventricular hypertrophy and heart failure due to pulmonary hypertension

A

Cor pulmonale

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13
Q

Dusky blue mottling of the skin and mucous membranes due to excessive amount of reduced hemoglobin in the blood

A

Cyanosis

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14
Q

Flat end piece of the stethoscope used for hearing relatively high pitched heart sounds

A

Diaphragm of stethoscope

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15
Q

The heart’s filling phase

A

Diastole

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16
Q

Difficult or labored breathing

A

Dyspnea

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17
Q

Swelling of legs or dependent body part due to increased interstitial fluid

A

Edema

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18
Q

Traditional auscultatory area in the 3rd left intercostal space

A

Erb’s point

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19
Q

Occurs with closure of the atrioventricular (AV) valves signaling the beginning of systole

A

First heart sounds (S1)

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20
Q

Very soft, low pitched ventricular filling sound that occurs in late diastole when ventricles are done filling, vibrations right before S1 (atrial gallop)
People with CAD occasionally have this
After exercise, really high cardiac output states
Abnormal with cardio myopathy, CAD, high blood pressure, semi aortic stenosis

A

Extra fourth heart sound S4

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21
Q

The addition of a 3rd or a 4th heart soundmakes the rhythm sound like the cadence of a galloping horse

A

Gallop rhythm

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22
Q

Technique of moving the stethoscope incrementally across the precordium through the auscultatory areas while listening to the heart sounds

A

Inching

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23
Q

Increase in thickness of myocardial wall that occurs when the heart pumps against chronic outflow obstruction (aortic stenosis)

A

LVH (left ventricular hypertrophy)

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24
Q

Imaginary vertical line bisecting the middle of the clavicle in each hemithorax

A

MCL (midclavicular line)

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25
Q

Incompetent mitral valve impedes forward flow of blood into left ventricle during diastole

A

Mitral stenosis

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26
Q

Left AV valve separating the left atria and ventricle

A

Mitral

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27
Q

Uncomfortable awareness of rapid or irregular heart rate

A

Palpitation

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28
Q

Opposite of a normal split S2 so that the split is heard in expiration, and in inspiration the sounds fuse to one sound

A

Paradoxical splitting

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29
Q

High pitched, scratchy extra cardiac sound heard when the precordium is inflamed

A

Pericardial friction rub

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30
Q

Normal variation in S2, heard as 2 separate components during inspiration

A

Physiological splitting

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31
Q

Area of the chest wall overlying the heart and great vessels, chest wall in front of the heart

A

Precordium

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32
Q

Backflow of blood through incompetent pulmonic valve into right ventricle (pulmonic insufficiency)

A

Pulmonic regurgitation

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33
Q

Calcification of pulmonic valve that restricts forward flow of blood during systole

A

Pulmonic stenosis

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34
Q

Right semilunar valve separating the right ventricle and pulmonary artery

A

Pulmonic valve

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35
Q

Occurs with closure of the semilunar valves, aortic and pulmonic, and signals the end of systole

A

Second heart sound S2

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36
Q

Abnormal mid-diastolic heart sound heard when both the pathologic S3 and S4 are present

A

Summation gallop

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37
Q

Temporary loss of consciousness due to decreased cerebral blood flow (fainting) caused by ventricular asystole pronounced bradycardia, or ventricular fibrillation

A

Syncope

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38
Q

The hearts pumping phase

A

Systole

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39
Q

Rapid heart rate >90 beats per min in the adult

A

Tachycardia

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40
Q

Soft, low pitched ventricular filling sound (vibration from ventricles not wanting to fill easily) that occurs in early diastole (S3 gallop) and may be an early sign of heart failure
Heard after S2 and heard best at the apex
Might disappear as a person sits up
Usually abnormally with CHF, hyperthyroidism, anemia, and sometimes with pregnancy youll get an s3

A

Extra third heart sound S3

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41
Q

Palpable vibration on the chest wall accompanying severe heart murmur
Aortic or pulmonary stenosis, pulmonary HTN occur with it

A

Thrill

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42
Q

Right AV valve separating the right atria and ventricle

A

Tricuspid valve

43
Q

The top of the heart is known as the..

A

Base

44
Q

The bottom of the heart is known as the…

A

Apex

45
Q

Which side of the heart sits more forward

A

The right side

46
Q

Which chambers which chambers hold the blood and which chambers pump it

A

The atriums hold the blood

The ventricles pump it

47
Q

The region between the lungs

A

Mediastinum

48
Q

What space does the heart take up.. from what to what

A

2nd to 5th intercostal space
To the right border of the sternum
To the left midclavicular line

49
Q

Arteries and veins that are connected to the heart

A

Great vessels

50
Q

2 great vessels that return the deoxygenated blood to the right side of the heart

A

Superior and inferior vena cava

51
Q

Artery carrying deoxygenated blood to the lungs

A

Pulmonary

52
Q

Veins carrying oxygenated blood to the left side of the heart

A

Pulmonary

53
Q

Artery carrying oxygenated blood to the rest of the body

A

Aortic

54
Q

The outermost layer of the heart, a double wall sac surrounding and protecting the heart

A

Pericardium

55
Q

The middle layer of the heart, the muscle wall, the area that contracts

A

Myocardium

56
Q

The inner layer of the heart, lines the inside of the heart, chambers, and valves

A

Endocardium

57
Q

The fluid in between all 3 layers of the heart that allow for smooth movements

A

Pericardial fluid

58
Q

The thicker side of the heart containing more tissue, so it will take longer to heal

A

The right side

59
Q

What are the 4 valves

A

Tricuspid, Bicuspid (mitral), aortic, pulmonic

60
Q

The chambers of the heart are unidirectional meaning..

A

They prevent backflow of blood by only opening one way, the pressure pushing the blood to the next chamber

61
Q

The phase of the heart when the AV valves open

A

Diastole

62
Q

The phase of the heart when the AV valves close

A

Systole

63
Q

The phase of the heart when the semilunar valves open, ejecting the blood from the heart

A

Systole

64
Q

The phase of the heart when the semilunar valves are closed

A

Diastole

65
Q

What will the patient experience with left sided heart failure

A

Pulmonary congestion: trouble breathing, SOB, crackles

66
Q

What will the patient experience with right sided heart failure

A

A backing up of the venous blood: jugular neck veins will be distended (swollen/easy to see), edema or swelling of extremities

67
Q

What does heart failure mean

A

The blood is not being efficiently pumped to the heart

68
Q

The rhythmic flow of blood through the heart is called the

A

Cardiac cycle

69
Q

Systole occurs between what 2 heart sounds

A

S1 (lub) and S2 (dub)

70
Q

This phase is usually 1/3 of the cardiac cycle

A

Systole

71
Q

This phase is usually 2/3 of the cardiac cycle

A

Diastole

72
Q

You can hear S1 (the closure of the AV valves) loudest at..

A

The apex of the heart

73
Q

You can hear S2 (the closure of the semilunar valves) loudest at…

A

The base of the heart

74
Q

A respiration effect heard on S2 from pressure changes pushing air more to the right and less to the left, heard on inspiration, might sound like lub dub from valves closing separately

A

S2 Split

75
Q

Turbulent blood flow in a vessel or in the heart, fluctuating or irregular flow

A

Murmur

76
Q

What sound does a murmur make

A

Swishing, wooshing, blowing sound

77
Q

What 3 things can cause murmurs

A

High velocity speed of blood –> when someone is exercising or if someone has thyroid problems so they have a high cardiac output
Thin blood caused by anemias
Heart defects –> problems with valves or chambers

78
Q

What are the 4 characteristics you look at when describing a heart sound

A

Frequency or pitch –> high or low
Intensity or loudness –> loud of soft
Duration –> how long does it last (typical heart sounds are shorter and silence is longer)
Timing –> occurring during diastole or systole

79
Q

What is the unique ability a heart has to conduct contractions by itself like its own electrical system

A

Automaticity

80
Q

The heart contracts because of an electrical system called..

A

The conduction system

81
Q

The hearts pacemaker that creates an electrical impulse and then sends it through the heart causing it to contract

A

SA node

82
Q

What is the order of the conduction system

A

SA node –> AV node –> Bundle of HIS –> right and left branches –> purkinje fibers causing the ventricles to contract

83
Q

The cardiac output is equal to …

A

stroke volume x heart rate per minute

84
Q

The stroke volume is the..

A

blood pumped during each systolic phase

85
Q

What is the stroke volume (liters of blood pumped per minute)

A

4-6 LPM

86
Q

The venous return or the blood that is coming in the ventricles and building up during diastole

A

Preload

87
Q

The ventricle resistance or the blood that is leaving the ventricles and causing high pressure in order to get aortic and pulmonic valves to open

A

Afterload

88
Q

The artery between the trachea and sternomastoid muscle, close to the heart

A

Carotid artery

89
Q

Internal and external veins that empty deoxygenated blood into the vena cava

A

Jugular veins

90
Q

There are no valves in the jugular veins to prevent backflow and this is why you can get..

A

Jugular vein distention

91
Q

What is the subjective data you should gather

A 
Chest pain (#1 sign of a heart attack)
--where, rate it, is it radiating
Dyspnea
Orthopnea
Cough
Fatigue
Cyanosis or pallor
Edema
Nocturia
Cardiac history
Family history
Personal habits
92
Q

What are cardiac risk factors

A 
Elevated serum cholesterol
Elevated blood pressure
Blood glucose above 130
Diabetes
Obesity
Smoking
Low activity level
Hormone replacement therapy
93
Q

What objective data do you need to collect

A 
Vital signs (BP and pulse)
Palpate neck vessels one at a time
Examine precordium of the chest
Examine extremities for swelling
Check posture when breathing
Developmental changes
94
Q

How do you inspect neck vessels

A

Should be able to see the jugular vein distended when pt is laying at 45 degrees or less, disappears as the bed rises
If CAD is suspected then auscultate carotid artery
–listen for bruiting which is turbulent flow that sounds like swooshing, have them breath in out and hold, and use the bell of the stethoscope

95
Q

How do you inspect the precordium

A

Auscultate and palpate for apical impulse at the LMCL at the 4th of 5th ICS
its the PMI
Sometimes you can see and palpate

96
Q

Where do you auscultate for the aortic valve area

A

2nd right interspace

97
Q

Where do you auscultate for the pulmonic valve area

A

2nd left interspace

98
Q

Where do you auscultate for the tricuspid valve area

A

Left lower sternal border

99
Q

Where do you auscultate for the mitral valve area

A

5th interspace at left midclavicular line

100
Q

What cardiac changes occur in an older adult

A

Increased systolic blood pressure
–common because arteries become stiffer with age
HTN
Systolic murmurs are common

101
Q

You might hear a little click in mechanical valves with a

A

mitral prosthetic valve sound

102
Q

When the pericardium becomes inflamed and you hear a high pitched, scratchy sound
Usually have pericarditis with this

A

Pericardial friction rub

103
Q

Chest wall lifts up and you can see it rise with the beating of the heart
Sometimes occurs if R ventricle is enlarged, pulmonic valve disease or HTN, or with chronic lung patients

A

Lift or heave at sternal border

Assessment (11 decks)

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