Ch. 20 (The Heart & Neck Vessels)

Question 1

What part of the heart anatomy would be called the base?

Answer 1

the top

Question 2

What part of the heart anatomy would be called the apex?

Answer 2

the bottom

Question 3

There are three layers to the heart.

What layer is a tough sac that surrounds and protects the heart?

Answer 3

pericardium

Question 4

There are three layers to the heart.

What layer is a muscular wall that does the pumping in the heart?

Answer 4

myocardium

Question 5

There are three layers to the heart.

What layer is a thin wall that lines the inner surface?

Answer 5

endocardium

Question 6

What happens during diastolic (bottom number-BP)?

Answer 6

blood floods into the heart

aortic & pulmon. valves are closing, S2 - best heard at erb’s/pulmonic

louder at base (DUB)

Question 7

What happens during systole (top number-BP)?

Answer 7

pushes blood out to the system

mitral & tricuspid valve are closing, S1 - best heard at mitral & tricus

louder at apex (LUB)

Question 8

What is happening during s1 (lub)?

Answer 8

mitral and tricuspid valve closing

systole -best heard at the tricuspid & mitral listening points

louder at apex (LUB)

Question 9

What is happening during s2 (dub)?

Answer 9

aortic and pulmonic valve closing

diastole - best heard at erbs point/pulmonic area

louder at base (DUB)

Question 10

We live most of our lives in what heart cycle?

Answer 10

diastole (2/3)

systole - 1/3

Question 11

Where do we hear S1 loudest?

Answer 11

apex

Question 12

Where do we hear S2 loudest?

Answer 12

base

Question 13

What are some conditions that would cause heart murmurs?

Answer 13

• thickness (viscosity) of blood increases
• viscosity decreases
• valve problems (most common)

pregnancy can cause temporary murmurs

Question 14

What does a heart murmur sound like?

Answer 14

a gentle “wooshing” sound

Question 15

What portion of the heart contains specialized cells near the superior vena cava that initiates electrical pulse?

Answer 15

SA Node

natural pacemakers

Question 16

What portion of the heart is located low in septum of right atrium, making it contract?

Answer 16

AV node

Question 17

During heart conduction, the impulse travels into branches in the left atrium called what?

Answer 17

bundle of his

Question 18

What is the equation used to calculate cardiac output?

Answer 18

CO = SV x R
stroke volume x rate = cardiac output

Question 19

What are the main two neck vessels?

Answer 19

• carotid artery (in groove between trachea and sternomastoid process)
• jugular veins

Question 20

What main neck vessel carries O2 blood to the head?

Answer 20

carotid artery

Question 21

What main neck vessel empties deoxygenated blood into the superior vena cava?

Answer 21

jugular vein

Question 22

What can chest pain be described as in subjective data?

Answer 22

• squeezing
• crushing

Question 23

People who have heart problems usually experience dyspnea with what?

Answer 23

supine position (laying down)

Question 24

People who have heart problems usually ease their orthopnea with what?

Answer 24

tons of pillows to prop themselves up

Question 25

Women compared to men tend to experience what sort of symptoms when experiencing a heart attack?

Answer 25

* stomach pain (GI issue) * extreme fatigue | men is usually the classic symptoms

Question 26

What type of symptoms could you have with heart problems?

Answer 26

* chest pain * dyspnea (laying down pain when breathing) * orthopnea (ease in pain when sitting up) * coughing * fatigue * cyanosis or pallor * edema/swelling * nocturia (getting up to pee alot at night due to extra pressure on kidneys when laying down) * diabetes * hypertension | dental problems are correlated with heart problems due to bacteria

Question 27

How do you inspect the jugular venous pulse?

Answer 27

pt lies supine 30-45 degree angle, no pillow, turn head slightly away, use good light

Question 28

when palpating the chest, what part of the hand are you using and why?

Answer 28

* ulnar surface of hand * checking vibrations

Question 29

When palpating across the precordium using the ulnar surface of your hand, the vibration feels similar to a cat purring. What kind of vibration would that be called and would that cause any concern?

Answer 29

* thrill (vibration) * usually present in patients with really bad heart problems

Question 30

When auscultating the chest, what acronym do we use to remember the order we go in?

Answer 30

* Aortic * Pulmonic * Erbs point * tricuspid * o * Mitral * n | ape to men

Question 31

Every what heart beat, will you hear the pulmonic area inspirate?

Answer 31

4th beat

Question 32

When listening for murmurs, timing is important. When the brewer sound/murmur is heard during the systole cycle, what would it be called?

Answer 32

systolic murmur | usually not that serious

Question 33

When listening for murmurs, timing is important. When the brewer sound/murmur is heard during the diastole cycle, what would it be called?

Answer 33

diastolic murmur | usually serious

Question 34

When listening for murmurs, position can help detect it. What positions can the pt follow to help you detect your confirmation of heart mumurs?

Answer 34

* roll pt on left side, listen w/bell on apex * sit up and lean forward, listen w/diaphragm on base

Question 35

What type of abnormal finding is classified as chest pain?

Answer 35

angina | stable is predictable, variant is anything goes

Question 36

What type of abnormal finding is classified as sudden decrease in blood flow to the heart?

Answer 36

acute coronary syndrome (classic heart attack) | usually from a clot

Question 37

What type of abnormal finding is classified as clot that lodges in the lungs, described as sharp and stabbing that is worse with a deep breath?

Answer 37

pulmonary embolism

Question 38

Heart failure can either be classified as...?

Answer 38

* acute (sudden) * chronic (slow)

Question 39

What type of abnormal finding occurs with abdominal swelling, dilated jugular veins (jvd), swollen feet, nocturia?

Answer 39

right sided heart failure | usually left side eventually joins in (congestive heart failure)

Question 40

What type of abnormal finding occurs with coughing, shortness of breath (SOB), crackles upon ascultation, orthopnea (needing a pillow to breathe), lower O2?

Answer 40

left sided heart failure | usually right side eventually joins in (congestive heart failure)

Question 41

What kind of heart problem causes atrial spasming (irregular beating), electrical conduction issue, and blood pools causing clots which increases risk of MI and strokes?

Answer 41

atrial fibrillation (AFIB) | blood thinners are usually prescribed

Question 42

Describe the steps of heart conduction.

Answer 42

1. S.A. Node activates flowing across the atria to the AV node - making AV contract 2. impulse travels into right and left bundle branches (Bundle of His) and then into the ventricles - causing rest of heart to contract

Question 43

What peripheral vascular abnormality is caused by a blood clot in the lower extremities which is shown through redness, swlling, discomfort and asymmetry in the legs?

Answer 43

deep vein thrombosis (DVT)

Question 44

What peripheral vascular abnormality is caused by the valves in veins not closing all the way, resulting in enlarged veins, and painful heavy-feeling legs?

Answer 44

varicose veins

Question 45

What peripheral vascular abnormality describes pain and discomfort felt in the legs when walking and exercising?

Answer 45

claudication | major symptom of peripheral artery disease

Question 46

What peripheral vascular abnormality causes pooling of blood in the lower extremities resulting in incompetent valves, enlarged veins, edema, brown patches, soggy skin and a normal pulse?

Answer 46

venous insufficency

Question 47

What peripheral vascular abnormality is caused by plaque build up in the arties resulting in cold temperature in the lower extremities, very pale skin, pain in the calf when wlaking, shiny skin, no hair, and a light pulse?

Answer 47

arterial insufficency

Question 48

What peripheral vascular abnormality is caused by narrowed arteries resulting in reduce blood flow, leg pain when walking and increases risk of heart attack and stroke?

Answer 48

peripheral artery disease

Question 49

What vascular abnormality causes buildup of plaque on artery walls, making the arteries become rigid and harden?

Answer 49

atherosclerosis | eventually leads to stenosis

Question 50

What can atherosclerosis eventually evolve into?

Answer 50

stenosis

Question 51

What vascular abnormality is caused by narrowing of an artery?

Answer 51

stenosis | generally developed after atherosclerosis