Flashcards in Chapter 11 - Heart Deck (107)
Major categories of heart disease
4. Bacterial endocarditis
Which type of heart disease is the MC?
Why is bacterial endocarditis still a problem?
Despite abx, # of cases are increasing d/t IV street drug use
Circulation system consists of a ___ pressure delivery system and a ___ pressure return system
High delivery (left)
Low return (right)
Most of the anterior cardiac surface is the ____ ventricle
The RA forms a narrow border from the ___ to ___ ribs to the ___ of the sternum
Where is the apex of the heart located?
5th ICS at midclavicular line
What is the apical impulse also known as?
Point of maximum impulse (PMI)
4 classic auscultatory areas and where they are
1. Aortic = 2ICS-RSB (right sternal border)
2. Pulmonic = 2ICS-LSB
3. Tricuspid = LLSB
4. Mitral = 5ICS-MCL (midclavicular line)
Also Erb's point (3rd ICS) - best for aortic/pulmonic
What are the only sounds that should be heard normally?
Closing of the valves (S1 and S2)
What does S1 indicate?
Closing of the AV valves (lub)
What does S2 indicate?
Closing of the semilunar valves (dub)
When can opening of the valves be heard?
Only when they are damaged
Define "opening snap" and when it occurs
Sound of an AV valve opening when it is stenotic
Define "ejection click" and when it occurs
Sound of a SL valve opening when it is stenotic
How do the pulmonic and aortic valves open/close in relation to each other?
Pulmonic opens first, but closes last
When does isovolumetric contraction occur?
Between closure of AV valves and opening of the SL valves
Ejection is defined as:
Time between opening and closing of SL valves
Incisura/Dicrotic notch =
The point at which ejection is completed and the aortic and left ventricular curves separate
When does isovolumetric relaxation occur?
Between closure of SL valves and opening of AV valves
Third heart sound - end of ventricular filling
*Mainly heard in children/young adults
What does an S3 in 30+ yos indicate?
Ventricular volume overload (could be from regurg/CHF)
4th heart sound - atrial contraction/additional ventricular filling
*Normal in children/young adults
What does an S4 in 30+ yos indicate?
Noncompliant/stiff ventricle (from pressure overload/CAD)
What are gallop sounds?
S3 and S4
The ___ heart sound is loudest at the cardiac apex
The ___ heart sound is loudest at the base
Splitting of the first heart sound may be heard in the ___ area
What is sinus arrhythmia?
Reflex tachycardia during inspiration that compensates for decreased LV volume