Chapter 17—Cardio & Lymph

Question 1

diastole

valves opening and closing?

chambers filling & relaxing?

Answer 1

• AV valves open
• ventricles relaxed & filling
• SL valves closed
• atria contracting

Question 2

systole

valves opening and closing?

chambers filling & relaxing?

Answer 2

AV valves closed
ventricles contract
SL valves open
atria relaxed

Question 3

what is S1?

what does it signify?

where do we hear it?

Answer 3

Lub
closure of AV valves
start of systole
apex of heart (PMI)

Question 4

What is S2?

what does it signify?

where do we hear it?

Answer 4

Dub
closure of SL valves
start of diastole
base of heart (2nd ICS)

Question 5

spots to listen to valves of the heart (5)

Answer 5

• Aortic - 2nd ICS, R sternal border
• Pulmonic - 2nd ICS, L sternal border
• Erb’s - 3rd ICS, L sternal border
• Tricuspid - 4th ICS, L sternal border
• Mitral - 5th ICS, L midclavicular - point of maximum impact (PMI)

Question 6

S3

technical name

“___”

caused by…

pathological? normal?

heard where/how?

Answer 6

Ventricular Gallop

“Kentucky”

rapidly flowing blood hits compliant ventricular wall

pathological in most adults

normal in children/young adults/pregnancy/athletes

apex with bell

Question 7

S4

technical name

“___”

caused by…

pathological? normal?

heard where/how?

Answer 7

Atrial Gallop

“Tennessee”

blood hits less compliant ventricle

almost never normal

diastolic HF, untreated HTN, coronary heart disease, aortic stenosis, etc

apex with bell

Question 8

turbulent blood flow caused by leaky valves

Answer 8

murmur

Question 9

how are murmurs graded?

Answer 9

1-6

1 is quietest, 6 is strongest

Question 10

at what grade can you palpate a murmur?

Answer 10

4 +

Question 11

what is a thrill?

Answer 11

palpable murmurs

Question 12

CO =

Answer 12

stroke volume x HR

Question 13

what is preload?

Answer 13

volume of blood at end of diastole

Question 14

what is afterload?

Answer 14

pressure the ventricle has to overcome to eject blood into aorta

Question 15

what is depolarization?

Answer 15

contraction

Question 16

what is repolarization?

Answer 16

relaxation

Question 17

primary pacemaker

Answer 17

sinoatrial node

Question 18

other fibers that control cardiac rhythm if SA node fails

Answer 18

AV node

Bundle of His

Purkinje fibers

Question 19

what does HR drop down to if AV node or Purkinje fibers have to take over conduction?

Answer 19

• AV - 40-60 bpm
• Purkinje - 20-40 bpm

Question 20

what is P-R?

Answer 20

beginning of electrical conduction in atria

Question 21

what is the Q-R-S complex?

Answer 21

coincides with ventricles’ contraction

Question 22

what is the S-T interval?

Answer 22

heart muscles relax & fill

Question 23

what is T?

Answer 23

beginning of the next electrical conduction

Question 24

normal jugular vein

Answer 24

6-8 cm

Question 25

JVP indicates… (4)

Answer 25

right sided heart failure pulmonary HTN PE cardiac tamponade

Question 26

how to check JVP

Answer 26

stand on right side, HOB at 30-45, turn head to left, shine flashlight, look for pulsation

Question 27

intermittent pain r/t PVD, often with activity & relieved by rest

Answer 27

intermittent claudication

Question 28

Allen test

Answer 28

obliterate radial & ulnar pulses - release one at a time to see if BF returns

Question 29

hands - numbness, tingling, pain, coolness, extreme pallor, extreme abrupt tricolor in hands with cold

Answer 29

Raynaud's disease/sign

Question 30

manual compression assessment of veins palpable vein indicates?

Answer 30

incompetent venous valve

Question 31

pressure buildup from internal bleeding/edema - decreases BF - severe pain

Answer 31

compartment syndrome

Question 32

thickening of inner wall of artery

Answer 32

arteriosclerosis

Question 33

plaque formation in arteries

Answer 33

atherosclerosis

Question 34

**arterial ulcers** edges? colors? temp? dry/wet? pain? skin appearance? location?

Answer 34

well defined edges deep pale base - black necrotic tissue cool skin dry ulcer intense pain shiny hairless skin on distal toes or foot

Question 35

**venous ulcers** edges? colors? temp? dry/wet? pain? location? skin appearance?

Answer 35

uneven edges reddish brown - pale dead tissue lining crater warm skin exudate moderate/no pain - itching usually around ankle darkening skin

Question 36

Virchow's node

Answer 36

left supraclavicular

Question 37

location of iliac nodes

Answer 37

pelvic girdle

Question 38

Label: P, Q, R, S, T

Answer 38