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EC Health Assessment > Chapter 20: Heart and Neck Vessels > Flashcards

Chapter 20: Heart and Neck Vessels Flashcards

1
Q

Angina pectoris

A

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

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2
Q

Aortic regurgitation

A

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

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3
Q

Aortic stenosis

A

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

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4
Q

Aortic valve

A

The left semilunar valve separating the left ventricle and the aorta

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5
Q

Apex of the heart

A

Tip of the heart pointing down toward the 5th left ventricle and the aorta

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6
Q

Apical impulse

A

Point of maximal impulse (PMI); pulsation created as the left ventricle rotates against the chest wall during systole, normally at the 5th left intercostal space in the midclavicular line

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7
Q

Base of the heart

A

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

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8
Q

Bell (of the stethoscope)

A

Cup-shaped endpiece used for soft. low-pitched heart sounds

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9
Q

Bradycardia

A

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

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10
Q

Clubbing

A

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

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11
Q

Coarctation of aorta

A

Severe narrowing of the descending aorta, a congenital heart defect

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12
Q

Cor pulmonale

A

Right ventricular hypertrophy and heart failure due to pulmonary hypertension

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13
Q

Cyanosis

A

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

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14
Q

Diaphragm (of the stethoscope)

A

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

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15
Q

Diastole

A

The heart’s filling phase

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16
Q

Dyspnea

A

Difficult, labored breathing

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17
Q

Edema

A

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

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18
Q

Erb’s point

A

Traditional auscultatory area in the 3rd left intercostal space

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19
Q

First heart sound (S1)

A

Occurs with closure of the atrioventricular valves signaling the beginning of systole

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20
Q

Fourth heart sound (S4)

A

S4 gallop, atrial gallop; very soft, low-pitched ventricular filling sound that occurs in the late diastole

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21
Q

Gallop rhythm

A

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

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22
Q

Inching

A

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

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23
Q

Left ventricular hypertrophy (LVH)

A

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

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24
Q

Midclavicular line (MCL)

A

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

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25
Q

Mitral regurgitation

A

Mitral insufficiency; incompetent mitral valve allows regurgitation of blood back into left atrium during systole

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26
Q

Mitral stenosis

A

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

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27
Q

Mitral valve

A

Left atrioventricular valve separating the left atrium and ventricle

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28
Q

Palpitation

A

Uncomfortable awareness of rapid or irregular heart rate

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29
Q

Paradoxical splitting

A

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

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30
Q

Pericardial friction rub

A

High-pitched, scratchy extracardiac sound heard when the precordium is inflamed

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31
Q

Physiologic splitting

A

Normal variation in S2 heard as two separate components during inspiration

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32
Q

Precordium

A

Area of the chest wall overlying the heart and great vessels

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33
Q

Pulmonic regurgitation

A

Pulmonic insufficiency; backflow of blood through incompetent pulmonic valve into the right ventricle

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34
Q

Pulmonic stenosis

A

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

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35
Q

Pulmonic valve

A

Right semilunar valve separating the right ventricle and pulmonary artery

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36
Q

Second heart sound (S2)

A

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

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37
Q

Summation gallop

A

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

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38
Q

Syncope

A

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

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39
Q

Systole

A

The heart’s pumping phase

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40
Q

Tachycardia

A

Rapid heart rate, greater than 95 beats per minute in the adult

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41
Q

Third heart sound (S3)

A

Soft, low-pitched ventricular filling sound that occurs in early diastole (S3 gallop) and may be an early sign of heart failure

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42
Q

Thrill

A

Palpable vibration on the chest wall accompanying severe heart murmur

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43
Q

Tricuspid valve

A

Right atrioventricular valve separating the right atrium and ventricle

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44
Q

Define apical impulse and describe its normal location, size, and duration

A

k

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45
Q

Which abnormal conditions may affect the location of the apical pulse

A

l

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46
Q

Explain the mechanism producing normal first and second heart sounds

A

k

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47
Q

Describe the effect of respiration on the heart sounds

A

,

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48
Q

Describe the characteristics of the first heart sound and its intensity at the apex of the heart and at the base

A

k

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49
Q

Describe the characteristics of the second heart sound and its intensity at the apex of the heart and at the base

A

k

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50
Q

Explain the physiologic mechanism for normal splitting of S2 in the pulmonic valve area

A

j

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51
Q

Define the third heart sound. When in the cardiac cycle does it occur? Describe its intensity, quality, location in which it is heard, and method of auscultation.

A

.

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52
Q

Differentiate a physiologic S3 from a pathologic S3

A

k

53
Q

Define the fourth heart sound. When in the cardiac cycle does it occur? Describe its intensity, quality, location in which it is hear, and method of auscultation.

A

k

54
Q

Explain the position of the valves during the cardiac cycle in diastole, isometric contraction, systole, and isometric relaxation.

A

.

55
Q

Define venous pressure and jugular vein pressure.

A

.

56
Q

Differentiate between carotid artery pulsation and jugular vein pulsation

A

.

57
Q

List the major risk factors for heart disease and stroke as identified in this text.

A

.

58
Q

Define bruit, and discuss what it indicates.

A

.

59
Q

State 4 guidelines to distinguish S1 and S2.

A

.

60
Q

Define pulse deficit, and discuss what it indicates.

A

.

61
Q

Define preload and afterload.

A

Preload: Volume; the venous return that builds during diastole Afterload: Pressure; the opposing pressure the ventricle must generate to open the aortic valve against the higher aortic pressure

62
Q

List the characteristics to explore when you hear a murmur, including the grading scale of murmurs

A

.

63
Q

Discuss the characteristics of an innocent or functional murmur.

A

.

64
Q

Identify label A

A

Internal Jugular Veins

65
Q

Identify label B

A

Superior vena cava

66
Q

Identify label C

A

Right atrial appendage

67
Q

Identify label D

A

Right atrium

68
Q

Identify label E

A

Right ventricle

69
Q

Identify label F

A

Inferior vena cava

70
Q

Identify label G

A

Aorta (thoracic)

71
Q

Idenfity label H

A

Common carotid arteries

72
Q

Ifentify label I

A

Aorta (arch)

73
Q

Identify label J

A

Pulmonary artery

74
Q

Idenfity label K

A

Left atrial appendage

75
Q

Identify label L

A

Left ventricle

76
Q

Identify label M

A

Apex

77
Q

Identify label N

A

Base

78
Q

Identify label A

A

Superior vena cava

79
Q

Identify label B

A

Right pulmonary artery

80
Q

Identify label C

A

Right atrium

81
Q

Identify label D

A

Right pulmonary veins

82
Q

Identify label E

A

Fossa ovalis

83
Q

Identify label F

A

Right atrioventricular valve (tricuspid valve)

84
Q

Identify label G

A

Right ventricle

85
Q

Identify label H

A

Chordae tendineae

86
Q

Identify label I

A

Inferior vena cava

87
Q

Identify label J

A

Aorta

88
Q

Identify label K

A

Left pulmonary artery

89
Q

Identify label L

A

Left atrium

90
Q

Identify label M

A

Left pulmonary veins

91
Q

Identify label N

A

Pulmonary semilunar valve

92
Q

Identify label O

A

Left atrioventricular valve (bicuspid valve)

93
Q

Identify label P

A

Aortic semilunar valve

94
Q

Identify label q

A

Left ventricle

95
Q

Identify label r

A

Interventricular septum

96
Q

Identify label s

A

Myocardium

97
Q

Identify label t

A

Visceral pericardium

98
Q

Identify label A

A

Right external jugular vein

99
Q

Identify label B

A

Right common carotid artery

100
Q

Identify label C

A

Sternomastoid muscle

101
Q

Identify label D

A

Superior vena cava

102
Q

Identify label E

A

Neck Vessels

103
Q

Identify label F

A

Aorta

104
Q

Identify label H

A

Left internal jugaular vein

105
Q

Identify label i

A

Left common carotid artery

106
Q

Identify label j

A

Left external jugular vein

107
Q

The precardium is:

a. A synonym for the mediastinum
b. The area on the chest where the apical impulse is felt
c. The area on the anterior chest overlying the heart and great vessels
d. A synonym for the area where the superior and inferior venae cavae return oxygenated venous blood to the right side of the heart

A

c. The area on the anterior chest overlying the heart and great vessels

108
Q

Select the best description of the tricuspid valve.

a. Left semilunar valve
b. Right atrioventricular valve
c. Left atrioventricular valve
d. Right semilunar valve

A

b. Right atrioventricular valve

109
Q

The function of the pulmonic valve is to:

a. Divide the left atrium and left ventricle
b. Gaurd the openings between the right atrium and right ventricle
c. Protect the oriface between the right ventricle and the pulmonary artery
d. Gaurd the entrance to the aorta from the left ventricle

A

c. Protect the oriface between the right ventricle and the pulmonary artery

110
Q

Atrial systole occurs:

a. During ventricular systole
b. During ventricular diastole
c. Concurrently with ventricular systole
d. Independently of ventricular function

A

b. During ventricular diastole

111
Q

The second heart sound is the result of:

a. Opening of the mitral and tricuspid
b. Closing of the mitral and tricuspid valves
c. Opening of the aortic and pulmonic valves
d. Closing of the aortic and pulmonic valves

A

d. Closing of the aortic and pulmonic valves

112
Q

The examiner has estimated the jugular venous pressure. Identify the finding that is abnormal.

a. Patient elevated to 30 degrees, internal jugular vein pulsation at 1 cm above sternal angle
b. Patient elevated to 30 degrees, internal jugular vein pulsation at 2 cm above sternal angle
c. Patient elevated to 40 degrees, internal jugular vein pulsation at 1 cm above sternal angle
d. Patient elevated to 45 degrees, internal jugular vein pulsation at 4 cm above sternal angle

A

d. Patient elevated to 45 degrees, internal jugular vein pulsation at 4 cm above sternal angle

113
Q

The examiner is palpating the apical impulse. Which is a normal-sized impulse?

a. less than 1 cm
b. Approximately 1 x 2 cm
c. 3 cm
d. Varies depending on the size fo the person

A

b. Approximately 1 x 2 cm

114
Q

The nurse auscultates the pulmonic valve area in which region?

a. Second right interspace
b. Seond left interspace
c. Left lower sternal border
d. Fifth interspace, left midclavicular line

A

b. Seond left interspace

115
Q

Which description would differentiate a split S2 from S3?

a. S3 is lower pitched and is heard at the apex
b. S2 is heard at the left lower sternal border
c. The timing of S2 varies with respirations
d. S3 is heard at the base; the timing varies with respirations

A

a. S3 is lower pitched and is heard at the apex

116
Q

You ausculatate a patient to rule out a pericardial friction rub. Which assessment technique is most appropriate?

a. Listen with the diaphragm, patient sitting up and learning forward, breath held in expiration
b. Listen using the bell with the patient leaning forward
c. Listen at the base during normal respiration
d. Listen with the diaphragm, patient turned to the left side

A

a. Listen with the diaphragm, patient sitting up and learning forward, breath held in expiration

117
Q

When ausculatating the heart, your first step is to:

a. Identify S1 and S2
b. Listen for S3 and S4
c. Listen for murmurs
d. Identify all four sounds on the first round

A

a. Identify S1 and S2

118
Q

You will hear a split S2 most clearly in which area?

a. Apical
b. Pulmonic
c. Tricuspid
d. Aortic

A

b. Pulmonic

119
Q

The stethoscope bell should be pressed lightly against the skin so that:

a. Chest hair doesn’t stimulate crackles
b. High-pitched sounds can be heard better
c. The bell does not act as a diaphragm
d. The bell does not interfere with amplification of heart sounds

A

c. The bell does not act as a diaphragm

120
Q

A murmus is heard after S1 and before S2. This murmur would be classified as:

a. Diastolic (possibly benign)
b. Diastolic (always pathologic)
c. Systolic (possibly benign)
d. Systolic (always pathologic)

A

c. Systolic (possibly benign)

121
Q

When assessing the carotid artery, the nurse whould palpate:

a. Bilaterally at the same time while standing behind the patient
b. Medial to the sternomastoid muscle, one side at a time
c. For a bruit while asking the patient to hold his or her breath briefly
d. For unilateral distention while turning the patient’s head to one side

A

b. Medial to the sternomastoid muscle, one side at a time

122
Q

S1 is best heard at the _______ of the heart, where as S2 is loudest at the _____ of the heart. S1 coincides with the pulse in the ______ and coincides with the ___ wave if the patient is on an ECG monitor.

A

S1 is best heard at the APEX of the heart, where as S2 is loudest at the BASE of the heart. S1 coincides with the pulse in the CAROTID and coincides with the R wave if the patient is on an ECG monitor.

123
Q

Tough, fibrous, double-walled sac that surrounds and protects the heart.

a. Pericardial fluid
b. Ventricle
c. Endocardium
d. Myocardium
e. Pericardium
f. Atrium

A

e. Pericardium

124
Q

Thin layer of endothelial tissue that lines the inner surface of the heart chambers and valves

a. Pericardial fluid
b. Ventricle
c. Endocardium
d. Myocardium
e. Pericardium
f. Atrium

A

c. Endocardium

125
Q

Reservoid for holding blood

a. Pericardial fluid
b. Ventricle
c. Endocardium
d. Myocardium
e. Pericardium
f. Atrium

A

f. Atrium

126
Q

Ensures smooth, friction-free movement of the heart muscle

a. Pericardial fluid
b. Ventricle
c. Endocardium
d. Myocardium
e. Pericardium
f. Atrium

A

a. Pericardial fluid

127
Q

Muscular pumping chamber

a. Pericardial fluid
b. Ventricle
c. Endocardium
d. Myocardium
e. Pericardium
f. Atrium

A

b. Ventricle

128
Q

Muscular wall of the heart

a. Pericardial fluid
b. Ventricle
c. Endocardium
d. Myocardium
e. Pericardium
f. Atrium

A

d. Myocardium

EC Health Assessment (14 decks)

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