Heart and Neck Vessels (LM)

Question 1

HEART LOCATION

Answer 1

middle of thoracic cavity between lungs in the space call the mediastinum; extends vertically from 2nd to 5th ICS (Intercostal Space) and horizontally from the RIGHT edge of sternum to the left MCL (Mid Clavicular Line).

Question 2

_____ CIRCULATION: right side of the heart

Answer 2

PULMONARY CIRCULATION

Question 3

_____ CIRCULATION: left side of the heart

Answer 3

SYSTEMIC CIRCULATION

Question 4

It is the contraction of the ventricles

Answer 4

systole, S1 sound (Lub)

Question 5

It is the relaxation of the ventricles.

Answer 5

Diastole, S2 sound (Dup)

Question 6

______ gallop: S3
______ gallop: S4

Answer 6

Ventricular gallop
Atrial gallop

Question 7

TRADITIONAL AREAS OF AUSCULTATION

Answer 7

Aortic area
Pulmonic area
Erb point
Tricuspid area
Mitral (apical)

Question 8

TRADITIONAL AREAS OF AUSCULTATION
1. _____ Second ICS at the right sternal border—the base of the heart
2. _____ Second or third ICS at the left sternal border—the base of the heart
3. _____ Third ICS at the left sternal border
4. _____ Fifth ICS near the left MCL—the apex of the heart 5. _____ Fourth or fifth ICS at the left lower sternal border

Answer 8

Aortic area
Pulmonic area
Erb point
Mitral (apical)
Tricuspid area

Question 9

can be cardiac, muscular, gastrointestinal in origin.

Answer 9

Chest pain

Question 10

Cardiac chest pain (squeezing around the heart; steady, severe pain, and sense of pressure radiating to the left shoulder and down the left arm or the jaw).

Answer 10

Angina

Question 11

lack of oxygen in the heart muscles causing damage to the cells of the heart.

Answer 11

MYOCARDIAL ISCHEMIA

Question 12

irreversible heart damage due to myocardial ischemia.

Answer 12

MYOCARDIAL INFARCTION

Question 13

tear in the wall lining of the aorta.

Answer 13

AORTIC DISSECTING ANUERYSM

Question 14

inflammation of the parietal pleura next to the pericardium.

Answer 14

PERICARDITIS

Question 15

In palpating the apex, the left sternal border, and the base, what technique are you going to use?

Answer 15

Using the palmar aspects of your four fingers

Question 16

feels like a more sustained thrust than an expected apical pulse and is felt during systole.

Answer 16

Lift

Question 17

a more prominent thrust of the heart against the chest wall during systole.

Answer 17

Heave

Question 18

a palpable vibration over the precordium or artery: it feels like a fine, palpable, rushing vibration. It is associated with a loud murmur.

Answer 18

Thrill

Question 19

a visible sinking in of tissues between and around the ribs.

Answer 19

Retraction

Question 20

may indicate atrial fibrillation, atrial flutter, premature ventricular contractions, and varying degrees of heart block.

Answer 20

Pulse deficit

Question 21

represents closure of the atrioventricular valves as the ventricular pressures exceed atrial pressures at the beginning of systole

Answer 21

S1

Question 22

represents closure of the semilunar valves

Answer 22

S2

Question 23

A split S2 (into two distinct sounds of its components—A2 and P2) is normal and termed?

Answer 23

physiologic splitting (late inspiration)

Question 24

S3 and S4 pathologic sounds together create a quadruple rhythm, which is called a _____.

Answer 24

summation gallop

Question 25

Distention of jugular vein on one side may be caused by a _____ or _____

Answer 25

kink or aneurysm

Question 26

Distention, bulging, or protrusion at 45, 60, or 90 degrees may indicate _____.

Answer 26

right-sided heart failure

Question 27

An inspiratory increase in venous pressure, called _____.

Answer 27

Kussmaul sign

Question 28

A bruit, a blowing or swishing sound caused by turbulent blood flow through a narrowed vessel

Answer 28

occlusive arterial disease

Question 29

Pulse inequality may indicate arterial constriction or occlusion in one carotid artery.

Question 30

A delayed upstroke

Answer 30

aortic stenosis

Question 31

Loss of elasticity may indicate _____

Answer 31

arteriosclerosis

Question 32

narrowing of the artery

Answer 32

Thrills

Question 33

A thrill or a pulsation is usually associated with a _____ or higher murmur.

Answer 33

grade IV

Question 34

The abnormal split can be one of three types:

Answer 34

wide, fixed, or reversed.

Question 35

S3 and S4 pathologic sounds together create a quadruple rhythm, which is called a _____

Answer 35

summation gallop

Question 36

elevated venous pressure only during expiration.

Answer 36

obstructive pulmonary disease

Question 37

Pulse inequality may indicate _____

Answer 37

arterial constriction or occlusion in one carotid artery.

Question 38

Weak pulses may indicate_____

Answer 38

hypovolemia, shock, or decreased CO.

Question 39

A bounding, firm pulse may indicate _____

Answer 39

hypervolemia or increased CO.

Question 40

apical impulse is larger than 1–2 cm, displaced, more forceful, or of longer duration.

Answer 40

suspect cardiac enlargement.

Question 41

Less than 60 beats/min

Answer 41

Bradycardia

Question 42

more than 100 beats/min

Answer 42

Tachycardia

Question 43

difference between the apical and peripheral/radial pulses

Answer 43

Pulse deficit

Question 44

may indicate atrial fibrillation, atrial flutter, premature ventricular contractions, and varying degrees of heart block.

Answer 44

Pulse deficit

Question 45

A pathologic S4 (atrial gallop) toward the left side of the precordium

Answer 45

coronary artery disease, and aortic stenosis.

Question 46

A pathologic S4 toward the right side of the precordium

Answer 46

pulmonary hypertension and pulmonic stenosis.

Question 47

Characteristics: 1. Diminished pulse pressure 2. Weak and small on palpation 3. Slow upstroke 4. Prolonged systolic peak

Answer 47

SMALL, WEAK PULSE

Question 48

Characteristics: 1. Increased pulse pressure 2. Strong and bounding on palpation 3. Rapid rise and fall with a brief systolic peak

Answer 48

LARGE, BOUNDING PULSE

Question 49

Characteristics: Double systolic peak

Answer 49

PULSUS BISFERIENS

Question 50

Cause: Left ventricular failure (usually accompanied by an S3 sound on the left)

Answer 50

PULSUS ALTERNANS

Question 51

These beats occur earlier than the next expected beat and are followed by a pulse. The rhythm resumes with the next beat.

Answer 51

PREMATURE VENTRICULAR CONTRACTIONS

Question 52

With this dysrhythmia, the HR speeds up and slows down in a cycle, usually becoming faster with inhalation and slower with expiration.

Answer 52

ATRIAL FIBRILLATION AND ATRIAL FLUTTER WITH VARYING VENTRICULAR RESPONSE

Question 53

Heard during early systole at the second right ICS and apex. Occurs with the opening of the aortic valve and does not change with respiration.

Answer 53

Aortic Ejection Click

Question 54

Best heard at the second left ICS during early systole. Often becomes softer with inspiration.

Answer 54

Pulmonic ejection click

Question 55

Heard in mid or late systole. Can be heard over the mitral or apical area and is the result of mitral valve leaflet prolapse during left ventricular emptying.

Answer 55

Midsystolic Click

Question 56

Occurring in early diastole. Heard with the opening of a stenotic or stiff mitral valve. Heard throughout the whole precordium, it does not vary with respirations. Often mistaken for a split S2 or an S3, the OS occurs earlier in diastole and has a higher pitch than an S3.

Answer 56

Opening Snap

Question 57

caused by inflammation of the pericardial sac.

Answer 57

Pericardial Friction Rub

Question 58

is a congenital anomaly that leaves an open channel between the aorta and pulmonary artery. It is classified as a continuous murmur because it extends through systole and into part of diastole.

Answer 58

Patent Ductus Arteriosus

Question 59

Common in children, is a benign sound caused by turbulence of blood in the jugular veins.

Answer 59

Venous Hum

Question 60

characterized by turbulent blood flow, which creates a swooshing or blowing sound over the precordium.

Answer 60

Heart murmurs

Question 61

The most common type of heart murmurs

Answer 61

midsystolic murmurs

Question 62

occur during ventricular ejection and can be innocent, physiologic, or pathologic. They have a crescendo- decrescendo shape and usually peak near mid systole and stop before S2.

Answer 62

midsystolic murmurs