Quiz 3 Concepts

Question 1

What is the pericardium and why is it double-walled>

Answer 1

it is a sac that surrounds and protects the heart
-it is double-walled to make it harder for things to hurt the heart

Question 2

What is the myocardium?

Answer 2

the muscular wall of the heart, it is responsible for contraction of the heart

Question 3

What is the endocardium?

Answer 3

the thin layer of endothelial tissue that lines the inner surface of the heart chambers

Question 4

What is the flow of blood starting at the vena cava?

Answer 4

right atrium –> tricuspid valve–> right ventricle–> pulmonary valve–> pulmonary artery–>pulmonary vein–> left atrium–> mitral valve–> left ventricle–> aortic valve–> aorta

Question 5

What does S2 indicate?

Answer 5

the closing of the semilunar valves (aortic and pulmonary valves)
-this is the end of systole

Question 6

Where is S2 heard the loudest?

Answer 6

the base of the heart

Question 7

What does S1 indicate?

Answer 7

the closing of the mitral and tricuspid valves
-heard the loudest at the apex

Question 8

What occurs after the pacemaker is initiated?

Answer 8

the impulse travels to the atria to the AV node, it delays, and gives the atria time to contract

Question 9

What gives information about the activity on the right side of the heart?

Answer 9

jugular veins, they reflect volume changes and filling pressures

Question 10

With aging, what happens to the heart?

Answer 10

systolic pressure increase
no change in diastolic pressure

Question 11

What occurs with paroxysmal nocturnal dyspnea?

Answer 11

it is shortness of breath that occurs at night, lying down increases blood volume and the weak heart can’t accomodate

Question 12

How do you assess for significant risk factors of coronary artery disease?

Answer 12

assess serum cholesterol, elevated BP, blood glucose levels, diabetes, obesity,

Question 13

What should auscultate if cardiovascular disease is suspected?

Answer 13

each carotid artery to listen for a bruit

Question 14

How do you avoid compromising arterial blood to the brain?

Answer 14

palpate one carotid artery gently at a time, medially

Question 15

How does heart failure affect the heart?

Answer 15

it decreases cardiac output and circulation becomes backed up bc the heart can’t pump it

Question 16

What sound is associated with heart failure?

Answer 16

S3

Question 17

Where is S4 heard and who does it occur in?

Answer 17

its heard at the end of diastole and ventricles resist filling, mainly occurs in older adults

Question 18

How do you auscultate the carotid artery for bruits?

Answer 18

applying the bell of the stethoscope over the carotid artery at three levels
-the patient should breath, exhale, and briefly hold it

Question 19

How does blood move through the veins?

Answer 19

contracting skeletal muscles to milk the blood toward the heart
pressure gradients
the valves

Question 20

What would occur if skeletal muscle, valves, and lumen didn’t work?

Answer 20

venous stasis

Question 21

What would occur if somebody stood or sat for a prolonged amount of time?

Answer 21

venous disease because they do not get the milking action that walking causes

Question 22

What propels the flow of lymph?

Answer 22

contracting skeletal muscles

Question 23

Where does lymph flow?

Answer 23

from the tissue spaces to the bloodstream

Question 24

Where are the epitrochlear nodes located and what do they drain?

Answer 24

in the antecubital fossa and they drain the lower arm

Question 25

Where are the inguinal nodes and what do they drain?

Answer 25

drain lymph in the lower extremities and they are located in the groin

Question 26

What happens to the peripheral blood vessels as aging occurs?

Answer 26

they become more rigid and cause a rise in systolic blood pressure (arteriosclerosis)

Question 27

What is intermittent claudication?

Answer 27

feels like a cramp

Question 28

What patient population is night leg pain common in and what does it indicate?

Answer 28

ischemic rest pain of peripheral arterial disease, common in aging adults

Question 29

If there are alterations in arterial circulation,what can occur?

Answer 29

pain that worsens with leg elevation and eases when the extremity is dangled

Question 30

What does a capillary refill time of 5 seconds indicate?

Answer 30

a decrease in capillary refill indicating vasoconstriction or decreased cardiac output

Question 31

What does a weak thready pulse indicate?

Answer 31

shock or peripheral artery disease, associated with decreased cardiac output and peripheral arterial disease

Question 32

What does unilateral coolness indicate?

Answer 32

arterial problems

Question 33

How does brawny edema appear?

Answer 33

as nonpitting edema and it feels hard to the touch

Question 34

What causes superficial varicose veins?

Answer 34

incompetent distant valves in the veins resulting in blood reflux and dilated veins

Question 35

Raynaud phenomenon

Answer 35

episodes of abrupt progressive tricolor changes of the fingers in response to cold, vibration, stress

Question 36

lymphedema

Answer 36

accumulation of lymph fluid in the interstitial spaces in the arm that may occur with breast cancer

Question 37

What does lymphedema look like in someone who has breast cancer?

Answer 37

unilateral swelling and nonpitting brawny edmea

Question 38

What is deep vein thrombosis and how does it present?

Answer 38

development of a clot in a deep vein, commonly in the legs presents with swelling, pain, redness, and warmth

Question 39

Where do arterial ischemic ulcers occur and how are they characterized?

Answer 39

toes, metatarsal heads, heels, and lateral ankles -pale, no bleeding, well defined edges

Question 40

What is held in the right upper quadrant?

Answer 40

liver, gallbladder, duodenum, head of the pancreas, right kidney, adrenal gland

Question 41

What is held in the left upper quadrant

Answer 41

stomach, spleen, left lobe of the liver, body of the pancreas

Question 42

What is held in the right lower quadrant of the abdomen?

Answer 42

cecum, appendix, right ureter, fallopian tube

Question 43

what is held in the left lower quadrant?

Answer 43

descending colon, left ureter, left ovary, fallopian tube

Question 44

What additional structures lie in the midline of the abdomen?

Answer 44

aorta, distended bladder, enlarged uterus

Question 45

What is dysphagia?

Answer 45

diffuculty swalloing

Question 46

What is dysphasia?

Answer 46

difficulty speaking

Question 47

When can you palpate a spleen?

Answer 47

if its 3x the normal size

Question 48

Contour

Answer 48

describes profile of the abdomen, describes nutritional state, ranges from flat to round

Question 49

Convex

Answer 49

curved, rounded, outward protrusion

Question 50

Hernia

Answer 50

protrusion of the abdominal viscera through an abnormal opening in the abdominal muscle wall

Question 51

What can cause diminished or absent bowel sounds?

Answer 51

paralytic ileus

Question 52

How long must you auscultate the abdomen before deciding that bowel sounds are absent?

Answer 52

5 minutes

Question 53

When should you examine any identified tender areas of the abdomen?

Answer 53

at the end of the assessment

Question 54

Why might decreasing gastric acid secretions cause pernicious anemia?

Answer 54

decreased gastric acid interferes with the absorption of vitamin B12

Question 55

Ascites

Answer 55

free fluid in the peritoneal cavity occurs with heart failure, portal hypertension, cirrhosis, hepatitis, pancreatitis, cancer

Question 56

How do you assess for an inflamed appendix?

Answer 56

obturator and iliopsas muscle tests

Question 57

What could rebound tenderness indicate?

Answer 57

peritoneal inflammation, cholecystitis

Question 58

What test determines that someone has cholecystitis?

Answer 58

pain occurs when palpating the liver because the descending liver pushes the inflamed gallbladder onto the examining hand (murphy test)

Question 59

How do peptic ulcers occur?

Answer 59

acid in the digestive tract erodes the inner surface of the stomach or small intestine - can occur with frequent NSAID use, alcohol use, smoking

Question 60

What are the signs and symptoms of acute venous problems?

Answer 60

sudden onset pain in the calf that is warm, red, and swollen

Question 61

How do arterial symptoms present?

Answer 61

the pain begins with exertion and is relieved with rest or dangling, pale and cool skin -pts. usually have a smoking history and diabetes