Test2-Heart and Neck Vessels-MJ

Question 1

What does APETM (all physicians eagerly take money) stand for?

Answer 1

It is the acronym for the way to listen to the heart sounds:

Atrial, Pulmonary, Erbs, Tricuspid, Mitral

Question 2

What is the basic blood flow in the heart?

*this is a real simple answer, not the complicated one

Answer 2

R.Atrium–>R.Ventricle –>Lungs–>L.Atrium

–>L.Ventricle–>Body–>Back to R.Atrium

Question 3

S1= closer of ____ valves

Answer 3

AV valves

Question 4

S2= closer of ___ valves

Answer 4

Semilunar valves

Question 5

Is S1 systolic or diastolic?

Answer 5

Systolic

Question 6

Is S2 systolic or diastolic?

Answer 6

Diastolic

Question 7

Where is the S1 sound heard best?

Answer 7

This is the systolic sound; it is heard best at the apex of heart

Question 8

Where is the S2 sound heard best?

Answer 8

This is the diastolic sound; it is loudest at base of the heart

Question 9

Why do we listen for S1S2 sounds at Erbs Point?

Answer 9

Erbs point is in the middle of where it is heard best for systolic and diastolic, this is the best place to hear both of them equally loud

Question 10

Define: turbulent blood flow

Answer 10

Murmur

Question 11

What are the normal heart sounds?

Answer 11

S1S2

Question 12

What are the extra heart sounds?

Answer 12

S3S4

Question 13

What is a murmur?

Answer 13

Turbulent blood flow

Question 14

What is a bruit?

Answer 14

Anywhere else in the body (outside the heart) where there is turbulent blood flow

Question 15

Can you feel a bruit?

Answer 15

No

Question 16

Is a bruit a low or high pitched sound? So what side of the stethoscope would you use?

Answer 16

Bruit are LOW pitched, so you use the bell of the stethoscope

Question 17

Can you feel a thrill?

Answer 17

Yes

Question 18

What is a thrill?

Answer 18

Turbulent blood flow you can feel

Question 19

For a friction rub: How would you be able to tell the difference between a friction rub that is in the lungs vs. in the heart?

Answer 19

Ask them to old their breath; if you can still hear it when they are holding their breath, that means the friction rub is in the heart

Question 20

When you see/feel heaves and lifts, what does that tell you?

Answer 20

The heart is having to work very hard

Question 21

What does it mean when you have a pulse deficit?

Answer 21

There is a difference in the HR monitor pulse and the manual pulse

Question 22

What type of patient might you see a pulse deficit in?

Answer 22

Patients who have A-Fib

Question 23

What is syncope?

Answer 23

Fainting

Question 24

What is the inspection sequence for the heart and neck?

Answer 24

Inspection
Palpation
Percussion
Auscultation

Question 25

What are the two main things you look for during inspection?

Answer 25

- Apical impulse | - Heaves/lifts

Question 26

Inspection: Who can you see apical impulses in better?

Answer 26

Children

Question 27

Inspection: When do heaves/lifts occur?

Answer 27

Ventricular hypertrophy

Question 28

Heaves/lifts: Where is the right ventricular seen?

Answer 28

Sternal boarder

Question 29

Heaves/lifts: Where is the left ventricular seen?

Answer 29

At the apex

Question 30

What are the 3 main areas for palpation?

Answer 30

Carotid arteries Apical impulse Precordium

Question 31

How do you palpate the carotid arteries?

Answer 31

- Avoid excessive pressure - Only palpate one at a time - Note couture and amplitude - Both sides should be equal

Question 32

How do you palpate the apical impulse?

Answer 32

- Use one finger pad - Asks patients to exhale and hold - May need to roll client to the LEFT

Question 33

What are the four apical pulse findings?

Answer 33

Location Size: 1X2 cm Amplitude: Short, mental tap Duration

Question 34

The apical pulse can be difficult to find. 25-40% of adults you can't find it when they are in a supine position. What position can you move them to so that you can feel it better. This increases the chances of finding it to 50-73%.

Answer 34

Left lateral position

Question 35

What other types of patients may have "difficult to find" apical pulses?

Answer 35

Obese patients and those with thick chest walls

Question 36

How do you palpate the precordium?

Answer 36

Use palmar aspect of 4 fingers

Question 37

What do you palpate for the precordium?

Answer 37

Apex Left sternal boarder Base

Question 38

What do we do for percussion when checking the heart and neck?

Answer 38

Nothing

Question 39

What do we auscultate for the heart and neck?

Answer 39

Heart and caarotid arteries

Question 40

What are the 5 steps to heart auscultation?

Answer 40

1. Start with diaphragm 2. Note regularity of rhythm 3. Identify S1 and S2 4. Listen for extra heart sounds and murmurs 5. Repeat with the bell

Question 41

What type of clients would need to have the carotid arteries auscultated?

Answer 41

Clients with CAD risk factors

Question 42

For carotid artery auscultation, when would a bruit be heard?

Answer 42

When 1/2 to 2/3 of the artery is occluded; the bruit will fade after it is stopped being occluded

Question 43

How do you auscultate the carotid artery?

Answer 43

1. Keep neck in neutral position 2. Lightly apply the bell over: - angle of jaw - Midcervical area - Base of neck