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Heart & PV. Assessme
N314-315 Assessment Lecture 4 exam 2
| Question | Answer |
|---|---|
| location | anterior chest wall |
| landmarks to heart | midsternal line, midclavicular line |
| intercostal space of the heart | located 2-5 ICS left of MSL to LMCL |
| chest area is called | precordium |
| cardiac muscles | epicardium, myocardium, endocardium |
| epicardium, is the ? layer | outer heart layer |
| myocardium, | middlelayer/ cardiac muscle contracting |
| endocardium | inner layer |
| atria | acts as a reservoir, receives blood returning |
| ventricles | larger thicker than atria (left)pumps blood 2 rest of body and (Right) to the lungs |
| _____ seperate atria from ventricles | A V valves = r= Atrium tricuspid ventricle L= atrium, bicuspid / mitral ventricle |
| closure of valves produce ? | normal sounds |
| S1= | lub |
| S2= | dub |
| valves open = | blood flow |
| valves close = | prevent flow |
| valves dont work = | murmur |
| names of 4 valves | Atrioventricular valves = tricuspid, mitral Semilunar Valves = aortic, pulmonic |
| AV valves = | tricuspid, mitral, |
| semilunar valves = | aortic, palmanic |
| when ATRIA CONTRACT ,VALVES do what ? | A.V.Tricuspid bicuspid valves-OPEN, when ventricles contract, A.V.(Tricuspid bicuspid) valves snap shut. When ATRIA are contracting, AV valves open When VENTRICLES are contracting, AV valves close. |
| when ventricles contract, values do what? | when ventricles contract, AV valves snap shut and semilunar (Aortic/pulmonic)open. When atria contract, SL valves close/AV open When ventricles contract, SL open/AV close |
| Pulmonic seperates _____ from _____ | Right ventricle, pulmonary artery (going to the lungs). |
| aortic valve seperates ______from _______ | left ventricle, the aorta |
| when ventricles contract, valves ?? | open semilunar |
| when ventricles relax, valves??? | semilunar valves close Av valves open |
| blood flow through heart | s & i vena cava,right atrium, tricuspid valve,right ventricle, pulmonic valve, pulmonary artery , in the lung ,back into the pulmonary veins, to the left atrium, through bicuspid valve, Left ventricle, aortic valve, aorta, rest of body. |
| Cardiac Cycle | 1, SA node, 2. Av node, 3. bundle of His, 4, ventricles |
| EcG is a record of ??? | the cardic cycle |
| Blood fills? | R & L atrium |
| Blood fills R and L atrium pulse ??? | pulse increases |
| P increases, valves ____, atria _____ | Pulse increases, valves open, atria contract |
| Blood into ventricles= P increases, __ valves _____ | Blood into ventricles= P increases, AV valves close S1 |
| ventricles contract = | systole |
| Heart is located ____ of midline behind _______ | left of midline, behind sternum |
| the heart is shapped like a ? | inverted triangle |
| the base of the heart is ?? | @ the top |
| the Apex of the heart is ? | @ the bottom |
| apical impulse is located ? | @ the apex of the heart |
| S1 = | blood into ventricles, p increases, av valves close |
| systole | ventricles contract |
| semilunar valves open allowing blood where? | pulmonary artery and aorta |
| S2 = | p - semilunar valves close |
| diastole= | ventricles relax |
| co cardiac out put = | stroke volume sv x heart rate hr |
| if co is decreASED what happens to the pulse? | @ first pulse will decrease than the pulse will increase to try to compensate |
| ventricle preassure rises = | systole |
| systole = increase in preassure = | AV valves close |
| ventricles contract during | systole |
| LV ejects blood to | body |
| Rv ejects blood to | lungs |
| Systole known as | S1 or lub |
| ventricles relax while atria contract = | diastole |
| When preassure in ventricles < aorta and pulmonary attery = | diastole |
| known as S2 or Dub | Diastole |
| Occasionally hear third sound while ventricles fill = | S3 |
| Is an S3 sound normal ? | Younger = normal growth spurts older = pathologic |
| Preassure in L side of heart > where | right side of heart |
| While assessing a client what would u want 2 know about their history | diet, exercise, cholesterol, HTN, diabetes, gender, stress, heart trouble, Palpitations, dyspnea, orthopnea, edema, fatique, chest pain (coldspa) medication |
| dyspnea | Dyspnea (Latin dyspnoea, Greek dyspnoia from dyspnoos - short of breath) or shortness of breath (SOB) is perceived difficulty breathing or pain on breathing. It is a common symptom of numerous medical disorders. |
| orthopnea | Discomfort in breathing that is relieved by sitting or standing in an erect position. |
| History pacemaker | A part of the body, such as the specialized mass of cardiac muscle fibers of the sinoatrial node, that sets the pace or rhythm of physiological activity. |
| automatic internal defibrillato | pacemaker |
| split S2 = | Preassure in L side of heart > right side occasionally hear aortic valve close prior to pulmonic valve |
| Type of info to find out about the heart while taking a health history | Pacemaker, AID, |
| Type of info to find out about the heart while taking a past health health history | diabetes, dependent edema, congenital heart defect, CAD, rheumatic fever, ECG when? any other diagnosis, |
| Type of info to find out about the heart while taking a family health history | Angina, heart disease, MI, Stroke, DM, Hyperlipidemia, sudden death age? |
| What does 3,3,5 represent? | 3 techniques, 3 positions, 5 IPA sights |
| name the 3 techniques of a heart assewssment | IPA |
| name the 3 positions of a heart assessment | sittting, supine, then L recumbent as needed |
| IPA sights | Aortic, Pulmonic, erbs point, tricuspid, Mitral, |
| Inspection and palpation give cues prior to ? | ausculation |
| What is needed to inspect the chest? | bare chest, quiet room, privacy, |
| During inspection you should stand on paticents _____ side. | right |
| How is the precordium inspected? | R side, light shine over movements, |
| Inspect 5 sights for | lifts, Pulsations |
| Lifts + | Enlargement of heart push up or increased cardiac workload |
| Precordium is palpated in 5 sights for? | Heave, thrills |
| thrills = | fell palpable like a cat purring Indicitative of a rushing sensation, turbelant blood flow? R or L ICS + aortic or pulmonic stenosis |
| why is the precordium and carotid artery palpated @ the same time? | S1 should coincide with carotid impulse |
| What should be heard @ the interval between S1 and S2? | the interval should be silent |
| Aortic sounds best heard ??? | @nd 2nd ICS RSB |
| Pulmonic sounds best heard ? | 2nd ICS LSB |
| Erb's Point sounds best heard | 3rd L ICS LSB |
| Tricuspid sounds best heard | 5th L ICS LSB |
| Mitral sounds best heard | 5th. L ICS MCL |
| S1 is the loudest @ ? | loudest at apex. tricuspid and mitral sites LUB-dub |
| S2 is loudest @ ? | loudest at base. Pulmonic and aortic sites -lub- DUB |
| To increase heart souns what can the client do ? | exhale & hold breath |
| What is heard best with the diaphragm?and why? | S1 & S2 high pitched |
| assess ? during heart auscultation? | heart sounds S1, & s2, rate, rythm regular vs irregular, extra sounds |
| S1 is best heard @ ? | apex |
| S2 is best heard @ where? | at base |
| Split S2 | may be physiologic increased during inspiration should dissappear during exhalation |
| s3 = | EXTRA HEART SOUND |
| s3 IS BEST HEARD WITH ? | BELL |
| when will an S3 heart sound be heard? | during L ventricular filling |
| Physiologic in children and young adult (,25) , pregnancy | S3 extra heart sound |
| an S3 after age 40 suggests ? | ventricular or valve problems |
| How are extra heart sounds described? | describe findings in terms of location Timing systole or diastoloe |
| S4 is best heard? | L lateral recumbent position with bell |
| is an S4 heard in young adults? | seldom unless well conditioned |
| S4 in older people = | OK or heart disease |
| s4 indicates? | resistance to ventricular filling HTN or pulmonary HTN |
| murmur | sound superimposed on S1 and S2 blowing or whooshing hum describe as during systole or diastole continous sound caused by turbelent blood flow |
| Bruit secondary 2 a mumurincreased bloood flow | incomplete valve congential heart defect |
| functional mumur | usually systolic 30%-50% of young pregency fever |
| abnormal murmur | all diastolic |
| Semilunar valves work in near | synchrony |
| pulmonic seperates _____ from _____ | rt. ventricle from pulmonary = deoxygenated blood (fyi) only artery in body w/eoxygenated blood) |
| Aortic seperates ____ from _____ | left vent from aorta |
| when ventricles contract valves ____? when ventricles relax valves _____? | ventricles contract =valves open |
| Heart sounds = | Heart sounds = blood fills R and L atrium |
Created by:
garrowcousino
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