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Phys. Assess Ch. 19
Heart
| Question | Answer |
|---|---|
| What is the pericardium? | a tough, fibrous, double walled sac that surrounds and protects the heart |
| What does the pericardial fluid ensure? | smooth, friction-free movement of the heart muscle |
| What is the myocardium? | muscular wall of the heart, it does the pumping |
| What is the endocardium? | thin layer of endothelial tissue that lines the inner surgace of the heart chambers and valves |
| Right side of the heart pumps into? | the lungs |
| Left side of the heart pumps to? | the body |
| What is the septum? | middle of heart |
| What is chordae tendineae? | leaflets that achor valves |
| What is diastole? | hearts filling phase |
| What is systole? | pumping phase |
| Where are the semilunar valves? | inbetween the ventricles and arteries |
| What are the semilunar valves? | pulmonic (right) and aortic (left) |
| What is the cardiac cycle? | rythmic movement of blood through the heart |
| What are the 2 phases of the cardiac cycle? | diastole and systole |
| What happens in diastole? | ventricles relax and fill with blood |
| What takes up 2/3 of the cardiac cycle? | diastole |
| What is systole? | heart's contraction |
| What is one third of cardiac cycle? | systole |
| What is protodiastolic filling? | first passive filling phase from the atria to ventricles |
| What is artrial systole, or atrial kick? | Where the atrium pushes the rest of the blood into the ventricles |
| What is the first heart sound? s1? | closure of av valvles, signals the beginning of systole |
| What is isometric contraction? | contraction against a closed system works to build pressure inside the ventricles to a high level (all 4 valves are closed, ventricualr walls contract) |
| What is isometric relaxation? | all four valves are closed and the ventricles relax |
| What is the s2 sound? | closure of the semilunar valves signals the end of systole |
| S1= M1-? | T1 |
| S2= A2-? | P2 |
| S2 is loudest at? | base |
| S1 is loudest at? | apex |
| Usually diastole is? | silent |
| What are vibrations heard by diastole called? | S3 |
| What does S4 occur? | at the end of diastole, when the ventricle i resistant to filling |
| What is a murmur? | a gentle, blowing, swooshing sound |
| All heart sounds are described by? | Frequency, intensity, duration and timing |
| SA node is the? | pacemaker |
| What is P wave? | depolarization of atria |
| What is RP interval? | beginning of P wave to beginning of QRS complex |
| What is QRS complex? | depolarization of the ventricles |
| What is T wave? | repolarization of the ventribles |
| How much blood is pumped/min? | 4-6 liters |
| What is preload? | the venous return that builds during systole |
| What is afterload? | opposing pressure the ventricle must generate to open the aortic valve against the higher arotic pressure |
| What do jugular veins do? | empty unoxygenated blood directly into the superior vena cava |
| External juglar vein is more? | superficial |
| What internal juglar vein is more? | deep |
| What is paroxysmal nocuturnal dyspna? | lying down increases volume, and weakened heart cannot accomodate |
| What is orthopnea? | the need to assume a more upright position to breath |
| What occurs with myocardial infarction? | cyanosis or pallor |
| Cardia edema is worse? | in the evening |
| babies with heart faiilure will have? | fatigue while eating |
| What is carotid sius hepersensitivity? | the condition in which pressure over the crotid sinus leads to decreased heart rate, BP, and ischemia with syncope |
| Diminished pulse= | decrease SV |
| Increased pulse= | hyperkinetic states |
| When is a carotid bruit audible? | when the lumen is occluded by 1/2 to 2/3 |
| If heart failure is present the? | jugular veins will elevate and stay elevated |
| What is a heave or lift? | sustained forceful thrusting of the ventricle during systole (ventricular hypertrophy) |
| What is a thrill? | palpable vibration, purring cat, signifies turbulent blood flow and accompanies loud murmurs |
| Cardiac enlargment is due to? | increased ventricular volume or wall thickness, occurs with hypertension, CAD, heart failure, and cardiomyopathy |
| What is premature beat? | isolated beat is early or a pattern occurs in which every third or fouth beat |
| Irregularly irregular? | no pattern to the sounds, beats come rapidly and at random intervals |
| What is a pulse deficit? | signals a weak contraction of the ventricles, occurs with atrial fibrillation, premature beats and heart failure |
| What is a fixed split? | unaffected by repiration, split is always there |
| What is paradoxical split? | the opposite of what you would expect, the sounds fuse on inspiration and split on expiration |
| A pathologic S3 occurs with? | heart failure and volume overload |
| What pathologic S4 occurs with? | CAD |
| A diastolic mumur always indicates? | heart disease |
| A murmur of mitral stenosis is? | rumbling (may only be heard on left side) |
| Aortic stenosis is? | harsh (may only be heard leaning forward) |
| Tachycardia is? | >200 |
| Bradycardia is? | <90 |
| Fixed split s2 indicates? | atrial septal defect |
| A substernal heave occurs with? | right ventriular enlargement |
| S3 is associted with? | heart failure |
| What is the mammary soufle? | sounds heard becasue of increased blood flow through the internal mammary artery |
| What is the venous hum? | normal sound, low pitched, soft hum heard througout the cycle |
| What is grade 1 of murmers? | barely audible |
| What is grade 2 of murmers? | clearly audible |
| What is grade 3 of murmers? | moderately loud, easy to hear |
| What is grade 4 of murmers? | loud, thrill palpable on chest wall |
| What is grade 5 of murmers? | Very loud, heard with some of the stethoscope off chest |
| What is grade 6 of murmers? | loudest, heard with whole stethoscope lifted off chest |
| what is the most common extra sound? | midsystolic click (mitral valve prolapse) |
| What are the 5 auscultatory areas? | aortic, pulmonic, erb's pt, mitrol and tricuspid |
| What causes S2 split? | when the pulmonic vavle is not closing with the aortic valve |
| What are other heart sounds? | clicks and snaps, efection clicks, murmurs (audible vibrations) thrills (palpable vibrations) |
| SV=? | SV x HR for 1 min |
| Preload is caused by? | excess pressure going into the heart |
| Afterload causes what? | regurgitation into lungs |
| What are heart changes in adults? | wall thicken, left atrium may increase in size, vessels and valves are more rigid, SBP may increase, May have an S4 |
| HDL:LDL what is ideal? | 1:2 |
| LDL? | <100 |
| Total- | <200 |
| HDL? | >40 <60 |
| What increases heart risks? | smoking, alcohol, drug abuse, age, gender, stress, hypertension, high cholestoer, fat, hx |
| What should you palpate? | apical impulse, across precardium, five auscultatory locations plus epigastrium |
| Ausclutation: APE TO MAN | aortic, pulmonic, tricuspid, mitral |
| What should be noted with auscultation? | rate and rhythm |
| What are characteristics of Right sided heart failure? | fatigue, increase peripheral venous pressure, destended jugular veins, anorexia, swelling in hand and finger, edema |
| What are characteristics of left sided heart failure? | restlessness, confusion, orthopnea, tachycardia, exertional dyspena, cynosis |
| What are the neck vessels? | carotid artery ad jugualr veins |
Created by:
alicia.rennaker
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