Cardiovascular Tips for Success
Help!
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| What is the base of the heart? | broader upper portion of the heart
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| What is the apex of the heart? | Narrow lower tip of the heart
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| What is the primary muscle mass of the heart? | ventricles
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| What is the anterior surface? | right ventricle
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| What is posterior surface? | left ventricle
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| What is the left border of the heart? | left ventricle
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| What is responsible for the apical impulse? | the left ventricle
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| What is the right border? | the right atrium
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| What is preload | pressure stretching the ventricles of the heart cause by venous return
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| What is afterload? | pressure that the left ventricle must squeeze against to eject blood into the aorta
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| What is systole? | The ventricles contracting and ejecting blood from the left ventricle into the aorta and from the right ventricle into the pulmonary artery
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| What is diastole? | The atria contract and the ventricle dilate (blood moves from the atria to the ventricles)
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| Where do electrical impulses originate? | SA node
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| Where is the SA node located? | Right atrium
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| What is the path of the electrial impulses in the heart? | SA Node -> AV Node -> Bundle of His -> Purkinje Fibers
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| Where is the AV node located? | atrial septum
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| Where is the bundle of His and the purkinje fibers | Ventricles
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| How do ventricles contract? | At apex and spread to base
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| How does the fetus compensate for nonfunctional lungs? | umbilical vessels
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| Where does the right ventricle pump blood in the fetus? | ductus arteriosus
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| When does teh ductus arteriosus close? | after birth in approximately 24-48 hours
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| When does the foramen ovale close? | As pressure rises in the left atrium at birth
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| How much does blood increase in pregnant women? | 40-50%
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| Why does blood increase in pregnant women? | increased plasma volume
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| How does the heart compensate during pregnancy? | The left ventricle increases in wall thickness and mass?
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| Why does the heart compensate during pregnancy? | to allow for increased work load
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| What happens to the heart in older adults | The left ventricle wall thickens and valves tend to fibrose and calcify
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| What causes changes to the heart in older adult? | stress on the heart due to HTN, heart disease, etc.
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| One finger to chest pain indicates? | non-cardiac pain
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| N/Vomiting/Diaphoresis with chest pain is? | cardiac till proven otherwise
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| What does jaw pain indicate? | ischemia and pericarditis
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| What does sharp chest pain and hemoptysis indicate? | pulmonary embolism or tumor
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| What does pain with swallowing indicate? | esophageal spasm or pericarditis
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| What does fever with chest pain indicate? | pneumonia
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| What does sighing and mood issues with chest pain indicate? | anxiety and depression
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| What are cardiac risk factors? | age
hyperlipidemia
family Hx
obesity
sedentary lifestyle
tobacco
diabetes
personality
hypertension
gender
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| If a person has hyperlipidemia, tobacco use or diabetes, the odds on having cardiac issues are what? | 8x more likely
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| What are the 5 points of auscultation? | Aortic
Pulmonic
Erbs Point
Tricuspid
Mitral
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| Where is the aortic auscultation point? | 2nd intercostal space on the RIGHT side
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| Where is the pulmonic auscultation point? | 2nd intercostal space on the LEFT side
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| Where is the Erbs point? | 3rd intercostal space on the left side
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| Where is the tricustpid auscultation point? | 4th intercostal space on the left side
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| Where is the mitral valve auscultation point? | 5th intercostal space on the left side
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| What is Erbs Point? | where S2 is best auscultated
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| What is the point of maximal impulse? | 5th intercostal space, left mid-clavicular line
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| Where does PMI shift in left ventricular hypertrophy? | downward and laterally
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| what is S1? | during ventricle systole when the mitral and tricuspid valves are closing
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| What is S2? | During ventricular diastole when the aortic and pulmonic valves close.
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| What is S3? | rapid filling of left ventricle in diastole.
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| When is an S3 sound normal? | normal into 3rd decade
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| What does S3 indicate in an older adult? | sign of heart failure
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| What does S4 heart sound? | Atrial diastolic gallop caused by vibration of valves and ventricular walls
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| What causes an S4 heart sound? | aortic stenosis
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| What is a grade I murmur? | barely audible in quiet room
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| What is a grade II murmur? | quiet but clearly audible
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| What is a grade III murmur | moderately loud
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| What is a grade IV murmur? | Loud with thrill
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| What is a grade V murmur? | Very loud with thrill and easily palpable
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| What is a grade VI murmur? | very loud, audible without a stethoscpe not in contact with chest, thrill palpable and visible.
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| What is a thrill? | fine palpable rushing vibration. Innocent murmurs do NOT have thrills
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| What are the two systolic murmurs? | Aortic stenosis and mitral regurgitation
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| Where is aortic stenosis heard? | 2nd intercoastal space and radiating to carotids
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| Where is mitral regurgitation heard? | best at teh apex and radiating to the left axilla
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| What are the two diastolic murmurs? | Aortic regurgitation and mitral stenosis
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| Where is aortic regurgiation heard? | right 2nd intercostal space with teh patient leaning forward using the diaphragm of the stethoscope
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| Where is mitral stenosis heard? | Left mid-clavicular line, 5th intercostal space with the patient lying in the left lateral recumbent position using the bell of the stethoscope
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| What murmurs are always pathological? | Diastolic Murmurs (Aortic regurg and mitral stenosis)
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| What needs to be inspected and palpated for the peripheral vascular system? | skin temperature, color, texture, pulses, any pain/tenderness, presence of edema, varicosities, hair distribution, muscle tone
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| How do you grade a normal pulse? | +2
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| What is the scale to grade pulses? | 0 - +4
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| What is Homan's Sign | calf pain with dorsiflexion of ankle indicating DVT
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| What is JVD? | Jugular Vein Distension
Asymmetry of the jugular veins seen on inspection of patient sitting at 45 degrees
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| What does JVD indicate? | Right sided heart failure
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| What is the hepato-jugular reflex? | press lightly for 30 seconds on the right upper quadrant. If you see an increase in JVD then there could be right ventricular dysfunction.
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| What are bruits? | heard over renal arteries, carotids, abodminal aorta, iliac arteries, temporal arteries, and orbital arteries
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| How do you hear bruits? | With the bell of the stethoscope
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| What do bruits sound like? | "whooshing"
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| What do bruits indicate? | a build up of plaque
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| What does pitting edema indicate? | right sided heart failure
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| What is +1 pitting edema? | 1-2mm
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| What is +2 pitting edema? | 2-4mm
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| What is +3 pitting edema? | 4-6mm
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| What is +4 pitting edema? | 6-8 mm
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| What are the 5 P's of arterial occusion? | Pain
Pallor
Paralysis
Paresthesia
Pulselessness
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Created by:
tjamrose
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