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