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Cardiovascular Tips for Success

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