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263 CH21
263 EXAM 2
| Term | Definition |
|---|---|
| cardiovascular system | pulmonary and systemic |
| heart upper portion | left 2nd intercostal space, base |
| heart lower portion | left 5th intercostal space, apex |
| atrioventricular valves | open during diastole (filling) to allow ventricles to fill with blood, close to prevent regurgitation, S1 |
| semilunar valves | separate ventricles from arteries, open during pumping (systole) to allow blood to be ejected from the heart, S2 |
| pericardium | surrounds heart |
| epicardium | membrane covering outside the heart |
| myocardium | middle, thickest layer |
| endocardium | innermost layer |
| SA node | impulses 60 - 100 bpm, both atria contract simultaneously to send blood to ventricles |
| AV node | 40 - 60 bpm, delays electrical impulses, relays signals to AV bundle |
| electrocardiography | records depolarization and repolarization |
| systole | large amounts of blood in the ventricles, higher pressure in the ventricles causing the AV valves to close and semilunar valves to open |
| preload | the load that stretches the cardiac muscle prior to contraction, amount of blood in ventricles at the end of diastole |
| diastole | AV valves are open, ventricles relax, increased pressure in atria causes blood to rush through atria into the ventricles |
| s1 | produced by closing of AV valves, signals beginning of systole, lub, loudest at apex |
| s2 | closure of aortic and pulmonic valves, end of ventricular systole, beginning of ventricular diastole, loudest at base, dub |
| s3 | caused by blood hitting ventricle wall, lub dub dub, kentucky, best heard with bell in left lateral position, pulse varies between beats |
| s4 | caused by blood flowing rapidly into stiff ventricles after atrial contractions, lub lub dub, Tennessee, heard with bell over apical areas in supine/ left lateral position |
| pericardial friction rub | caused by inflammation of pericardial sac, high pitched, scratchy |
| cause of cardiac murmurs | increased blood viscosity (thickness), structure valve disorders, valve malfunction, abnormal chamber openings, louder over the upper precordium and quiet near neck |
| systolic murmurs | heard when heart contracts |
| diastolic murmurs | heard when heart relaxes |
| description of murmur | intensity (I-VI), timing (sys/dia), pitch, pattern, quality, location, radiation, position |
| murmurs are result | regurgitation, stenosis |
| S&S of murmurs | cyanosis, edema, jugular vein distention, chest pain, shortness of breath, dizziness, fainting |
| midsystolic murmur | physiologic murmur, caused by aortic/ pulmonic stenosis |
| pansystolic murmur | caused by mitral regurgitation, tricuspid regurgitation |
| diastolic murmurs | caused by aortic regurgitation, mitral stenosis |
| carotid artery | located between trachea and R/L sternocleidomastoid muscle |
| carotid artery pulse | amplitude, contour |
| diminished uni/bilateral carotid artery pulse | atherosclerotic stenotic carotid artery |
| orthopnea | shortness of breath when lying flat |
| bruit | swooshing sound, result of turbulent blood flow, audible when artery is partially obstructed, higher pitch, superficial, only in arteries |
| apical pulse | left midclavicular line, fifth intercostal space |
| 5 areas apical pulse | aortic, pulmonic, erb point, tricuspid, mitral |
| erb point | 3rd intercostal space at left sternal border |
| aortic | 2nd intercostal space left sternal border |
| mitral | 5th intercostal space medial to sternal border |
| pulmonic | 2nd intercostal space right sternal border |
| pulse rate deficit | completed if irregularity is detected (difference in apical and radial pulse) |
| newborns cardiac assesment | foramen ovale closes within first hour, may be born with murmur |
| childbearing cardiac assessment | increased heart rate, blood volume |
| geriatric cardiac assessment | check for orthostatic hypotension, sitting standing, supine |
| fremitus | vibration of chest wall produced by vocalization |
| pectus excavatum | sunken in sternum, result of congenital disease |
| P wave | atrial depolarization, conduction of the impulse throughout the atria |
| PR interval | beginning of atrial depolarization to beginning of ventricular depolarization |
| QRS complex | ventricular depolarization, conduction of the impulses throughout the ventricles, triggers contraction of ventrices |
| ST segment | period between ventricular depolarization and beginning of ventricular repolarization |
| T wave | ventricular repolarization, ventricles return to resting state |
| QT interval | total time for ventricular depolarization and repolarization, from beginning of Q wave to end of T wave, varies with heart rate |
| U wave | may or may not be present, final phase of ventricular repolarization |
| bigeminal pulse | regular, irregular rhythm (one normal beat followed by a premature contraction) |
| paradoxical pulse | palpable decrease in pulse amplitude, pulse is stronger on exhalation |
| causes of paradoxical pulse | pericardial tamponade, constrictive pericarditis, obstructive lung disease |
| ventricular lift | lifting left during systole at lower left sternal border, associated with right ventricular hypertrophy caused by pulmonic valve disease, pulmonic hypertension, chronic lung disease |
| patent ductus arteriosus | congenital anomaly leaves an open channel between the aorta and pulmonary artery, continuous murmur extends through systole and diastole (loudest in systole) |
| venous hum | caused by turbulence of blood in the jugular veins, above medial third of the clavicles |
| grade 1 murmur | faint, may not be heard in all position |
| grade 2 murmur | quiet but heard immediately |
| grade 3 murmur | moderatley loud |
| grade 4 murmur | loud |
| grade 5 murmur | very loud, may be heard with stethoscope partly off chest |
| grade 6 murmur | may be heard without stethoscope on chest |
| quality of murmurs | blowing, rushing, roaring, rumbling, harsh |
| physiologic murmur | caused by temporary increase in blood flow, can occur with anemia, pregnancy, fever and hyperthyroidism, grade 1 or 2 |
| pulmonic stenosis murmur | impeded flow across pulmonic valve and increased right ventricular afterload, 2nd and 3rd intercostal space |
| aortic stenosis murmur | stenosis of the aortic valve impeding blood flow across the valve increases left ventricular afterload |
| hypertrophic cardiomyapthy | unusually rapid ejection of blood from the left ventricle during systole, result of massive hyopertrophy of ventricular muscle |
| coronary artery disease | damage or disease in heart's major blood vessels, caused by buildup or plaque |
| internal jugular vein oscillations | right atrium change in pressure |
| right ventricular failure | s2 split |
| jugular distention, bulging | indicate right sided heart failure |
| pulsus arternans | left ventricular failure, changes in amplitude |
| signals beginning of systole | closure of mitral and tricuspid valves |
| jugular vein distention | excess fluid --> administer diuretic |
| afterload | degree of vascular resistance to ventricular contraction |
| mitral valve stenosis | snaps early in diastole |
| decrease CO | heart pumps inadequate amount of blood, monitor BP, tachycardia |
| pulmonary circulation | flow of blood from heart to lungs (right side) |
| systemic circulation | flow of blood from lungs to body (left side) |
| semilunar valves | exit of each ventricle, beginning of great vessels |
| aortic stenosis | pressure overload of left ventricle, increase amplitude of apical pulse |
| tricupsid | between right atrium and right ventricle |
| bicupsid | between left atrium and left ventricle |
| mid systolic click | mitral valve prolapse |
| sinus node | cardiac pacemaker, in right atrium, |
| closure of AV valves | s1 |
| bundle branch block | wide splitting, delays activation of right ventricle |
| right ventricular failure | fixed s2 split |
| wide splitting | right bundle branch block, pulmonic stenosis |
| paradoxical splitting | left bundle branch block |
| hypertrophy of left ventricle | duration of apical pulse |
| amplitude of apical pulse | aortic stenosis, anemia |
| causes increased jugular venous pressure | constrictive pericarditis, right sided heart failure |
| older adults and trained athletes | may have s4 |
| stiffening of ventricles | s4 sound |
| abnormal contraction of ventricles | split s1 |
| left ventricular failure | pulsus arternans difference in amplitude beat to beat |
| paradoxical pulse | decreased amplitude; pericardial tamponade, constrictive pericarditis, obstructive lung disease |
| bigeminal pulse | one normal beat followed by premature contraction |
| bisferins | double systolic peak, aortic regurgitation, aortic stenosis |
| mitral valve prolapse | late systole murmur |
Created by:
ahommel
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