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Assessment
Cardiac
| Question | Answer |
|---|---|
| Thin sac composed of fibroserous material that surrounds the heart | pericardium |
| The pericardium's tougher layer protectes the heart and anchors it to the adjacent structures such as the diaphragm and great vessels | fibrous pericardium |
| The inner layer is called | serous pericardium |
| The pericardium is composed of two layers | parietal and visceral |
| The parietal layer of the pericardium is the (inner or outer) layer | outer |
| The visceral layer of the pericardium is the (inner or outer) layer | inner (it lines the surface of the heart) |
| The heartbeat is most easily palpated over the _______ | apex (this point is referred to as the point of maximum impulse - PMI) |
| The heart is composed of three walls | 1.) epicardium 2.) myocardium 3.) endocardium |
| The endocardium is anatomically identical to the | visceral pericardium |
| The myocardium is the thick, muscular layer. It is made up of bundles of cardiac fibers reinforced by a branching network of connective tissue fibers called _____________ | fibrous skeleton of the heart |
| The innermost layer of the heart is the _________. | endocardium (provides an inner lining for the chambers of the heart.) |
| The interatrial septum separates the two _____. | atria |
| The interventricular septum divides the _______. | ventricles |
| The __________ valve separates the right atria/ventricle. | tricuspid |
| The most muscular chamber of the heart is the ________. | Left ventricle (a female's heart has about 10% muscule mass than a male.) |
| Valves are classified by their location as either ____________ or _______________. | Atrioventricular or Semilunar |
| The AV valves separate the _______ from the ___________. | atria from the ventricles |
| The ___________ valve lies between the RIGHT atrium and the RIGHT ventricle. | tricuspid |
| The ___________ valve lies between the LEFT atrium and the LEFT ventricle. | mitral (biscupid) |
| The atrioventricular valves (tricuspid and mitral) are __________ shaped. | leaflet |
| The semilunar valve separates the ventricles from the _____________. | vascular system |
| The pulmonary semilunar valve separates the right ventricle from the ___________________. | trunk of the pulmonary arteries |
| The aortic semilunar valve separates the _______ ________ from the aorta. | left ventricle |
| S1 = _________________________ | Mitral, tricuspid valves close |
| S2 = _________________________ | Aortic, pulmonic valves close |
| #1 sign of hypoxia | confusion and restlessness |
| Friction rubs result from inflammation of the ___________ sac. | pericardial |
| Heart murmurs are ______, ________ sounds | harsh, blowing |
| Murmur sounds: Grade 3 | Moderately loud |
| Murmur sounds: Grade 6 | Loudest |
| Murmur sounds: Grade 1 | Barely |
| Murmur sounds: Grade 5 | Very loud |
| Murmur sounds: Grade 2 | Very soft |
| Murmur sounds: Grade 4 | Distinctly loud, in addition to palpable thrill |
| The ___________ vein serves as the tributary for the majority of blood drainage and empties into the coronary sinus. | great cardiac vein |
| The main structures of the cardiac conduction system are: | 1. SA node 2. AV node 3. bundle of His 4. right/left bundle branches 5. Purkinje fibers |
| The ______ node is the pacemaker of the heart. | SA node |
| The SA node is located at: __________________ | the junction of the superior vena cava and the right atrium. |
| The SA node discharges an average of __ - __ times per minute. | 60 - 100 |
| The Intra-Atrial Conduction Pathway is composed of three main pathways: _________, ________, and posterior. | anterior, middle, and posterior |
| The AV node and bundle of His are intricately connected and function to receive current that has finished spreading throughout the atria. The impulse is slowed for about ___ second before it passes to the bundle of His. | .01 second |
| The AV node can kick in if the SA node shuts down. It fires about ___ per minute. | 60 |
| The right and left bundle branches spread electrical current through the _______________ myocardial tissue. | ventricular |
| The Purkinje fibers penetrate into the myocardial tissue and spread to ____________. | the actual tissue of the heart |
| The bundle brandes are also capable of initiating electrical charges if the SA and AV node shut down. Their rate averages __ to __ per minute. | 40 to 60 |
| The sympathetic fibers stimulate the heart by.... | increasing the heart rate, force of contraction, and dilation of the coronary arteries. |
| The parasympathetic fibers (eg., the vagus nerve)... | slow the heart rate, ..... |
| Cardiac plexus | |
| The average time for each cardiac cycle to be completed is ___ seconds. | 0.8 seconds |
| The cardiac cycle is divided into 3 parts: | 1. Period of Ventricular Filling 2. Ventricular systole 3. Isovolumetric relaxation |
| Period of Ventricular Filling (the start of the cardiac cycle) 70% of blood ends up in the ventricles. Another 30% enters -- this is known as... | atrial kick |
| Ventricular systole (2nd step in cardiac cycle) -- the electrical current stimulates the ventricles; they contract; the force of the contraction increases pressure in both ventricles; the mitral and tricuspid valves respond by snapping SHUT. | |
| Isovolumetric Relaxation | |
| When assessing the heart, the closing of which valves causes the first heart sound? | Mitral and tricuspid |
| When the aortic and pulmonic valves close, the nurse should detect which heart sounds through auscultation? | S2 |
| Pulmonary arteries carry ____________ blood to the lungs. | Deoxy |
| __________ describes the amount of blood that is ejected with every heart beat. | Stroke volume |
| ___________ describes the amount of blood ejected in 1 minute. | Cardiac output |
| ___________ is the amount of stress/tension present in the ventricular wall during systole. | Afterload |
| Cardiac output ÷ Patient's body surface area | Cardiac index |
| To assess JVD, the patient should be in a ___ degree angle. | 45 degrees |
| Normally, veins (jugular) distend ___ cm | 3 cm |
| RN palpates an abnormal tremor with murmur, it is a... | thrill |
| Pericarditis affects which layers of the heart? | Between the pericardium and myocardium |
| Contraction of the atria is referred to as: | depolarization |
| Muscle of the heart is too large = | cardiomyopathy |
| Ischemia is: | decreased O2 -- causes pain (angina) |
| Cardiac output is calculated by? | HR x Stroke volume (normal is 60 cc/min) |
| "thready" pulse means: | weak, fast pulse |
| Left-side heart failure could be caused by? | Left ventricle or left valve -- fluid backs up into lungs |
| You would hear what with pulmonary edema? | crackles |
| Right-side heart failure is HARDER to detect. What happens in RS heart failure? | Increase BP and Increase HR because the body is trying to get rid of the edema |
| Mottled tissue is indictive of... | decreased O2 |
| ******* Hypovolemic shock -- what happens in the body? | DECREASED in blood pressure; INCREASE in heart rate. The HR increases to push out the small amount of blood, but the BP is taking a break because there isn't much blood to begin with... |
| 5 quality sounds of murmurs | blowing, harsh, muscial, raspy, rumbling |
| In pregnancy, the heart is displaced where? | Up and to the left |
| HDL ("H") means what kind of cholesterol? | Healthy |
| LDL ("L") means what kind of cholesterol? | Lousy |
| Tri before you Bi | Tricuspid before Mitral/Bicuspid |
| Apical pulse is... | PMI (point of max impulse) |
| Aortic sound is heard at | RSB 2nd ICS |
| Pulmonic sound is heard at | LSB 2nd ICS |
| Erb's sound is heard at | LSB 3rd ICS |
| Tricuspid sound is heard at | LSB 4th ICS |
| Mitral/Bicuspid sound is heard at | MCL 5th ICS |
| KEY WORDS: mucous plug, lack of surfactant, compressed chest wall | Atelectasis |
| Normal stroke volume is ___ to ___ ml/beat | 55 - 100 |
| Normal adult cardiac output is ___ to ___ L/min. | 4 - 8 |
| (Infants) The ____________ is a passageway for blood between left and right atria | foramen ovale |
| (Infants) An opening between the pulmonary artery and the descending aorta. | ductus arteriosus |
| The ductus arteriosus closes between __ and __ hours after birth | 24 - 48 hours |
| If the septal defect occurs, a murmur may not be heard in the infant until __ to __ weeks after birth. | 4 - 6 weeks |
| The heart rate of a new born can be as high as ___ to ___. Over the first 6 to 8 hours, it gradually decreases to an avg of ___ to ___ bpm | 175 - 180 bpm; then to 115 - 120 |
| patent ductus arteriosus, tetralogy of Fallot, and septal defects... | murmurs of a congenital defect in infants |
| In pregnant women, the heart is displaced... | upward and to the left |
| In a pregant woman, the heart is displaced to the left and up, and the apex of the heart is... | pushed laterally to the left |
| Preg woman's blood volume may increase __% to __% | 30% - 50% |
| PREGNANT WOMEN -- plasma volume does what? | increases as much as 50% |
| PREGNANT WOMEN -- plasma albumin does what? | decreases |
| PREGNANT WOMEN -- cardiac output increase __% to __% | 30% to 50% |
| PREGNANT WOMEN -- the heart can appear __% larger on chest radiography | 10% |
| PREGNANT WOMEN -- systolic BP may decrease as much as ____________ during first half of pregnancy | 2 to 3 mm Hg |
| PREGNANT WOMEN -- dyastolic BP may decrease as much as ____________ during first half of pregnancy | 5 to 10 mm Hg |
| A blood pressure greater than __/__ may indicate preeclampsia | 140/90 |
| Aortic stenosis increases chances of... | murmurs |
| S_ sound is common in older people who do not have a hx of cardio disease. | S4 |
| flushed skin may indicate | rheumatic heart disease or fever |
| grayish skin may indicate | coronary artery disease or shock |
| ruddy skin may indicate | polycythemia (increase in # of RBCs) or Cushing's Syndrome |
| bluish color in the sclera | Marfan's syndrome |
| Xanthelasma | yellowish cholesterol deposits in eyelids -- indicative of atherosclerosis |
| Cor pulmonale | right side failure by long-term high blood pressure in the pulmonary arteries and right ventricle |
Created by:
DOMONIC
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