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Nurs 228 Chapter 20

Health Assessment in Nursing: Chapters 20 & 21

What is the space between the lungs where the heart is located called? The mediastinum
The heart extends vertically from the ___ ICS (intercostal space) to the ___ ICS. 2nd ICS --> 5th ICS
The heart extends horizontally from the _____ sternal border to the ____ ___-______ line. right sternal border --> left mid-clavicular line
The large veins and vessels leading straight to and away from the heart are referred to as the ___________? great vessels
The pulmonary ______ bifurcates, and carries blood from the heart to the lungs. artery
The pulmonary _____ return oxygenated blood from the lungs to the heart. (hint: there are four, two from each lung) veins
The pulmonary veins return oxygenated blood from the lungs to the ____ ______ of the heart. left atrium
Which two valves make up the atrioventricular (AV) valves? The tricuspid (btwn RA and RV), and the bicuspid or mitral valve (btwn LA and LV)
Collagen fibers called _______ _________ anchor the flaps of AV valves to papillary muscles within the ventricles of the heart. chordae tendinae
Which heart valves are located at the exit of each ventricle? The semi-lunar valves (each valve has three cusps or flaps)
What is the fibroserous sac that surrounds the heart? The pericardium
What is the serous layer that covers the heart? The epicardium
The _________ is the thickest layer of the heart, and is made up of contractile cardiac muscle. The myocardium
The ___________ is a thin layer of endothelial tissue that forms the innermost layer of the heart. The endocardium
What is the process called that involves the filling and emptying of the cardiac chambers? The cardiac cycle (p. 352)
Outline the pathway of electrical impulse through the heart. SA node (atrial contraction) --> AV node --> delay --> AV bundle or "bundle of his" --> purkinje fibers (ventricular contraction)
Which phase of the cardiac cycle occurs when the AV valves are open, and the ventricles are relaxed. Diastole (p. 352)
T/F Atrial contraction causes an increase in left ventricular pressure? True; referred to as "atrial kick," or "atrial systole," or "presystole."
Which phase of the cardiac cycle begins with the closing of the AV valves (S1)? Systole (p. 352); AV valves shut (S1) --> ventricles contract & semi-lunar valves open --> pressure falls --> semi-lunar valves close (S2)
At what location is it best to auscultate the S1 heart sound? Left mid-clavicular line, 5th ICS
At what location is it best to auscultate the S2 heart sound? Best heard at the base of the heart (2nd ICS, R + L sternal borders) p. 357-358
T/F Cardiac output measures the amount of blood ejected by ventricles with each contraction. False: SV = amount ejected with VC; CO = amount over time (SV*HR) normal adult = 5-6L/min
What are are the factors that may result in a pronounced S2 sound? Hypertension, Increased pressure in pulmonary vasculature (mitral stenosis or CHF), semilunar calcification w/ normal mobility
What are are the factors that may result in a diminished S2 sound? Hypotension, aortic or pulmonic stenosis (semi-lunar calcification w/diminished mobility)
A normal S2 split is head during ___________, and disappears during __________. Inspiration, expiration; a split S2 that does not disappear during expiration may indicate heart disease.
Which valve sound of the S2 is typically heard over the other? (Hint: It's either pulmonic, or aortic) Typically the aortic valve is heard. (See split S2 on p. 356)
Which abnormal heart sound occurs when there is a delayed electrical impulse to the right ventricle? a) Split S2 b) Wide split S2 c) S3 d) S4 Wide split S2; A split S2 is normal, and s3 and s4 are extra sounds related to diastolic filling. (p. 354-356)
T/F A grade 5 murmur can be heard without a stethoscope? False: Murmurs are ranked on a scale of 1-6 based on intensity. Grade 5 can be heard with the stethoscope partly on chest, but must be a grade 6 to hear without. (p. 375)
The P wave on an ECG indicates ______ depolarization. atrial (p. 353)
The QRS complex on an ECG represents what? Ventricle depolarization (p. 353)
The T wave on an ECG represents ventricular ______________. repolarization (p. 353)
T/F The "U wave" on an ECG represents the final phase of ventricular repolarization, and may or may not be present? True; for the most part the T wave represents repolarization (should be present) the U wave follows (may or may not be present)
Created by: scottheadrick