1 A Cardiac Assessment
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| S1 Is it heard best at the base or the apex? | show 🗑
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| S1 is it heard in Systole or Diastole? | show 🗑
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| S1 which valves closing make this sound? | show 🗑
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| show | loudest at the base
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| S2 is it heard in Systole or Diastole? | show 🗑
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| S2 What valves closing make this sound? | show 🗑
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| S3 is it heard in systole or diastole? | show 🗑
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| What causes the sound of S3? | show 🗑
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| S3 is heard with what disease processes? | show 🗑
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| show | S3 may be normal in children and young adults.
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| S3 is it an atrial or ventricular gallop? | show 🗑
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| S4 is it heard in Systole or Diastole? | show 🗑
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| What causes the sound of S4? | show 🗑
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| S4 is heard with what disease processes? | show 🗑
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| S4 is this ever a normal sound? | show 🗑
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| S4 is this an atrial or ventricular gallop? | show 🗑
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| show | Lying in the left lateral position shifts the heart closest to the chest wall
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| Which of the four heart sounds is the only one heard during systole? | show 🗑
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| show | AV valves
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| Systolic murmur does it occur between S1 and S2 or between S2 and S1? | show 🗑
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| show | Semilunar valves (Aortic and Pulmonic)
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| Does Diastolic murmur occur between S1 and S2 or between S2 and S1 | show 🗑
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| What is Hemodynamics? | show 🗑
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| show | The amount a vessel will stretch due to a change in pressure.
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| show | Veins-Think vericose veins how they stretch
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| Which is less compliant veins or arteries? | show 🗑
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| What is Isovolumetric contraction? | show 🗑
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| Does Isovolumetric contraction happen during Systole or Diastole? | show 🗑
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| show | After S1 and before S2
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| What is Isovolumetric relaxation? | show 🗑
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| show | At the beginning of Diastole
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| show | Before S1 and after S2
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| show | High pitched and scratchy like sandpaper
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| What patient position is best to hear a pericardial friction rub? Supine taking a deep breath in? or Sitting up, leaning forward, with breath held in expiration? | show 🗑
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| show | Tissue Paper My Assets=Tricuspid, Pulmonic from the right side, Mitral, Aortic from the left side.
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| Where do you listen to the Aortic valve sound? | show 🗑
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| show | 2nd left intercostal space
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| Where do you listen to hear Erb's point? | show 🗑
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| Where do you listen to hear the Tricuspid valve sound? | show 🗑
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| Where do you listen to hear the Mitral valve sound? | show 🗑
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| Where do you auscultate the Apical pulse? | show 🗑
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| Where do you palpate the point of maximal impulse (PMI) or apical impulse? | show 🗑
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| What is a mnemonic for remembering where to listen to the valve sounds? | show 🗑
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| show | Because the sound radiates with the direction of blood flow.
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| show | If you feel the carotid and auscultate at the apex the sound you hear when you feel each pulse is S1
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| show | Have the Patient sit up and lean forward or roll to their left (and “breathe out” and “hold it” but not too long) to place the heart closest to the chest wall, Turn down the TV, close the door, place the stethoscope on skin not over clothing.
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| If the point of maximal impulse (PMI) is palpated at the 6th intercostal space. Is that normal or abnormal? | show 🗑
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| show | Fluid around the heart-Cardiac Tamponade
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| What would cause the PMI to be palpable at the 6th (ICS)-intercostal space? | show 🗑
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| What would cause enlargement of the heart? Swelling your chest as you breathe in deeply? Increased ventricular volume? Increased ventricle wall thickness? | show 🗑
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| show | All of them.
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| show | An enlarged heart with a shifted PMI (at the 6th intercostal space or greater) could be seen on Xray.
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| show | Right
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| show | They carry unoxygenated blood from the body back to the right atrium
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| Does the Aorta carry oxygenated or unoxygenated blood out to the body? | show 🗑
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| show | Left side
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| Which carries “unoxygenated blood”- Pulmonary Arteries or Pulmonary Veins? | show 🗑
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| show | Pulmonary arteries carry unoxygenated blood from the right side of the heart to the lungs
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| show | The pulmonary veins carry oxygenated blood.
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| Do the pulmonary veins carry blood to the left atrium or the lungs? | show 🗑
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| show | Their are valves in the veins of our legs that keep the blood from flowing back down with gravity.
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| Are there valves in the veins of your head? | show 🗑
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| show | Blood would back up and cause (JVD) Jugular vein distension.
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| What position of the patient might be best to observe JVD? Supine-lying down flat, Sitting straight up, or with the bed at a 30 to 45 degree angle? | show 🗑
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| Is Jugular vein distension a sign of right sided or left sided heart failure? | show 🗑
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| Does JVD reveal pressure changes in the right side of the heart or volume changes in the right side of the heart? | show 🗑
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| True or False? Abnormally high pressure in the right side of the heart shows up in the neck veins and the abdomen. | show 🗑
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| show | True. These are signs of right sided heart failure. Just think of where the veinous blood would back up to on the right side of the body and how gravity would take it back down to the liver and the hands and feet
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| True o False? Abnormally high pressure or volume in the left side of the heart would back blood up to the lungs? | show 🗑
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| True or False? Abnormally high pressure or volume in the left side of the heart may show up as crackles in the lungs, cough, dyspnea on exertion, cyanosis, and increased “pulmonary”-capillary wedge pressure and blood tinged sputum? | show 🗑
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