Health Assessment in Nursing: Chapters 20 & 21
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| What is the space between the lungs where the heart is located called? | The mediastinum
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| The heart extends vertically from the ___ ICS (intercostal space) to the ___ ICS. | 2nd ICS --> 5th ICS
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| The heart extends horizontally from the _____ sternal border to the ____ ___-______ line. | right sternal border --> left mid-clavicular line
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| The large veins and vessels leading straight to and away from the heart are referred to as the ___________? | great vessels
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| The pulmonary ______ bifurcates, and carries blood from the heart to the lungs. | artery
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| The pulmonary _____ return oxygenated blood from the lungs to the heart. (hint: there are four, two from each lung) | veins
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| The pulmonary veins return oxygenated blood from the lungs to the ____ ______ of the heart. | left atrium
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| 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)
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| Collagen fibers called _______ _________ anchor the flaps of AV valves to papillary muscles within the ventricles of the heart. | chordae tendinae
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| Which heart valves are located at the exit of each ventricle? | The semi-lunar valves (each valve has three cusps or flaps)
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| What is the fibroserous sac that surrounds the heart? | The pericardium
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| What is the serous layer that covers the heart? | The epicardium
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| The _________ is the thickest layer of the heart, and is made up of contractile cardiac muscle. | The myocardium
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| The ___________ is a thin layer of endothelial tissue that forms the innermost layer of the heart. | The endocardium
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| What is the process called that involves the filling and emptying of the cardiac chambers? | The cardiac cycle (p. 352)
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| 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)
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| Which phase of the cardiac cycle occurs when the AV valves are open, and the ventricles are relaxed. | Diastole (p. 352)
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| T/F Atrial contraction causes an increase in left ventricular pressure? | True; referred to as "atrial kick," or "atrial systole," or "presystole."
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| 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)
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| At what location is it best to auscultate the S1 heart sound? | Left mid-clavicular line, 5th ICS
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| 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
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| 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
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| 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
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| What are are the factors that may result in a diminished S2 sound? | Hypotension, aortic or pulmonic stenosis (semi-lunar calcification w/diminished mobility)
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| 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.
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| 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)
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| 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)
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| 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)
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| The P wave on an ECG indicates ______ depolarization. | atrial (p. 353)
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| The QRS complex on an ECG represents what? | Ventricle depolarization (p. 353)
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| The T wave on an ECG represents ventricular ______________. | repolarization (p. 353)
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| 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)
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