Term
| Leading cause of death is... |
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Definition
Heart disease for both male and female
women 10-15 years later than men |
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Term
CO__SV__HR
(possible answers: +, -, x, /, and =) |
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Definition
CO=SV x HR
CO-cardiac output
SV-stroke volume
HR-heart rate
-if CO goes down SV and HR will go up to compensate |
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Term
| personality types related to heart disease |
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Definition
type A-used to be related but not anymore
type D-negative mood, pessimistic coupled with social inhibition-is more related to heart problems because it increases stress |
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| dental care-related to CV |
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Definition
| bacteria on teeth make their way to the vascular system and adhere to the valves and cause inflammation of the heart |
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Term
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Definition
Picture of a heart attack
-Severe crushing substernal pain
-Hand over chest-looking like they are in pain
-Seen more often in men
-Women-complain of indigestion, severe fatigue, SOB, and GI symptoms (postmenopausal or women with family history of heat attack) |
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Definition
| aortic (goes to the body) pulmonic (goes to the lungs) |
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Definition
| bottom-palpate at 5 ICS LMCL |
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Definition
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Term
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Definition
-Superior vena cava→ Rt. Atria→ Tricuspid valve → Rt. Ventricle → Pulmonic valve → PA → lungs
-PV → Lt. Atria → Mitral valve → Lt. ventricle → Aortic valve → Aorta → systemic circulation |
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Term
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Definition
-SA node (fires an impulse-pacemaker which controls our heart beat (50-90))
-AV node (takes over if SA node is not working--rate is 30-40)
-Bundle of His
--LBB & RBB
--This allows you to study EKGs |
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Definition
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Definition
-Semilunar valves open (A&P)
-AV valves close (M&T) –hear this
-Blood pumped from ventricles to pulmonary and systemic circulation
-1/3 of cardiac cycle
-ventricles become empty |
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Term
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Definition
-Semilunar valves close (A&P) –hear this
-AV valves open (M&T)
-Ventricles fill with blood
-2/3 of cardiac cycle |
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Term
| hemodynamic events-aging (Jarvis p.465) |
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Definition
-increase in systolic pressure caused by stiffening of the large arteries which leads to arteriosclerosis (calcification of the vessel walls.
-left ventricular wall thickness increases (does not make the heart bigger). this is an accommodation from the vascular stiffness.
-no change in diastolic pressure causes an increase in pulse pressure.
-no change in resting heart rate or cardiac output.
-decreased ability of the heart to augment cardiac output with exercise. |
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Term
| which comes first, electrical event or mechanical event? |
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Definition
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Term
T or F
right (T&P) side events precede left side events (M&A) |
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Definition
FALSE!
left (M&A) side events precede right (T&P) side events |
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Term
T or F
right sounds are better heard during inspiration and left sounds are better heard during expiration |
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Definition
TRUE!
-Right heart is engorged with blood and is in closer contact with the chest wall during inspiration
-Volume of lung tissue confirming apex is smaller; left chambers are closer to chest wall during expiration |
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Term
origin of heart sounds
-sound 1&2
-sound 3
-sound 4 |
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Definition
-sound 1&2-valve closure
-sound 3-blood movement within the heart (this is when murmurs are heard)-early in diastole
-sound 4-muscle contraction-end of diastole |
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S4-S1-S2-S3
-S1→S2=systole
-S2→S1=diastole |
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Definition
| Seeing the client chest wall lift up when heart is pumping (abnormal) |
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Definition
| Lifts and moves to a side (abnormal) |
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Definition
| Distention when patient is setting up-bad-excessive fluid volume (only seen when laying down) |
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Definition
| Palpable vibration on chest wall-usually accompanies a murmur (feels like cat purring) |
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| all of systole, all of diastole |
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Term
| heart sound trasmission or radiation |
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Definition
do we hear it anywhere else?
-murmurs transmitted to neck |
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Term
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Definition
M&T closing
Corresponds with carotid pulse
“high pitched” sounds-diaphragm
Louder at apex
S1 split-normal but rare
-No relationship to respirations |
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Term
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Definition
A & P closing
Higher pitched than S1
Louder at base
Physiological split is nl. (more likely in S2 than S1)
Both components of S2 heard during INSPIRATION at pulmonic area (left-2 ICS)
Abnormal S2 Splitting
-Fixed splitting
--Throughout I & E
---Atrial septal defect
-Paradoxical splitting
--Heard on E
---Left Bundle Branch Block (LBBB) |
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Term
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Definition
Blood hitting ventricular wall creates vibrations heard in early diastole
Low pitched-heard with bell over T to M areas
Normal in children and young adults (the ventricles are so close to the chest wall)
Abnormal
-Called ventricular gallop rhythm, S3 gallop or pathological S3
-In older adults-after 35 or 40 (may mean heart is enlarged)
-May persist in women until 40 |
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Term
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Definition
atrial muscle contraction:
Low pitched sound heard with bell over T to M area
Normal
-In well trained athletes
-In persons over age 50
Abnormal
-In people who aren’t well conditioned
-Under age 50
-Called pathological S4, atrial gallop, or S4 gallop |
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Term
| Heart sound loudness decreased by |
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Definition
Dec. force of contraction-CHF
Increased thickness of chest wall-Obesity
Increased air in chest cavity-COPD (emphysema)
Increased fluid around the heart-plural effusion (cardiac empanada)
Electrical problems-arrhythmias |
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Term
tissues alter conduction of heart sounds
(liquid, bone, muscle, etc...) |
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Definition
Liquid: may increase audibility; large amount will decrease
Bone: good conductor
Muscles, fat and air: large amount will interfere |
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Term
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Definition
-Blowing, swooshing sound with turbulent blood flow in heart or great vessels
-blood having trouble getting through valves (because the valves are too small, too much blood going through, or backward flow of blood) |
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1-6
1: Softest audible
2: Medium intensity
3: Loud, no thrill
4: Loud, associated with palpable thrill
5: Heard with stethoscope ½ off chest wall
6: Heard with stethoscope off of chest wal
3+ grade can usually come with other symptoms |
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Term
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Definition
| no evidence of physiological or structural alteration |
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Definition
associated with physiological alterations
-anemia, pregnancy, increased blood vol. |
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Definition
| always caused by structural abnormalities of the heart |
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Definition
-Continuous, low-pitched, soft hum, heard throughout the cardiac cycle-loudest in diastole
-Due to turbulence of blood flow in the jugular venous system
-Normal in children and has no pathologic significance |
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Term
Apical Pulse
what site?
how long do you auscultate?
when to check?
what do you check? |
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Definition
-At M site or at apical impulse if heart is enlarged
-ALWAYS auscultate for one full minute whether regular or not
-ALWAYS check AP if the peripheral pulse is irregular
-Rate, rhythm, and regularity |
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Term
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Definition
| Pulse rate increases slightly on inspiration and decreases slightly on expiration. |
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Term
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Definition
| Fetal to pulmonic circulation occurs in immediate newborn period-ductus arteriosus & foramen ovale close & blood goes to the lungs |
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Term
| pregnant-what it does to your heart |
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Definition
systolic murmurs
blood volume increase 30-40% |
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Term
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Definition
| systolic murmurs over 50% |
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Term
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Definition
don't have good circulation
hair loss |
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Term
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Definition
Abnormal:
0: Not Palpable
1+: Thready, weak, fades easily, easily obliterated
Normal:
2+: May be somewhat difficult to palpate, obliterated with pressure
3+: Easily palpable, doesn’t fade, takes sufficient pressure to obliterate
4+: Strong, easily palpated, cannot obliterate, ―bounding |
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Term
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Definition
Checks patency of radial and ulnar arteries
-Occlude both arteries in one hand
-Client pump hand
-Release one artery (first radial and then repeat steps 1 & 2 and do ulnar) at a time and check for color to return |
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Term
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Definition
-one examiner check apical and one check radial pulse for the same one minute
-compare rates and check for A/R deficit (signals weak ventricular contraction)
-example
--Apical rate=118
--Radial rate=78
--A/R deficit=40 |
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Term
| Blood pressure differences |
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Definition
Check both arms
-Difference of more than 10-15 mm Hg may indicate arterial obstruction in side with lower reading |
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Term
| Intermittent claudication |
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Definition
leg pain following exertion; ischemic pain rest
-shows arterial insufficiency |
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Term
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Definition
| # of blocks walked or stairs climbed to produce pain |
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Term
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Definition
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Term
| signs of arterial insufficiency |
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Definition
Pain with exertion
Pallor
Cool temperature
Changes in skin, hair and nails
-Thin, fragile skin
-Hair loss-lower extremity-line of demarcation
-Thickened, claw-like toenails
-Ulcers lateral malleoli & tips of toes
Parasthesias: sensation of tingling
Diminished or absent pulses
No Edema |
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Term
| Ankle-brachial index (ABI) |
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Definition
-Objective, noninvasive measurement of arterial disease
-Use of a Doppler stethoscope to determine the extent of peripheral disease
-Systolic ankle pressure/systolic brachial pressure
-Normal is 1-1.2
-.9=PVD |
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Term
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Definition
pain in calf & popliteal area on passive dorsiflexion of foot
occurs in about 35% of deep vein thrombosis! |
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Term
| signs of venus insufficiency |
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Definition
Pain-aching, tiredness
Pulses present, but difficult to palpate
Skin coarse, thick and brown
Edema present
Ulcers at medial malleoli
Varicose veins |
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