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Flashcards

Cardiovascular

Adriana Morales PD Module 1 English 57 cards

Cards in this deck (57)

  1. 1Features of R ventricle- most anterior cardiac surface
    - thin wall
    - Under lower pressure
  2. 2Features of L ventricle- Lies behind R ventricle (except for apex)
    - Powerhouse of the pump
  3. 3Which side of heart sounds louder?Left heart sounds are more prominent and louder
  4. 4Anatomy: Base of Heart- Superior aspect of the heart
    - Rt & Lt 2nd ICS
    - Defines junction between pulmonic a. & R ventricle
    - Close to sternum
  5. 5Anatomy: Apex- Bottom of heart, defines inferior tip
    - Apex at 5th ICS
    - 7-9 cm from midsternal line
  6. 6Cardiac Cycle1. Pulmonary veins pump blood from lungs to L atrium
    2. Passes through mitral valve into L ventricle
    3. Pressure in L ventricle > L atrium, mitral valve closes
    4. Blood ejected out aorta through aortic valve
    5. Mitral valve closure = S1
  7. 7When and which valve closes/opens during systole1. LV pressure > Aortic pressure
    --> Aortic Valve opens
    - Blood pumped out of heart into aorta
    2. LV pressure < Aortic pressure
    --> Aortic Valve closes
    3. Aortic valve closure = S2
  8. 8When and which valve opens during diastole?Mitral valve opens as pressure rises in L atrium
    (not normally audible)
  9. 9When/where does contraction occur in diastole?After period of rapid ventricular filling, atrial contraction occurs
    (Usually inaudible)
  10. 10S3Rapid Ventricular Filling in Diastole
  11. 11S4Atrial Contraction in Diastole
  12. 12Which part of cardiac cycle is auscultated?- CLOSURE of valves responsible for heart sounds
    - normal heart sounds: S1 and S2
    (sometimes s3 and s4 heard)
  13. 13Cardiovascular Exam1. Assess Jugular Venous Pressure (JVP)
    2. Assess Carotid Pulse
    3. Examine Heart
    - Inspection
    - Palpation
    - Auscultation
    4. Peripheral Vascular Exam
  14. 14JVP exam- pt comfortable & supine
    - Head raised to 30˚ and tilted away from you
    - use tangential lighting to identify landmarks
    ID amplitude and timing of venous pulsations
  15. 15JVP look and feel- Arterial pulsations: look and feel like single strong impulses
    - Venous pulses: look like billowing sails with gentler wave forms
    - Compare with apical/radial pulse
  16. 16Significance of JV distentinCHF
  17. 17Measure JVP- ID highest pt of venous pulsation of internal jugular along SCM border
    - Measure vertical distance above sternal angle
  18. 18Pt position for Carotid PulseSupine with head of bed elevated at 30˚
  19. 19where to inspect for carotid pulsemedial to sternocleidomastoid muscles
  20. 20What to palpate for carotid pulse- Amplitude
    - Rate
    - Contour
    - Thrills
  21. 21How to auscultate carotid pulse (before palpation)- Have pt hold breath
    - Use stethoscope bell to listen for bruit
    - listen for rumbling sound of turbulent blood flow through artery
  22. 22Pt's position for cardiac exam- Starting position supine w/head elevated to 30˚
    - Other positions include:
    a. Left Lateral Decubitus (LLD)
    b. Sitting up, leaning forward
  23. 23Cardiac Exam: Inspection- Heaves
    - Point of Maximum Intensity (PMI) or Apical Impulse
  24. 24Cardiac Exam: Palpation- Lifts and heaves, thrills, PMI
    - Cardiac Silhouette
  25. 25Cardiac Exam: Auscultation- Heart Sounds
    - Murmurs
  26. 26Apical Impulse: Location4th or 5th intercostal space
  27. 27Apical Impulse: DiameterLess than 2.5 cm
  28. 28Apical Impulse: AmplitudeUsually small, brisk, tapping
  29. 29Apical Impulse: DurationListen, fell, and estimate proportion
  30. 30Cardiac Auscultation: stethoscopeUse both diaphragm and bell
    - Diaphragm for higher pitched sounds
    - Bell for lower pitched sounds
  31. 31Cardiac Auscultation: Left Lateral Decubitus Position- Use bell
    - Bring LV closer to chest wall
    Accentuates S3, S4, and mitral stenosis murmur
  32. 32Cardiac Auscultation: Sitting Up, Leaning Forward- Use Diaphragm
    - Accentuates aortic murmurs
  33. 33Cardiac Auscultation: Squatting, Valsalva maneuversMake different murmurs louder or softer
  34. 34When/Where is S1 and S2 loudest?- S1: loudest at apex (mitral valve closing)
    - S2: loudest at base (aortic valve closing)
  35. 35Which is longer- systole or diastole?Diastole
  36. 36When are pulses palpable?During systole
  37. 37Heart sounds: Physiologic splitting- Separation of S1 or S2 into separate sounds accentuated by inspiration
    -Splitting of S2 more clinically important
    - Disappears with expiration
  38. 38Extra Heart Sounds: Systole- Ejection sounds are pathologic, caused by opening of valves that should be closed
    - occurs early in systole, immediately after S1
  39. 39Effect of extra heart sounds in systoleAffects either aortic or pulmonic valves
  40. 40Auscultating Extra heart sounds in systole- High pitched
    - Sharp, clicking quality
    - Heard best with diaphragm
  41. 41Systolic Clicks- Heard mid-to-late systole
    - most common in Mitral Valve Prolapse
    - High-pitched
  42. 42Extra heart sounds in Diastole: Opening Snap- Heard early in diastole
    - Usually caused by opening of stenotic MV
    - Loud, high-pitched snapping sound
  43. 43Extra heart sounds in Diastole: S3 (Ventricular Gallop)- Physiological or pathological
    - Heard early in diastole during rapid ventricular filling
    - Can be physiologic in children but usually pathologic in patients >40 yo
  44. 44Extra Heart Sounds in Diastole: S4- Atrial Gallop
    - Heard late in diastole, just before S1
    - Dull, low-pitched sound
    - Heard best with Bell
    - Can be physiologic, but more often pathologic
  45. 45Heart Murmurs- Longer duration than heart sounds
    - Often caused by turbulent blood flow through a valve
    - can indicate disease or be benign
    - heard best over respective auscultatory areas for the involved valve
  46. 46Innocent Mumurs- Turbulent blood flow across valve due to strong ventricular ejection of blood
    - common in children & young adults
    - no evidence of cardiovascular disease
    - no physiological/structural abnormalities
  47. 47Pathologic Murmurs- arise from structural abnormalities in valves
    - stenosis --> hardening/narrowing of valve
    --> impedes valve blood flow
    - Regurgitation --> failure of valve to close completely
    --> allows blood backflow
  48. 48Heart Mumurs: Descriptive Traits- Location
    - Intensity
    - Timing
    - Pitch
    - Quality
    - Radiation
  49. 49Heart Murmurs: Grading (1-6)- Grade 1: very faint
    - Grade 2: quiet, but heard immediately
    - Grade 3: moderately loud
    - Grade 4: loud
    - Grade 5: very loud, heard with stethoscope partially off of chest
    - Grade 6: heard with stethoscope completely off of chest
  50. 50Systolic MumursMay be inocent or pathologic
    - Early Systole
    - Midsystolic
    - Late systolic
    - Holocystolic
  51. 51Diastolic MurmursALWAYS pathologic
    - early diastolic
    - mid-diastolic
    - late diastolic
  52. 52Heart Murmurs: Quality- Harsh (stenosis)
    - Blowing (regurgitation)
    - Rumbling
    - Musical
  53. 53Heart Murmurs: ContourPattern of sound intensity over time
    - crescendo: gets louder
    - descrescendo: gets softer
    - crescendo-decrescendo
    - plateau: intensity constant
  54. 54Adventitious Heart SoundsMixed cycle: not confined to one aspect of cardiac cycle
  55. 55Pericardial friction rubType of mixed cycle
    - inflammation of pericardial sac
  56. 56Patent Ductus ArteriosusType of adventitious heart sounds mixed cycle
    - congenital opening between aorta and pulmonary arteries
  57. 57Venous Hum (continuous)- Type of mixed cycle
    - Adventitious heart sounds
    - benign turbulent blood flow in jugular veins

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Description
PD Module 1 Flashcards on Cardiovascular, created by Adriana Morales on 22/10/2016.
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Adriana Morales
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  • Created by Esther Kim · Oct 17, 2016
  • Copied by Adriana Morales · Oct 22, 2016
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