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Chapter 19 Heart
Heart
102
Nursing
Undergraduate 3
09/24/2010

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Cards

Term
What is the pericardium?
Definition
Tough, fibrous, double walled sac that surrounds and protects the heart.
Term
What is the purpose of pericardial fluid?
Definition
To ensure fluid movement of the heart muscle.
Term
What is the purpose of the myocardium?
Definition
It's the muscular wall of the heart and does the pumping.
Term
What is the purpose of the endocardium?
Definition
lines the inner surface of the heart chambers.
Term
What is the purpose of the valves in the heart?
Definition
To prevent the Backflow of blood.
Term
How many valves are in the heart?
Definition
There are four valves.
Term
Where is the tricuspid valve located?
Definition
Between the right atria the right ventricle.
Term
What are the two atrioventricular valves?
Definition
Tricuspid and mitral valve
Term
Describe the location of the semi lunar valves?
Definition
Between the ventricles and the main arteries. (aorta, pulmonary artery)
Term
How many leaves do the semi lunar valves have?
Definition
Three
Term
what is the purpose of the av valves during systole?
Definition
to prevent blood flow into the atria.
Term
What is the purpose of the AV valves during diastole?
Definition
Remain open and to fill with blood.
Term
Which part of the cardiac cycle takes two thirds of the time?
Definition
diastole.
Term
Which part of the cardiac cycle takes one third of the time?
Definition
Systole.
Term
Describe the AV valves and the ventricles in diastole?
Definition
Ventricles are relaxed and valves are open.
Term
Define proto-diastolic filling?
Definition
The first passive filling phase.
Term
Define atrial kick, (Presystole)?
Definition
Atria contract and push blood into the ventricles.
Term
Define the S1 sound?
Definition
Mitral and tricuspid valves (AV) closes area
Term
Define the S2 sound?
Definition
Closure of pulmonic and aortic valves (semi lunar).
Term
Which side of the heart is faster, right or left?
Definition
The right side of the heart is much slower than the left side.
Term
What heart sound signals systole?
Definition
S-1.
Term
What heart sound signals the end of systole?
Definition
S-2.
Term
Define split S 2 sound?
Definition
Aortic valve closes faster than
Term
when does a split S2 sound occur?
Definition
It occurs during the end of inspiration.
Term
Where is the place a split S2 sound occurs?
Definition
Pulmonic area second left intercostal.
Term
Describe a split S2 during inspiration and expiration?
Definition
It begins with inspiration and fades out with expiration.
Term
What does inspiration do to intrathoracic pressure?
Definition
Decreases.
Term
How does respiration affect the volume on the right and left sides of the heart?
Definition
Volume goes more to the right heart and less to the left.
Term
Describe the S3 sound?
Definition
Usually diastole is silent but if the ventricles are resistant to filling then vibrations are audible.
Term
what is the difference in location between the s3 and split s2 heart sounds?
Definition
s3 is ually apex or left lower sternal border, split s2 is base
Term
What age group is the s3 sound normally found in?
Definition
children and young adults up to 40 years sometimes
Term
What age group is the s3 sound abnormal?
Definition
Adults
Term
Define the S4 heart sound?
Definition
Atria contract and push blood into a non-compliant ventricle.
Term
When does the S4 heart sound occur?
Definition
End of diastole.
Term
Describe a murmur?
Definition
A murmur is gentle blowing sound you heard on the chest wall.
Term
Where is the apical pulse located?
Definition
Fith intercostal space 7 to 9 cm from the midsternal line.
Term
What is the purpose of superior and inferior vena cava? I.e. What does it do?
Definition
To return unoxygenated blood to the right side of the heart.
Term
What is the function of the pulmonary veins?
Definition
To return fresh blood to the left side of the heart.
Term
What is the purpose of the pulmonary artery?
Definition
To carry venous blood to the lungs.
Term
In the resting adult how much blood is pumped in liters per minute?
Definition
4 to 6 L.
Term
What is the formula for cardiac output?
Definition
CO = SV x R, stroke volume x rate
Term
define preload?
Definition
Venous return that builds during diastole, the length to which the regular muscle is stretched just before you read.
Term
Define the Frank starling law?
Definition
The greater the stretch the stronger the heart contraction.
Term
Define after load?
Definition
The opposing pressure the ventricles must generate to open the aortic valve against the higher aortic pressure.
Term
What is the function of the jugular veins?
Definition
Two empty used blood into the vena cava.
Term
what age does a heart begin to function?
Definition
Three weeks gestation.
Term
Where is the location of the foramen ovale?
Definition
In between the atria.
Term
How much blood does the formaen ovale shunt, where does it send blood to?
Definition
Two thirds. To the aorta to the rest of the body.
Term
How much blood does the ductus arteriosus shunt? Where does it send blood to?
Definition
One third. To aorta.
Term
Where is the ductus areteriosus located?
Definition
Pulmonary artery and aorta.
Term
When does the formaen ovale close? Why?
Definition
Within the first hour due to new pressure in the right-sided heart that on the left side.
Term
When does the ducuts areteriosus close?
Definition
Within 10 to 15 hours.
Term
In infants, describe the heart position, apex, which intercostal space is the heart located in?
Definition
Fourth intercostal space, apex is higher, more horizontal.
Term
When does the heart reached the adult position?
Definition
Age seven years.
Term
In pregnancy in what trimester does blood volume increased by 30 to 40%?
Definition
Second trimester.
Term
Despite the increase in blood volume during the second trimester why blood pressure decrease in pregnancy?
Definition
Peripheral dilatationwhat trimester has the lowest blood pressure? Second trimester.
Term
Between the ages 20 and 60 how much does systolic pressure increase?
Definition
20mm Hg
Term
between the ages of 60 and 80 years how much does systolic blood pressure increase? Why?
Definition
20mm Hg, calcification of the vessel walls.
Term
Does the overall size of the heart increase with age?
Definition
No.
Term
Is there any significant change in diastolic pressure with age?
Definition
No.
Term
Is there any change in resting heart rate with age?
Definition
No.
Term
Why is there a decreased maximum heart rate with exercise with age?
Definition
Decreased ability to augment cardiac output due to age.
Term
Describe the PR interval, the QRS interval, the QT interval with age?
Definition
PR interval, QT interval increase. QRS no change.
Term
A BMI 25 KG/m2 would be considered?
Definition
Overweight.
Term
Define paroxysmal nocturnal dyspnea?
Definition
Heart failure, lying down in Increases volume of intrathoracic blood.Wakes up after two hours. Needs choose one.
Term
Define carotid sinus hypersensitivity?
Definition
Condition in which pressure over the carotid sinus leads to a restart rate blood pressure and may cause syncope.
Term
Define bruit?
Definition
A blowing, swishy sound indicating turbulence of blood flow.
Term
If you hear a carotid bruit, how much of the lumen has been occluded?
Definition
1/2 to 2/3.
Term
How much does the lumen need to be occluded to no longer hear a bruit?
Definition
More than two thirds.
Term
Define heaving or lifting?
Definition
Sustained forceful thrusting of the ventricle during systole.
Term
What causes heaving or lifting?
Definition
Regular hypertrophy as a result of increased work load.
Term
How does left ventricular dilation affect the apical impulse and intercostal space?
Definition
Displaces it down to the left and increases the size by more than one space.
Term
Define a thrill?
Definition
A palpable vibration.
Term
Define a pulse deficit?
Definition
Differences between the apical pulse and the radial pulse.
Term
What causes the S1 sound?
Definition
Closure of the AV valves ( mitral and tricuspid)
Term
What is a normal heart rate directly after birth?
Definition
100 to 180 per minute.
Term
What is a stable heart rate for a baby?
Definition
120 140 per minute.
Term
Heart rate for a baby while sleeping?
Definition
70 to 90 per minute.
Term
What does a fixed split S2 indicate in a baby?
Definition
Atrial septal defect.
Term
Why can you not trust clubbing in an infant?
Definition
Will not show until one year even with severe cyanosis.
Term
Your hear a turbulent blood flow in the jugular venous system in a child, what is the significance?
Definition
This is a venous hum, no pathologic significance.
Term
Describe the heart rate changes in a pregnant woman?
Definition
usually increases 10-15 beats per minute
Term
what is the significance of a s3 sound in someone who is 35 years or older?
Definition
Always assoicated with heart failure.
Term
Define a patent ductus arteriosus?
Definition
Open between the aorta and the pulmonary artery.
Term
What a subjective manifestation of a PDA?
Definition
Usually no symptoms in early childhood.
Term
Wide pulse pressure in blood pressure and bounding peripheral pulses, machinelike murmur?
Definition
Patent ductus arteriosus.
Term
Define atrial septal defect?
Definition
Abnormal open between the atria.
Term
What are the subjective symptoms of ASD in child and adult?
Definition
Rare in infants. Children and adults you have mild fatigue and DOE.
Term
You hear a sternal lift, s2 fixed split, medium pitch, best heard at the base at the second left interspace. What is this?
Definition
Atrial septal defect.
Term
Define ventricular septal defect?
Definition
Abnormal opening between the ventricles.
Term
What are the subjective symptoms of VSD?
Definition
Slow weight gain, pale, feeding problems, frequent respiratory infections.
Term
Loud, harsh, holosystolic murmur best heard at the left lower sternal border?
Definition
VSD
Term
what are the four malformations in Tetraology of Fallot?
Definition
Right ventricular stenosis, VSD, right ventricular hypertrophy, overriding aorta.
Term
What is a pathophysiology of TOF? I.e. what happens with all the blood?
Definition
All of blood does into the pulmonary system and never gets oxygenated.
Term
Cyanosis with crying and exertion then at rest, DOE common, uses squatting posture after walking, slow development. What is this?
Definition
TOF.
Term
Define coarcation of the aorta?
Definition
Severe narrowing of descending aorta.
Term
What is the end result of coarctation of the aorta?
Definition
Left ventricle has to work harder.
Term
Upper extremity hypertension greater than 20 over lower extremities, absent femoral pulses?
Definition
Coractation of the aorta.
Term
what trimester has the lowest blood pressure?
Definition
Second trimester.
Term
What causes the S2 sounds?
Definition
Closure of the semilunar valves (pulmonic and aortic valves).
Term
When does the S4 sound occur and what causes it?
Definition
S4 occurs at the end of diastole, at presystole, when atria contract and push blood into a noncompliant ventricle.
Term
When does an S3 sound occur and what causes it?
Definition
It occurs during early rapid filling (protodiastole) right after S2 when AV valves open and blood first pours into ventricles.
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