Term
| Risk Factors for Hypertension |
|
Definition
~Family History
~Advancing Age
~Race (most common in blacks)
~Obesity
~Tobacco Use
~High Intake of Sodium or Sat. Fat
~Excessive Alcohol Consumption
~Sedentary Lifestyle
~Stress |
|
|
Term
| Risk Factors for Coronary Artery Disease (CAD) |
|
Definition
~Atherosclerosis
~Dissecting Aneurysm
~Infectious Vasculitis
~Syphilis
~Congenital Abnormalities |
|
|
Term
| Risk Factors for Deep Vein Thrombosis (DVT) |
|
Definition
~Idiopathic
~Endothelial Damage
~Accelerated Blood Clotting
~Reduced Blood Flow, Stasis
~Prolonged Bed Rest
~Trauma, Especially Hip Fracture
~Surgery, Especially Hip, Knee, or Gynecologic
~Childbirth
~Hormonal Contraceptives Such as Estrogens
~Age over 40
~Obesity |
|
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Term
| Signs and Symptoms of Myocardial Infarction |
|
Definition
~Persistent, crushing substernal chest pain that may radiate to the left arm, jaw, neck, or shoulder blades
~Cool extremities, perspiration, anxiety, restlessness
~Shortness of Breath
~Fatigue or weakness
~Nausea and vomiting
~Jugular vein distention |
|
|
Term
| What is Congestive Heart Failure (CHF) |
|
Definition
| ~The heart condition of weakness, edema, and SOB caused by the inability of the heart to maintain adequate blood circulation in the peripheral tissues and the lungs. |
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|
Term
| Signs and Symptoms of CHF |
|
Definition
~SOB
~Fatigue and weakness
~Edema in ankles, legs, and feet
~Rapid or irregular heartbeat
~Reduced ability to exercise
~Persistent cough or wheezing with white, or pink blood tinged phlegm
~Increased need to urinate at night
~Swelling of abdomen (ascites)
~Sudden weight gain from fluid retention
~Lack of appetite and nausea
~Difficulty concentrating or decreased alertness
~Coughing up pink foamy mucus
~Chest pain |
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|
Term
| Difference Between Right and Left Sided Heart Failure |
|
Definition
~Right sided: ineffective right ventricular contractile function. Blood backs up into the right atrium and into the peripheral circulation.
~Left sided: Decreased left ventricular contractile function. Cardiac output falls, and blood backs up into the left atrium and then into the lungs. |
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Term
|
Definition
| ~The heart pumps freshly oxygenated blood through the arteries to all of the body tissues. It is a high-pressure system because of the pumping heart. This is what creates the pulses that we can palpate. |
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Term
|
Definition
| ~The course of the veins is parallel to the arteries, but the direction of flow is opposite; the veins absorb CO2 and waste products from the periphery and carry them back to the heart. It is a low-pressure system because there is no pump, they use mechanism instead. |
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|
Term
|
Definition
~The rhythmic movement of blood through the heart; 2 phases are diastole and systole
~In diastole, the ventricles relax and fill with blood; this takes up 2/3 of the cycle.
~Systole is heart contraction; during systole, blood is pumped from the ventricles and fills the pulmonary and systemic arteries; this makes up the remaining 1/3 of the cycle. |
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|
Term
|
Definition
~In the resting adult, the heart normally pumps between 4 and 6 L of blood per minute.
~This equals the volume of blood in each systole (stroke volume) X the number of beats per minute (rate).
~Preload and afterload affect the heart's ability to increase cardiac output. |
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|
Term
| Paroxysmal Nocturnal Dyspnea |
|
Definition
| ~attacks of severe shortness of breath and coughing that generally occur at night. It usually awakens the person from sleep, and may be quite frightening. |
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Term
| Sequence of Blood Flow through the Heart, Lungs, Arterial, and Venous System |
|
Definition
~From the liver to RA thru the inferior vena cava.
~Superior vena cava drains venous blood from head and upper extremities.
~From RA venous blood travels thru tricuspid valve to RV.
~From RV venous blood flows thru pulmonic valve to pulmonary artery.
~Pulmonary artery delivers unoxygenated blood to lungs.
~Lung oxygenate blood.
~Pulmonary veins return fresh blood to LA.
~From LA, arterial blood travels thru mitral valve to LV.
~LV ejects blood thru aortic valve into aorta.
~Aorta delivers oxygenated blood to body. |
|
|
Term
| Unborn Baby's Heart and Circulation |
|
Definition
~Fetal heart begins beating at 3 weeks
~Lungs are nonfunctional until after birth
~Oxygenation is through the umbilical cord and placenta |
|
|
Term
|
Definition
~Opening in the atrial septum where blood is shunted into the aorta
~When newborn begins to breathe, lungs inflate, pressure lowers in the right side of the heart compared to the left
~Because of pressure changes, closes within the first hour |
|
|
Term
|
Definition
~Vessel from right ventricle to pulmonary artery
~Closes within 10 – 15 hours after birth
~Its murmur is an expected finding in newborns until it closes. If the murmur persists after about a day, it is an unexpected finding and must be investigated. |
|
|
Term
| Normal/Expected Heart and Respiratory Rates and Blood Pressures for Adults |
|
Definition
~Heart rate or pulse range: 50-95 BPM
~Respiratory rate: 10-20 BPM
~Blood pressure: <120/80 |
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|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| Circulatory Changes During Pregnancy |
|
Definition
~Adaptation to nourish the baby while keeping the Mom healthy
~Blood volume increases 30-40%,mostly during second trimester
~Increases stroke volume and cardiac output, heart rate increases 10 – 15 bpm.
~BP decreases (peripheral vasodilation) – lowest during second trimester |
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|
Term
| Expected Change in BP with Aging |
|
Definition
| ~Increase in systolic BP, increase in pulse pressure |
|
|
Term
|
Definition
~Systolic 120-139
~Diastolic 80-89 |
|
|
Term
|
Definition
~Systolic 140-159
~Diastolic 90-99 |
|
|
Term
|
Definition
~Systolic > or = 160
~Diastolic > or = 100 |
|
|
Term
|
Definition
~Systolic > 180
~Diastolic > 110 |
|
|
Term
|
Definition
| ~Palpated in front of the ear |
|
|
Term
|
Definition
| ~Palpated in the groove between the sternomastoid muscle and the trachea. |
|
|
Term
|
Definition
~Major artery supplying blood to the arm.
~Runs in the biceps-triceps furrow of the upper arm and surfaces at the antecubital fossa in the elbow medial to the biceps tendon. |
|
|
Term
|
Definition
| ~Palpated just medial to the radius at the wrist. |
|
|
Term
|
Definition
| ~Is opposite of the radial pulse, on the ulna bone, but it is deeper and often difficult to palpate. |
|
|
Term
|
Definition
~Major artery that supplies blood to the leg.
~Passes under the inguinal ligament and travels down the thigh. |
|
|
Term
|
Definition
~Is where the femoral artery courses posteriorly
~Palpated behind the knee |
|
|
Term
|
Definition
~Travels down behind the medial malleolus and forms the plantar arteries of the foot.
~Palpated just below the ankle on the inside of the leg. |
|
|
Term
|
Definition
| ~Palpated on the dorsum (top) of foot. |
|
|
Term
|
Definition
~Used to evaluate the adequacy of collateral circulation before cannulating the radial artery.
~Firmly occlude both the radial and ulnar arteries of one hand while the person makes a fist several times.
~Ask the person to open the hand without hyperextending it; release pressure on the ulnar artery while maintaining pressure on the radial artery.
~Adequate circulation is suggested by a palmar blush, a return to the normal color of the hand in approximately 2-5 seconds. |
|
|
Term
|
Definition
~Returns unoxygenated venous blood to the right side of the heart.
~It is located on the below the superior vena cava on the right side of the heart |
|
|
Term
|
Definition
~Returns unoxygenated venous blood to the right side of the heart.
~It is located above the inferior vena cava on the right side of the heart. |
|
|
Term
|
Definition
~Empty unoxygenated blood directly into the superior vena cava.
~There are 2 jugular veins present in each side of the neck.
~The larger internal jugular lies deep and medial to the sternomastoid muscle.
~The external jugular vein is more superficial and lies lateral to the sternomastoid muscle, above the clavicle. |
|
|
Term
|
Definition
~Caused by venous congestion.
~Common sign of right-sided heart failure, due to the back up of blood on the right side of the heart. |
|
|
Term
|
Definition
~The force of the pulse shows the strength of the heart's stroke volume.
~ 3+ Full, bounding
~ 2+ Normal
~ 1+ Weak, thready
~ 0 Absent |
|
|
Term
|
Definition
~ 4+
~ Caused by anxiety, exercise, and some abnormal conditions |
|
|
Term
|
Definition
~ 1+
~ Caused by hemorrhagic shock |
|
|
Term
|
Definition
~The rate is the # of BPM
~Normally varies with age, being higher in infancy and childhood, and more moderate in adult and older years.
~Also varies with gender; after puberty females have a slightly faster rate than males. |
|
|
Term
|
Definition
~The pulse normally has a regular, even tempo.
~A common irregularity that is found in children and young adults is sinus arrhythmia. The heart rate varies with the respiratory cycle, speeding up with inspiration, and slowing down with expiration. |
|
|
Term
|
Definition
| ~If any irregularities are felt, auscultate heart sounds for a more complete assessment. |
|
|
Term
|
Definition
~Auscultating the apical beat while simultaneously palpating the radial pulse.
~Count a serial measurement (one after the other) of apical beat and radial pulse.
~Normally every beat you hear at the apex should perfuse to the periphery and be palpable.
~The 2 counts should be identical.
~When different, subtract the radial rate from the apical, and record the remainder as the pulse deficit. |
|
|
Term
| Skin Assessment R/T Circulatory Assessment |
|
Definition
~Cyanosis or pallor: occurs with MI or low cardiac output, that states as a result of decreased tissue perfusion
~Edema: is dependent when caused by heart failure
~Cardiac edema: is worse at evening and better in morning, after elevation of legs all night; it is bilateral
~Unilateral: has a local vein cause |
|
|
Term
| LOC and PERRLA R/T Circulation |
|
Definition
~PERRLA: Mydriasis is dilated and fixed pupils, indicates circulatory arrest
LOC: Confusion, unconsciousness from decreased O2 to brain |
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|
Term
| S/S of Peripheral Arterial Disease (PAD) |
|
Definition
S/S: Painful cramping in your hip, thigh or calf muscles after activity, such as walking or climbing stairs (intermittent claudication)
~Leg numbness or weakness
~Coldness in your lower leg or foot, especially when compared with the other side
~Sores on your toes, feet or legs that won't heal
~A change in the color of your legs
~Hair loss or slower hair growth on your feet and legs
~Slower growth of your toenails
~Shiny skin on your legs
~No pulse or a weak pulse in your legs or feet
~Erectile dysfunction in men |
|
|
Term
| Causes of Peripheral Arterial Disease (PAD) |
|
Definition
~Often caused by atherosclerosis.
~In atherosclerosis, fatty deposits (plaques) build up in your artery walls and reduce blood flow.
~Although the heart is usually the focus of discussion of atherosclerosis, this disease can and usually does affect arteries throughout your body. ~
When it occurs in the arteries supplying blood to your limbs, it causes peripheral artery disease.
~Less commonly, the cause of peripheral artery disease may be blood vessel inflammation, injury to your limbs, unusual anatomy of your ligaments or muscles, or radiation exposure. |
|
|
Term
| Complications of Peripheral Artery Disease |
|
Definition
~Critical limb ischemia. This condition begins as open sores that don't heal, an injury, or an infection of your feet or legs. Critical limb ischemia occurs when such injuries or infections progress and can cause tissue death (gangrene), sometimes requiring amputation of the affected limb.
~Stroke and heart attack. The atherosclerosis that causes the signs and symptoms of peripheral artery disease isn't limited to your legs. Fat deposits also build up in arteries supplying your heart and brain. |
|
|
Term
| Assessment Findings in Legs and Feet for Poor Arterial Circulation |
|
Definition
~Elevation pallor
~Dependent rubor
~Coolness
~Edema
~Arterial Ischemic Ulcer
~Signs of malnutrition
~Distal Gangrene |
|
|
Term
|
Definition
| ~A condition in which cramping pain in the leg is induced by exercise, typically caused by obstruction of the arteries. |
|
|
Term
|
Definition
| ~Normal leg veins have dilated as a result of chronic increased venous pressure (obesity, multiple pregnancies) and incompetent valves that permit reflux of blood back toward leg instead of forward to the heart. |
|
|
Term
| S/S of Peripheral Venous Disease |
|
Definition
~Edema
~Varicosities
~Weeping ulcers at ankles
~Red, warm, swollen leg
~Aching, tiredness, feeling of fullness, chronic pain increases at end of day |
|
|
Term
| Causes of Peripheral Venous Disease |
|
Definition
~Job with prolonged standing or sitting
~Obesity
~Pregnancy
~Prolonged bed rest
~Hx of heart failure, varicosities, or thrombophlebitis
~Veins crushed by trauma or surgery |
|
|
Term
| Complications of Peripheral Venous Disease |
|
Definition
~Deep Vein Thrombophlebitis
~Venous (stasis) ulcers |
|
|
Term
| Assessment Finding in Legs and Feet with Poor Venous Flow |
|
Definition
~Brown discoloration occurs with chronic venous stasis, caused by hemosiderin deposits from RBC degradation.
~Unilateral edema occurs with occlusion of a deep vein |
|
|
Term
| Complications of CABG (coronary artery bypass graft) R/T Removal of Saphenous Vein of the Leg |
|
Definition
~If bypass surgery fails to restore Circulation, clients may need to undergo amputation of the limb.
~Acute circulatory compromise in limb
o Severe pain at rest that interferes with ability to work |
|
|
Term
|
Definition
~Used to test a person's circulation. ~It is performed by pressing on the fingernail bed (blanching it), and then counting how long it takes for the nail to turn from white back to the normal color. Immediate-2 seconds is normal capillary refill time. If someone is wearing dark nail polish, it can be done on the tip of the finger.
~Potential reasons for delayed refill time: Dehydration, Shock, Peripheral vascular disease (PVD), Hypothermia |
|
|
Term
| Deep Vein Thrombosis (DVT) |
|
Definition
| ~An acute condition characterized by inflammation and thrombus formation, mainly in the deep veins of the legs. |
|
|
Term
| Deep Vein Thrombosis Causes |
|
Definition
~Idiopathic
~Endothelial damage
~Accelerated blood clotting
~Reduced blood flow, stasis
~Predisposing Factors: prolonged bed rest, trauma, surgery, childbirth, hormonal contraceptives such as estrogens, age over 40, obesity |
|
|
Term
|
Definition
~Vary with site and length of the affected vein (may have no symptoms)
~Pain or tenderness
~Fever, chills
~Malaise
~Edema and cyanosis of the affected arm or leg
~Redness and warmth over the affected area
~Palpable vein
~Surface veins more visible
~Lymphadenitis |
|
|
Term
| Deep Vein Thrombosis Complications |
|
Definition
~Pulmonary embolism
~Chronic venous insufficiency |
|
|
Term
| Characteristics of Arterial Ulcers |
|
Definition
~Buildup of fatty plaques on intima (atherosclerosis) plus hardening, calcification of arterial wall (arteriosclerosis)
~Coolness, pallor, elevational pallor, and dependent rubor; diminished pulses; systolic bruits; signs of malnutrition (thin, shiny skin; thick-ridged nails; atrophy of muscles); distal gangrene
~Ulcers occur at toes, metatarsal heads, heels, and lateral ankle and are characterized by pale ischemic base, well-defined edges, and no bleeding |
|
|
Term
| Characteristics of Venous Ulcers |
|
Definition
~After acute DVT or chronic incompetent valves in deep veins. Venous ulcers account for 80% of lower leg ulcers.
~Lower leg edema that does not resolve with diuretic therapy. Firm, brawny edema; coarse, thickened skin; pulses normal; brown pigmented discoloration; petechiae, dermatitis; venous stasis causes increased venous pressure, which then causes RBC's to leak out of veins and into skin. RBC's break down hemosiderin (iron deposits), which are brown pigment deposits.
~Borders are irregular; venous ulcers are shallow and may contain granulation tissue.
~A weepy, pruritic stasis dermatitis may be present.
~Ulcers occur at medial malleolus and are characterized by bleeding, uneven edges |
|
|
Term
|
Definition
| ~Edema (accumulation of fluid causing swelling) in tissues perfused by the peripheral vascular system, usually in the lower limbs. In the most dependent parts of the body (those hanging distally), it may be called dependent edema. |
|
|
Term
|
Definition
~If pitting is present, it is graded on the following scale:
~ 1+ Mild pitting, slight indentation, no perceptible swelling of leg
~ 2+ Moderate pitting, indentation subsides rapidly
~ 3+ Deep pitting, indentation remains for a short time, leg looks swollen
~ 4+ Very deep pitting, indentation lasts a long time, leg is grossly swollen and distorted |
|
|
Term
|
Definition
~High-protein swelling of the limb, most commonly caused by breast cancer Tx.
~Surgical removal of or damage to lymph nodes and vessels with radiation therapy impeded drainage of lymph.
~Protein-rich lymph builds up in the interstitial spaces, which further raises local colloidal oncotic pressure and promotes more fluid leakage.
~Stagnant lymphatic fluid increases risk for infection, delayed wound healing, chronic inflammation, and fibrosis of surrounding tissue. |
|
|
Term
|
Definition
~Lids are swollen and puffy. Lid tissues are loosely connected, so excess fluid is easily apparent.
~Occurs with local infections; crying; systemic conditions such as congestion heart failure, renal failure, allergy, hypothyroidism (myxedema) |
|
|
Term
|
Definition
| ~Anasarca is a general swelling in the body, considered a massive edema, and is brought on when there is a fluid build up in the tissue. It is a different medical condition than a slight swelling at particular areas of the body. |
|
|
Term
|
Definition
~Pulmonary edema is a condition caused by excess fluid in the lungs. This fluid collects in the numerous air sacs in the lungs, making it difficult to breathe.
~In most cases, heart problems cause pulmonary edema. But fluid can accumulate for other reasons, including pneumonia, exposure to certain toxins and medications, trauma to the chest wall, and exercising or living at high elevations. |
|
|
Term
|
Definition
~Mild cases of edema may result from:
Sitting or staying in one position for too long; Eating too much salty food; Premenstrual signs and symptoms; Pregnancy
~Edema can be a side effect of some medications, including: High blood pressure medications; Nonsteroidal anti-inflammatory drugs; Steroid drugs;
Estrogens; Certain diabetes medications called thiazolidinediones
~In some cases, however, edema may be a sign of a more serious underlying medical condition. Diseases and conditions that may cause edema include: Congestive heart failure; Cirrhosis; Kidney disease; Kidney damage; Weakness or damage to veins in your legs: Chronic venous insufficiency; Inadequate lymphatic system. |
|
|
Term
|
Definition
~The skin is extremely difficult to pinch up
~Would be described as poor to no mobility |
|
|
Term
| Skin Turgor with Dehydration |
|
Definition
~Poor turgor is evident in severe dehydration
~The pinched skin recedes slowly or "tents" and stands by itself |
|
|
Term
| Sequence and Location of Heart Sounds |
|
Definition
~2nd right interspace- Aortic valve area
~2nd left interspace- Pulmonic valve area
~3rd left interspace- Erb's point
~Left lower sternal border- Tricuspid valve
~5th interspace at around the left midclavicular line- Mitral valve area |
|
|
Term
|
Definition
| ~Occurs with the closure of the AV valves and is the beginning of systole; the tricuspid and mitral (bicuspid) |
|
|
Term
|
Definition
| ~Occurs with the closure of the semilunar valves and signals the end of systole; the pulmonic and aortic valves. |
|
|
Term
| S3, S4, and Split S2 Heart Sounds |
|
Definition
~S3- Ventricles are resistant to filling during early rapid filling phase (protodiastole); occurs immediately after S2.
~S4- Occurs at the end of diastole; at presystole, when the ventricle is resistant to filling; the atria contract and push blood into a noncompliant ventricle.
~Split S2- When the aortic valve closes significantly earlier than the pulmonic valve. |
|
|
Term
|
Definition
~Caused by some conditions that create turbulent blood flow and collision currents.
~Velocity of blood increases (flow murmur) such as exercise and thyrotoxicosis.
~Viscosity of blood decreases (anemia)
~Structural defects in valves (stenotic or narrowed valve, and incompetent or regurgitant valve) or unusual openings occur in the chambers (dilated chambers, septal defects) |
|
|
Term
|
Definition
~A rough, grating sound, like 2 pieces of leather rubbed together, indicating peritoneal inflammation.
~Occurs rarely; usually over organs with a large surface area in contact with peritoneum.
~Liver: friction rub over lower right rib cage from abscess or metastatic tumor.
~Spleen: friction rub over lower left rib cage in left anterior axillary line from abscess, infection, or tumor. |
|
|
Term
| S1, S2, S3, S4, and Murmurs |
|
Definition
| ~Listen with diaphragm; then switch to bell covering all auscultatory areas. |
|
|
Term
|
Definition
~Indicates turbulent blood flow, as found in constricted , abnormally dilated, or tortuous vessels.
~Listen with bell
~Aortic aneurysm: murmur is harsh, systolic, or continuous and accentuated with systole.
~Renal artery stenosis: murmur is midline or toward flank, soft, low to medium pitch.
~Partial occlusion of femoral arteries. |
|
|
Term
| Why does turning the patient to the left side make it easier to hear heart sounds? |
|
Definition
~Listen with the bell at the apex for presence of any diastolic filling sounds.
~S3, S4, and murmurs of mitral stenosis sometimes may be heard only when laying on left side. |
|
|
Term
|
Definition
~Nasal cavity via the nares, which are lined with respiratory mucosa; the nasal septum separated the 2 cavities.
~Air enters the pharynx or throat
~The larynx or voice box is just below the pharynx, and houses the vocal cords, glottis, and epiglottis.
~The epiglottis covers the opening of the larynx, and prevents food from entering the trachea.
~The trachea or windpipe is about 11 cm long that extends from the larynx in the neck to the bronchi in the chest cavity.
~The primary bronchi branch off of the trachea to each lung.
~From the primary bronchi, they branch into smaller or secondary bronchi.
~These secondary bronchi divide smaller and smaller into tiny tubes made only of smooth muscle called bronchioles.
~The bronchioles subdivide into microscopic tubes called alveolar ducts, and ends in several alveolar sacs, which are made up of numerous alveoli.
~The pleura covers the outer surface of the lungs and lines the inner surface of the rib cage.
~The muscles of respiration include: the diaphragm which is an inspiratory muscle, and the external intercostals.
~Expiratory muscles are the internal intercostals and abdominal muscles. |
|
|
Term
| How to Assess an Infants Respiratory Rate |
|
Definition
| ~Observe the abdomen bulge with each inspiration |
|
|
Term
| Accessory Muscles and Nasal Flaring |
|
Definition
| ~They are indicative of air flow obstruction and poor ventilation. |
|
|
Term
|
Definition
~People with COPD often use it
~Leaning forward with arms braced against their knees, chair, or bed.
~This gives them leverage so the abdominal, intercostal, and neck muscles all can aid in expansion. |
|
|
Term
| Barrel Chest or Enlarged AP Diameter |
|
Definition
~Ribs are horizontal, chest appears as if held in continuous inspiration
~Occurs with COPD from hyperinflation of the lungs |
|
|
Term
|
Definition
~Hold diaphragm firmly on chest wall and listen to at least 1 full respiration in each location
~While standing behind person, start at the apices at C7 to the bases (around T10) and laterally from the axilla down to the 7th or 8th rib.
~On the anterior side, from apices in the suprclavicular areas down to the 6th rib |
|
|
Term
|
Definition
~Percuss to map out the lower lung border in both expiration and inspiration
~Instruct to exhale and hold it briefly while you percuss down the scapular line until the sound changes from resonant to dull on each side
~This estimates the level of the diaphragm separating the lungs from the abdominal viscera.
~The vertical distance is the diaphragmatic excursion
~Should be equal bilaterally and measure about 3-5 cm in adults, but may be up to 7-8 cm in well conditioned people |
|
|
Term
| No Breath Sound Where They Should Be |
|
Definition
~When the bronchial tree is obstructed at some point by secretions, mucus plug, or a foreign body
~In emphysema as a result of loss of elasticity in the lung fibers and decreased force of inspired air; the lungs also are already hyperinflated, so the inhaled air does not make as much noise
~When anything obstructs transmission of sound between the lung and your stethoscope such as pleurisy or pleural thickening or air (pneumothorax)or fluid (pleural effusion) in the pleural space
~A silent chest means that no air is moving in or out; an ominous sign |
|
|
Term
|
Definition
~Collapsed shrunken section of alveoli or an entire lung as a result of:
~Airway obstruction (bronchus is completely blocked by thick exudate, aspirated foreign body, or tumor); the alveolar air beyond the obstruction is gradually absorbed by the pulmonary capillaries, and the alveolar walls cave in)
~Compression on the lungs
~Lack of surfactant (hyaline membrane disease) |
|
|
Term
|
Definition
~Free air in the pleural space causes partial or complete lung collapse
~Air in pleural space neutralizes the usual negative pressure present, making the lung collapse
~Usually unilateral
~Can be spontaneous (air enters thru rupture in lung wall)
~Traumatic (air enters thru opening or injury in chest wall)
~Tension (trapped air increases, compressing lung and shifting mediastinum to the unaffected side) |
|
|
Term
|
Definition
| ~Is a type of pleural effusion in which blood accumulates in the pleural cavity. |
|
|
Term
|
Definition
~Bronchial (tracheal): High pitch, loud, harsh, hollow, tubular sound; over the trachea and larynx
~Bronchovesicular: moderate pitch, moderately loud, mixed quality; over major bronchi where fewer alveoli are; anterior in 1st and 2nd intercostal spaces
~Vesicular: low pitch, soft, rustling like wind in trees; over peripheral lung fields |
|
|
Term
| Adventitious Breath Sounds |
|
Definition
~Fine Crackles: (formerly Rales) discontinuous, high pitched, short crackling, popping sounds heard during inspiration that are not cleared by coughing
~Coarse Crackles: (coarse Rales): Loud, low pitched bubbling and gurgling sounds that start in early inspiration and may be present in expiration
~Atelectatic Crackles:(atelectatic rales)sound like fine crackles but do not last and are not pathologic
~Pleural Friction Rub: A very superficial sound that is coarse and low pitched; grating quality; sounds just like crackles, but close to the ear; on inspiration and expiration
~High Pitched Wheeze: (sibilant) High pitched, musical squeaking sounds that sound polyphonic; predominant in expiration, but may occur in both
~Low pitched Wheeze: (sonorous rhonchi) Low pitched; monophonic, single note, musical snoring, moaning sounds; heard throughout the cycle, but are more prominent on expiration
~Stridor: High pitched, monophonic, inspiratory, crowing sound; louder in neck than over chest wall |
|
|
Term
|
Definition
~Tachypnea: rapid, shallow breathing; increased rate over 24 BPM; normal response to fever, fear, or exercise
~Hyperventilation: Increase in both rate and depth; normally occurs with extreme exertion, fear, anxiety; also with diabetic ketoacidosis (Kussmaul), hepatic coma, salicylate overdose,lesions of the midbrain, and alteration in blood gas concentration; blows off CO2, causing a decreased level in blood (alkalosis)
~Bradypnea:Slow breathing; decreased but regular rate under 10 BPM; as in drug induced depressing of the respiratory center in the medulla, increased ICP, and diabetic coma
~Hypoventilation:Irregular shallow pattern caused by an overdose of narcotics or anesthetics;
~Cheyne-Stokes:A cycle in which respirations gradually wax and wane in a regular pattern, increasing in rate and depth and then decreasing; breathing periods last 30-45 seconds, with periods of apnea (20 secs) alternating the cycle.
~Biot Respiration: Similar to Cheyne-Stokes, except pattern is irregular; series of normal respirations (3-4) is followed by period of apnea; cycle length varies anywhere from 10 secs to 1 minute
~Chronic Obstructive Breathing: normal inspiration and prolonged expiration to overcome increased airway resistance; any situation that increases heart rate may lead to dyspneic episode (air trapping)because the person does not have time for full expiration |
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~Difficulty breathing when supine or laying flat
~State # of pillows "2 pillow orthopnea" |
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| ~Normal, good, unlabored ventilation, sometimes known as quiet breathing or resting respiratory rate. In eupnea, expiration employs only the elastic recoil of the lungs. |
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| ~Difficult or labored breathing |
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~Acute: last less than 2 or 3 weeks
~Chronic: lasts over 2 months
~Characteristics: continuous throughout day could mean acute illness; afternoon/evening may be exposure to irritants at work; night could be postnasal drip, sinusitis; early morning could be chronic bronchial inflammation of smokers
~Hacking indicates mycoplasma pneumonia
~Dry cough indicates early heart failure
~Barking is croup
~Congested indicates colds, bronchitis, pneumonia |
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| Characteristics of Sputum |
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Definition
~White or clear mucoid indicative of colds, bronchitis, viral infections
~Yellow or green indicate bacterial infections
~Rust colored with TB, pneumococcal pneumonia
~Pink, frothy indicates pulmonary edema, some sympathomimetic medications have a side effect of pink-tinged mucus |
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~Symptoms: Initially asymptomatic, showing as positive skin test or X-Ray; progressive TB involves weight loss, anorexia, easy fatigue, low grade fevers, night sweats; may have pleural effusion; recurrent respiratory infections
~Lung sounds: Normal or decreased vesicular breath sounds; adventitious: crackles over upper lobes common, persistent following full expiration and cough |
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~Symptoms: fever, cough with pleuritic chest pain, blood-tinged sputum, chills, SOB, fatigue
~Lung sounds: tachycardia; loud bronchial breathing with patent bronchus; voice sounds have increased clarity; bronchophony, egophony, whispered pectoriloquy present; in children: diminished breath sounds may occur early; adventitious sounds: crackles, fine to medium |
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Definition
| ~Caused by destruction of pulmonary connective tissue (elastin, collagen); characterized by permanent enlargement of air sacs distal to terminal bronchioles and rupture of interalveolar walls, which increases airway resistance, especially on expiration, producing a hyperinflated lung and an increase in lung volume; cigarette smoking accounts for 80-90% of cases of emphysema. |
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| Breath Sounds of Emphysema |
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Definition
~Decreased breath sounds
~May have prolonged expiration ~Muffled heart sounds resulting from overdistention of lungs |
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~A grating sound or sensation produced by friction between bone and cartilage or the fractured parts of a bone.
~The production of crepitations in the lungs; rales. |
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| ~It is calculated by multiplying the number of packs of cigarettes smoked per day by the number of years the person has smoked. For example, 1 pack-year is equal to smoking 20 cigarettes (1 pack) per day for 1 year, or 40 cigarettes per day for half a year, and so on. |
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~The growing fetus increases the oxygen demand on the mother's body
~This demand is met easily by increasing tidal volume (deeper breathing).
~Little change occurs in the respiratory rate.
~An increased awareness of the need to breathe develops early in pregnancy.
~This physiological dyspnea affects close to 75% of women, but does not alter ADL's; is not associated with cough, wheezing, or exercise. |
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| Purpose of Percussion of the Thorax |
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Definition
| ~The lung is filled with air (99% of lung is air). Hence, percussion of it gives a resonance. This step helps identify areas of lung devoid of air. |
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| ~Ventricle of heart or brain |
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| ~Standing apart; expansion |
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| Irregular, shallow pattern of breathing, caused by inability to breath deeply due to pain or sedation? |
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| Low pitched, soft, rustling normal breath sound; heard over peripheral lung fields in the smaller bronchioles and alveoli? |
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| Extra sounds that are not normally heard in the lungs? |
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| Slow breathing; a decreased but regular rate, < 10 BPM? |
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| A breathing pattern in which respirations gradually increase in rate and depth, then decrease in a regular pattern. Each cycle lasts 30-45 secs and a period of apnea may be present between cycles? |
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| ~Cheyne-Stokes Respirations |
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| When sections of alveoli are not fully expanded by air; the lung is collapsing? |
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| Crackling sounds, may be fine and high pitched, or low pitched and bubbling caused by accumulation of secretions in the airway? |
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| High pitched, musical sounds caused by diffuse airway obstruction from asthma or emphysema? |
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| High pitched, loud, hollow sounding normal breath sounds heard predominantly in the trachea and larynx? |
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| Moderate pitched, moderately loud normal breath sound heard over major bronchi? |
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| Structure that prevents blood from moving backward in the veins? |
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| Term for widening or dilating of blood vessels? |
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| The largest artery in the body? |
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| Another name for the bicuspid valve is? |
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| The medical term for an irregular heartbeat is? |
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| Type of tissue that lines the inner walls of blood and lymph vessels? |
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| Structure that is essential for the development of lymphocytes? |
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| The vessel that drains lymph from the right upper quadrant? |
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| Lymph nodes located in the armpits? |
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| The organ that stores blood, filters old damaged blood cells, located in the LUQ of abdomen? |
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| Nodes that filter lymph from the lower extremities and pelvis? |
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| Lymph nodes located in the neck? |
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| Lymph capillaries in the intestine that remove digested fats? |
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| Structure that carries lymph from the lower body and LUQ to the left subclavian vein? |
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| Structure that functions to break down protein waste so it can be returned to the circulatory system? |
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| Lymph fluid originates as interstitial fluid? T/F |
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| The protein in the erythrocyte that contains iron for binding oxygen is hemoglobin? T/F |
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| Diastolic pressure is measured during heart relaxation? T/F |
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| A heart rate slower than 60 BPM is called tachycardia? T/F |
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| All veins carry deoxygenated blood back to the heart? T/F |
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| Pulmonary arteries carry oxygenated blood? T/F |
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| Erythropoietin is a hormone secreted by the liver that increases RBC formation? T/F |
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| The liquid portion of the blood is called? |
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| The formed element of blood that protects against infections is? |
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| All the formed elements of t |
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| All the formed elements of blood are created in the? |
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| Vessels moving away from the heart are called? |
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| Vessels moving blood toward the heart are called? |
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| The formed element of blood that is responsible for blood clotting is? |
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Definition
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| The formed element of blood that transports oxygen is the? |
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| The upper receiving chambers of the heart are the? |
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| The lower pumping chambers of the heart are the? |
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| The innermost lining of the heart is the? |
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| The muscle layer of the heart is the? |
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| The outermost layer of the heart muscle,or fascia, is the? |
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| The heart is found in what cavity? |
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| The term that means irreversible tissue death is? |
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| The term that means reversible injury to tissue caused by lack of oxygen is? |
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Definition
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| The heart is surrounded by a protective sac called the? |
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Definition
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| The decrease in the diameter of a blood vessel is? |
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| All exchanges of gas and nutrients occurs in the? |
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| Blood vessels that branch off the aorta and supply blood to the heart muscle are? |
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| A heart rate below 60 BPM is known as? |
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| The sinoatrial node, located in the right atrium, is known as the? |
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| Lymph fluid from the lower body and left upper quadrant drains into the? |
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| Receives blood directly from the pulmonary veins? |
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| The valve between the left atrium and left ventricle? |
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| The valve at the opening of the pulmonary artery? |
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