Term
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Definition
| turbulent blood flow and collision currents |
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Term
| conditions resulting in murmur |
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Definition
1. velocity of blood increases (exercise/ thyrotoxicosis)
2. viscosity of blood decreases
3. structural defects in valves |
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Term
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Definition
1. frequency (pitch)
2. intensity (loudness)
3. duration
4. timing |
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Term
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Definition
first heart sound
beginning of systole
pumping phase
loudest at apex |
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Term
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Definition
second heart sound
end of systole, beginning of diastole
filling phase
loudest at base |
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Term
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Definition
depolarization of atria
depolarization of ventricles
repolarization of ventricles |
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Term
| in the resting adult, the heart normally pumps |
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Definition
| 4 to 6 L of blood per minute |
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Term
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Definition
| Stroke Volume (volume of blood in each systole) x Rate (beats per minute) |
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Term
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Definition
venous return that builds during diastole
how much ventricle muscle is stretched at end of diastole just before contraction |
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Term
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Definition
opposing pressure the ventricle must generate to open the aortic valve against the higher aortic pressure
resistance against which the ventricle must pump its blood |
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Term
| carotid artery is located |
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Definition
| in the groove between the trachea and the sternomastoid muscle, medial to and along side that muscle |
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Term
internal jugular
external jugular |
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Definition
lies deep and medial to sternomastoid muscle, usually not visible
more superficial, lies lateral to the sternomastoid muscle above the clavicle |
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Term
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Definition
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Term
| in pregnancy blood volume |
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Definition
increases 30 to 40%
with most rapid expansion in second trimester
= increase SV, CO and pulse rate of 10-15 more beats per minute |
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Term
in pregnancy
despite increased CO |
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Definition
arterial blood pressure decreases as a result of peripheral vasodilation
drops to lowest in second trimester and rises after that (back to baseline) |
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Term
| hemodynamic changes with aging |
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Definition
increase in systolic blood pressure - stiffening of large arteries
size of heart does not increase but LV wall thickness increases
rising systolic with relatively constant diastolic pressure increases the pulse pressure |
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Term
factors of CVD
cardiovascular heart disease |
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Definition
High BP - Hypertension - Stage 1 (140/90)
smoking
serum cholesterol - high LDL's
obesity
type 2 diabetes |
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Term
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Definition
abnormal rhythm
increases with age |
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Term
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Definition
blowing, swishing sound indicating blood flow turbulence
turbulence due to a local vascular cause such as atherosclerotic narrowing |
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Term
CVP
Central Venous Pressure |
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Definition
| can be assessed from the jugular veins and judge the heart's efficiency as a pump |
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Term
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Definition
sternal angle
normal jugular venous pulsation is 2 cm or less above the sternal angle |
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Term
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Definition
apex beat
PMI - point of maximal impulse
5th intercostal space, at or medial to midclavicular line |
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Term
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Definition
aortic area - 2nd right ICS
pulmonic area - 2nd left ICS
Erb's point
Tricuspid area - left lower sternal border
Mitral area - 5th ICS at left midclavicular line |
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Term
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Definition
carotid artery pulse
the R wave (upstroke of QRS complex) if the person is on an ECG monitor |
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Term
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Definition
normal phenomenon in some, occurs near end of inspiration
inspiration separates the timing of the two valves closure (aortic and pulm)
heard only in the pulmonic valve area, 2nd left ICS
holding breath will cause split to go away |
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Term
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Definition
| about every 4th heart beat, fading in with inhalation and fading out with exhalation |
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Term
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Definition
| listen with the bell at the apex for the presence of any diastolic filling sounds (S3 or S4) |
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Term
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Definition
ventricular gallop
occurs with heart failure and volume overload |
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Term
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Definition
atrial gallop
occurs with CAD |
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Term
| may be heard only when the person is leaning forward in the sitting position |
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Definition
| murmur of aortic regurgitation |
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Term
|
Definition
Patent Ductus Arteriosus (PDA)
Atrial Septal Defect (ASD)
Ventricular Septal Defect (VSD)
Tetralogy of Fallot
Coarctation of the Aorta |
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Term
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Definition
persistence of the channel joining left pulmonary artery to aorta
S: no symptoms in early childhood
O: wide pulse pressure; continuous murmur heard in systole and diastole is called a machinery murmur |
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Term
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Definition
abnormal opening in atrial septum, left to right shunt, large increase in pulmonary blood flow
S: remarkably well tolerated, symptoms in infants rare, growth and development normal, children and adults have mild fatigue and DOE (dyspnea on exertion) |
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Term
| Ventricular Septal Defect |
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Definition
abnormal opening in septum between ventricles, usually subaortic area
S: small defects are asymptomatic, large have poor growth, slow weight gain; later look pale, thin; may have feeding problems, frequent respiratory infections
O: loud, harsh holosystolic murmur, best heard at left lower sternal border |
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Term
Tetralogy of Fallot
four components |
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Definition
1. right ventricular outflow stenosis
2. VSD
3. Right ventricular hypertrophy
4. overriding aorta
result: shunts a lot of venous blood directly into aorta away from pulmonary system, blood never gets oxygenated |
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Term
Tetralogy of Fallot
subjective
objective |
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Definition
S: severe cyanosis, not in first months of life but develops; cyanosis with crying and exertion, DOE
O: systolic, loud, crescendo-decrescendo |
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Term
Coarctation of the Aorta
description |
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Definition
severe narrowing of descending aorta, usually at the jxn of the ductus arteriosus and the aortic arch, just distal to the origin of the left subclavian artery
results: increased workload on left ventricle |
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Term
Coarctation of the Aorta
subjective
objective |
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Definition
S: first few months symptoms of heart failure develop
O: upper extremity HTN over 20 mm Hg higher than lower extremities measures is a hallmark of coarctation; absent or greatly diminished femoral pulses; systolic murmur is heard best at the left sternal border, radiating to the back |
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Term
Aortic Stenosis
subjective
objective
murmur |
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Definition
S: fatigue, DOE, palpitation, dizziness, fainting, anginal pain, chest pain
O: pallor, slow diminished radial pulse, thrill in systole
Murmur: loud, harsh, midsystolic, crescendo-decrescendo, loudest at 2nd right ICS, radiates widely to the side of neck, down left sternal border or apex |
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Term
Aortic Stenosis
description |
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Definition
| calcification of aortic valve cusps restricts forward flow of blood during systole, LV hypertrophy develops |
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Term
Mitral Regurgitation
description |
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Definition
| stream of blood regurgitates back into LA during systole through incompetent mitral valve |
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Term
Mitral Regurgitation
subjective
mumur |
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Definition
S: fatigue, palpitation, orthopnea, PND
murmur: pansystolic, best heard at apex, radiates well to left axilla |
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Term
Mitral Stenosis
description |
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Definition
calcified mitral valve will not open properly, impedes forward flow of blood into LV during diastole
LA enlarged and LA pressure increased |
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Term
Mitral Stenosis
subjective
murmur |
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Definition
S: fatigue, palpitations, DOE, orthopnea (difficulty breathing lying down)
murmur: low pitched diastolic rumble, best heard at apex, with person in left lateral position |
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Term
Aortic Regurgitation
description |
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Definition
| stream of blood regurgitates back through incompetent aortic valve into LV during diastole. LV dilation and hypertrophy due to increased LV stroke vol. Rapid ejection of large SV into poorly filled aorta, then rapid runoff in diastole |
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Term
Aortic Regurgitation
subjective
murmur |
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Definition
S: only minor symptoms for many years, rapid deterioration, DOE, PND, angina, dizziness
murmur: soft high pitched, blowing diastolic, decrescendo, best heard at 3rd left ICS at base, as person sits up and leans forward |
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