Health Assessment Exam 3-Chapters 19 & 20

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Great vessels:

Major arteries and veins connected to the heart.

Precordium:

area of anterior chest overlying the heart and great vessels.

Mediastinum:

The middle third of the thoracic cage between the lungs.

Position of heart:

Extends from the 2nd to the 5th intercostal space; from the sternum to the midclavicular line.

Apex:

Bottom of heart.

Base:

Top of heart.

Great Vessels:

Superior & inferior vena cava

Right ventricle:

Froms the greatest area of anterior surface of heart.

Superior & inferior vena cava:

Returns unoxygenated venous blood to the right side of the heart.

Pulmonary artery:

Leaves the right ventricle, bifurcates and carries venous blood to the lungs.

Pulmonary veins:

Returns freshly oxygenated blood to the left side of the heart, and the aorta carries it out to the body.

Pericardium:

Tough, fibrous, double-walled sac that surrounds and protects the heart.

Myocardium:

The outer, muscle layer of the pericardium.

Endocardium:

Thin layer of endothelial tissue that lines inner surface of heart chambers and valves.

Right:

This side of heart pumps blood to lungs.

Left:

This side of heart pumps blood simultaneously into body

Atriium:

Thin walled reservoir for holding blood.

Ventricle:

Thick walled muscular pumping chamber.

Tricuspid valve:

The right atrioventricular valve.

Mitral or bicuspid valve:

The left atrioventricular valve.

AV valves:

These valves open during diastole, allowing ventricles to fill w/blood.

Atrioventricular valves:

Separate the atria and the ventricles.

Semilunar valves:

Set between the ventricles and the arteries.

Pulmonic valve:

The right sided semilunar valve.

Aortic valve:

The left-sided semilunar valve.

Semilunar valves:

These valves open during systole (pumping) and allow blood to be ejected from the heart.

Pulmonary artery:

This delivers unoxygenated blood to lungs.

Cardiac cycle:

Two phases:
Diastole-2/3 of cardiac cycle; filling
Systole-1/3; contraction

Strep throat:

Can cause reumatic fever, which can damage the endocardium and heart valves.

Right atria:

Largest chamber in the heart.

Direction of blood flow:

Liver to superior & inferior vena cava to right atrium to right ventricle to pulmonary artery to lungs to pulmonary veins to left atrium to left ventricle to aorta into body.

S1 sound:

Closure of the AV valves that signals the beginning of systole.

S2 sound:

Closure of the SL valves that signals the end of systole.

Effect of respiration:

More to the right heart, less to the left.
Eariler aortic valve closure because of delayed pulmonic valve closure, causing a split S2 sound.

S3 sounds:

With some conditions, diastole (the vibrations of ventricular filling) can be heard.

S4 sounds:

This sound occurs at presystole, when the ventricle is resistant to filling.

Murmurs:

Turbulent back flow of blood swishing around.

Pregnancy:

This condition causes an increased blood volume of 30 to 50 percent.

Sinus Arythmia:

Heart rate increases with inspiration.

Cardiac output:

Heart rate x stroke volume; 4-6 L per minute

Carotid arteries:

Bring oxygenated blood to the brain.

Jugular veins:

Empty unoxygenated blood directly into the superior vena cava

Jugular Pressure:

Amount of pressure within the veins and heart.

Arteriosclerosis:

Calcification of vessel walls

Diaphoresis:

Excessive sweating commonly associated with shock and other emergency medical conditions.

Bell:

The part of the stethoscope that you hear murmurs with.

Bruit:

Tuburlant blood flow through the carotid artery.

Distension of veins:

This is a sign of congestive heart failure.

Syncope:

Is temporary loss of consciousness and posture, described as "fainting" or "passing out." It's usually related to temporary insufficient blood flow to the brain.

Pulse deficit:

The difference between the apicla pulse and the radial pulse.

2 causes of enlarged heart:

Hypertension and heart failure

Older adults:

Systole increases by 20 %
Calcification of atrial walls
Ventricular wall thickens
Decrease in skeletal muscle

2nd trimester:

Blood pressure decreases in the tiemester of pregnancy, due to increase in horomones.

Heave or Lift:

A sustained forceful thrusting of the ventricle during systole.

Thrill:

A palpable vibration, which signifies turbulent blood flow and accompanies loud murmurs.

Aortic stenosis:

The aortic valve does not fully open, restricting blood flow.

Extra systolic sounds:

Ejection click-aortic & pulmonic stenosis
Aortic prosthetic valve sounds
Midsystolic click

Extra Diastolic sounds:

Opening snap-mitral stenosis
Mitral prosthetic valve sounds
Third & fourth heart sounds
Summation sound-may hear after exercise
Pericardial friction rub

Patent Ductus Arteriosus:

Congenital heart defect-failure of shunts to close

ASD:

Atrial septal defect-opening between atria
Congenital heart defect

VSD/Tetralogy of Fallot:

Congential heart defect-Abnormal opening in the atrial septum

>200:

Persistent tachycardia in newborns

>150:

Persisten tachycardia in infants.

<90:

Bradycardia in newborns.

<60:

Bradycardia in infants.

Coarctation of Aorta:

Narrowing of aorta; congential defect.

Arteries:

Pump oxygenated blood through body.

Ischemia:

deficient supply of oxygenated arterial blood to a tissue caused by obstruction of a blood vessel.

Deep Veins -leg:

Run alongside deep arteries and conduct most of the venous return from the legs; femoral & popliteal veins.

Superficial veins-leg:

Great & small saphenous

Veins:

Drains deoxygenated blood and waste from the tissues and returns it to the heart; low pressure system.

Veins:

Return blood to the heart by:
Contracting skeletal muscles
Pressure gradient caused by breathing
Intraluminal valves, which ensure unidirectional flow

Lymphatics:

Separate vessel system which retrieves excess fluid from the tissue spaces and returns it to the blood stream.

Right Lymphatic Duct:

Drains the right side of the head, neck, arm, and right side of thorax, lung, pleura and liver; then empties into the right subclavian vein,

Thoracic duct:

Drains rest of body and empties into the left subclavian vein.

Functions of lymph system:

Conserves fluid and plasma that leaks out of capillaries
Forms major part of immune system
Absorbs lipids from the intestinal tract

Lymph nodes:

Small oval clumps of lymph tissue located at intervals along the vessels; filter fluid before it is returned to the blood stream.

Spleen:

Upper left quadrant-hidden under ribcage. Four functions:
Destroy old red blood cells; produce antibodies; store red blood cells; filter microorganisms from blood.

Tonsils:

Palatine, adenoid & lingual

Thymus:

Important in developing T lymphocytes in children; atrophies after puberty.

Hyperplasia:

a general term referring to the proliferation of cells within an organ or tissue beyond that which is ordinarily seen. Hyperplasia may result in the gross enlargement of an organ and the term is sometimes mixed with benign neoplasia/ benign tumor.

Atherosclerosis:

Deposition of fatty plaques on the intima of the arteries.

Arteriosclerosis:

Peripheral blood vessels grow more rigid with age.

Modified Allen Test:

Used to evaluate adequacy of collateral circulation; occlude both the ulnar and radial arteries.

Doppler Ultrasonic stethoscope:

Used to detect weak peripheral pulses, monitor blood pressure in infants/children, or low blood pressure.

Weak, thready pulse:

1+, hard to palpate, may fade in and out. Associated with decreased cardiac output, peripheral arterial disease, aortic valve stenosis.

Full, boundind pulse:

3+, easily palpable, pounds under fingertips. Associated with exercise, anxiety, fever, anemia, hyperthyroidism.

Water-Hammer (Corrigan's) pulse:

3+, greater than normal force, then collapses suddenly.

Aneurysms:

A sac formed by dilation in the artery wall. Most common site-aorta; most common cause is atherosclerosis.

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