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Exam 4 part 2 - Heart and neck vessels
Terms in this set (71)
area on the anterior chest directly overlying the heart
atrioventricular (AV) valves
separate the atria and the ventricles
right AV valve
left AV valve
collagen fivers that anchor the valves thin leaflets
semilunar (SL) valves
pulmonic (right) and aortic (left)
contraction against a closed system works to build pressure inside the ventricles to high level
volume of blood in each systole times the number of beats per minute. CO = SV X R
venous return that builds during diastole. Length to which the ventricular muscle is stretched at the end of diastole just before contraction.
opposing pressure the ventricle must generate to open the aortic valve against the higher aortic pressure.
located in the groove between the trachea and the sternomastoid muscle, medial to and alongside that muscle.
smooth rapid upstroke, a summit that is rounded and smooth.
empty unoxygenated blood directly into the superior vena cave.
occurs when the heart's own blood supply cannot keep up with metabolic demand
squeezing "clenched fist"
Symptoms of Angina
-diaphoresis, cold sweats, pallor, grayness
-palpitations, dyspnea, nausea, tachycardia, fatigue
Shortness of breath
Quantify exactly (after walking two level blocks)
-Constant or intermittent
Paroxysmal nocturnal dyspnea
occurs with heart failure. Lying down increases volume of intrathoracic blood, and the weakened heart cannot accommodate the increased load.
need to assume a more upright position to breath. note the exact number of pillows used
coughing up blood
Cyanosis or Pallor
occurs with MI or low cardiac output states as a result of decreased tissue perfusion
dependent when caused by heart failure
-worse at evening & better at morning after legs have been elevated all night
Recumbency at night promotes fluid resorption and excretion; occurs with heart failure in the person who is ambulatory during the day
Risk factors for CAD
elevated cholesterol, elevated BP, blood sugar levels above 100 mg/dL or known DM, obesity, cigarette smoking, low activity level, length of any hormone replacement therapy for postmenopausal women
Aging adult history
Known heart or lung disease?
-efforts to treat?
-change in symptoms?
-interfere w/ ADL?
-any medications (digitalis)?
Carotid sinus hypersensitivity
the condition in which pressure over the carotid sinus leads to a decreased heart rate, BP, and cerebral ischemia with syncope.
May occur in older adults with hypertension or occlusion of carotid artery
feels small and weak, decreased stroke volume as in cariogenic shock.
feels full and strong in hyperkinetic states
indicates turbulence from a local vascular cause and is a marker for atherosclerotic disease.
-increases risk of transient ischemic attack & ischemic stroke
-occurs in 5% of those ages 45-80 who have no significant carotid disease
audible when lumen is occluded by 1/2 to 2/3. Loudness increases as the atherosclerosis worsens until lumen is occluded by 2/3. (bruit loudness decreases after that when lumen is completely occluded)
sounds much the same to bruit but is caused by a cardiac disorder
Unilateral distention of external jugular veins
caused by a local cause (kinking or aneurysm)
Full extended jugular veins above 45 degrees
signify increased CVP with heart failure
level of pulsation that is > 3 cm above sternal angle while at 45 degrees
-occurs with heart failure, cardiac tamponade, and constrictive pericarditis
if venous pressure is elevated or if you suspect heart failure perform this.
-position person comfortably supine, and instruct him/her to breath quietly through an open mouth.
sustained forceful thrusting of the ventricle during systole.
-occurs with ventricular hypertrophy as a result of increased workload.
-Right ventricular heave seen at sternal border
-left ventricular heave seen at apex
Left ventricular dilation displaces impulse down and to left and increases size more than one space. A diameter of greater than/equal to 4 cm is likely a dilated heart
-heart failure & cardiomyopathy
increased force and duration but no change in location
-left ventricular hypertrophy & no dilation
palpable vibration. Feels like the throat of a purring cat.
-signifies turbulent blood flow and directs you to locate the origin of loud murmurs
isolated beat is early, or a pattern occurs in which every third or fourth beat sounds clearly
no pattern to the sounds; beat comes rapidly and at random intervals as in atrial fibrillation.
signals a weak contraction of the ventricles; occurs with atrial fibrillation, premature beats, and heart failure
infected by respiration; the split is always there
the opposite of what you would expect; sounds fuse on inspiration and split on expiration
occurs with heart failure and volume overload
occurs with CAD
may occur with a healthy heart or heart disease
always indicates heart failure
murmur of mitral stenosis
low pitched and rumbling
murmur of aortic stenosis
a sudden drop in BP when rising to sit or stand
associated with heart failure and is always abnormal over age 35 years
symptoms for heart attack in women
-uncomfortable pressure, squeezing, sense of fullness in chest
-pain or discomfort in both arms, back, neck, jaw, lower chest, and/or upper abdomen
-shortness of breath
-breaking out in cold sweat, nausea, and light headedness
-Pressure like discomfort
-substernal or retrosternal; teeth, jaw, neck, one or both arms or shoulders
-diaphoresis, nausea, vomiting, dyspnea
Prinzmental or variant angina
-Pressurelike discomfort often occurring at rest and early morning hours
-Retrosternal: can radiate to jaw, neck, left arm, or shoulder
-palpitations, syncope, or feelings of syncope
Acute coronary syndrome
-Heaviness, viselike squeezing, crushing, tightness
-poorly localized lasting 20-30 minutes to hours and does not resolve with rest
-substernal or retrosternal; teeth, jaw, neck, one or both arms or shoulders
-Indigestion-like feeling, nausea, vomiting, dizziness, flushing, perspiration, palpitations, dyspnea
-sudden sharp and stabbing pain often relieved by sitting or leaning forward and worsens when lying down or inspiration
-substernal: radiate to trap muscle region
-dry cough, muscle & joint aches, fever
Mitral valve prolapse
-sharp pain not associated with activity
-chest pain w/o radiation
-fatigue, light-headedness, irregular heartbeat, palpitations, exercise intolerance
-sudden severe pain with change in location and/or tearing sensation lasting for hours
-anterior chest pain with radiation to the neck, jaw, or intrascapular region of the back
-mental status changes, limb pain and weakness, dyspnea
-cardiac like chest pain with exertion
-dyspnea, lower extremity edema, fatigue
-sharp, stabbing pain worsening with deep breaths
-pain in chest, back, shoulder, upper abdomen
-dyspnea, hemoptysis, cough
-Sharp or stabbing pain associated with cough
-generalized to one side of chest but can have upper abdominal pain
-cough, fever, dyspnea, chills, sputum, myalgia, malaise
-Acute/sudden and sharp
-lateral region of the chest but can have referred pain to shoulder
-acute dyspnea, cough
-burning sensation with eating large meals
-cough, regurgitation of food, abdominal pain
-crushing chest pain
-dysphagia, sensation of object in throat or esophagus
-sudden onset of pain that crescendos and can last for up to 20 minutes, usually after eating a fatty meal
-epigastrium or right upper abdomen that can radiate to right intrascapular region, shoulder, back
-nausea, vomiting, anorexia, fever
-sudden dull, boring, steady pain
-epigastrium or periumbilical pain radiating to back
-nausea & vomiting, anorexia, sometimes diarrhea
-unilateral burning, bore-like pain
-chest region in dermatome distribution
-tingling, itching, burning
-fatigue, restlessness, withdrawal, weight gain/loss, depressed mood
-palpitations, dizziness, sweating, shaking, restlessness, fatigue, irritability
decreased cardiac output
occurs when the heart fails as a pump and the circulation becomes backed up and congested
acute onset of heart failure
following a MI when direct damage to the heart's contracting ability has occurred
chronic onset of heart failure
as with hypertension, when the ventricles must pump against chronically increased pressure
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