Latest - - (Latest - 1. Anatomy of the Heart Answer: righ...

NUFT 204 - Cardiac Assessment (Latest -

• Anatomy of the Heart

Answer: right atrium, right ventricle, left atrium, left ventricle

• Cardiac Cycle

Answer: A complete heartbeat consisting of contraction and relaxation of both atria and both ventricles

• auto-regulatory mechanisms of the heart

Answer:

The heart is supplied by the two branches of the autonomic nervous system.The sympathetic (adrenergic) The parasympathetic or (cholinergic)

• Characteristics of Heart Sounds

Answer: Pitch:

- High pitched: better heard with the diaphragm

- Low pitched: better heard with the bell

Intensity: loud or soft

Duration: short sounds, silent periods

Timing: systole or diastole

• first heart sound (LUB)

Answer:

• Occurs with closure of the two atrio-ventricular valves, when the ventricles start to contract.

This is called systole

• S1: Closure of AV valves (mitral and tricuspid valves: M before T)
• Correlates with the carotid pulse

• second heart sound (DUB)

Answer: The second heart sound is produced by closure of the aortic and pulmonary valves

• Occurs with diastole - the filling phase, relaxation of ventricles

- S2: Closure of Semilunar valves (aortic & pulmonic)

• Heard best over the aortic and pulmonic area

• Erb's Point

Answer: May hear more than one murmur, as murmurs may overlap due to proximity of valves

• Extra heart sounds

Answer: 1 / 2

S3 and S4 S3- ventricular gallop Caused by premature rush of blood into ventricle that is stiff or dilated from heart failure and HTN.S4- atrial gallop • Caused by an atrial contraction pushing blood against a ventricle not accepting blood because of heart failure or other alterations.

Extra heard sounds are best heard at the apex of the heart (the lower pointed end of the heart) with the patient lying on the left side.

• Murmur

Answer: Gentle, blowing, swooshing sound. Listen for murmurs in the same

Auscultatory sites APETM Heard on chest wall due to turbulence Velocity of blood increases Exercise, thyrotoxicosis, pregnancy

Viscosity of blood decreases Anemia Structural defects in valves or chambers Narrow valves, incompetent valves, wall defects, dilated chambers

• Stenosis

Answer:

A valve that does not close efficiently, results in the backflow of blood (i.e., insufficiency or regurgitation).

A valve that does not open wide enough may cause turbulent backflow secondary to obstruction or narrowing (i.e., stenosis).

• Cardiac Asessment

Answer:

Inspection: Position client supine

Then head elevated at 45 degrees Patient must be relaxed and comfortable

INSPECTION:

Visible pulsations, Lifts, heaves PMI (assess location) Inspect and palpate simultaneously.

• Cardiac Assessment

Answer:

Palpation: assessing the arterial pulse, measuring blood pressure, palpating any thrills on the chest, and palpating for the point of maximal impulse.

• / 2