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1. Jugular Vein Distention is a symptom of __________ sided heart failure.
2. Where do you place the stethoscope to listen to the apical pulse?
5th intercostal space mid-clavicular line
3. What are the 'grades' of pulses? 0 to 4+
- o 4+ Bounding
- o 3+ Full (normal)
- o 2+ Diminished
- o 1+ Weak
- o 0 Absent
4. Where are the dorsalis pedis pulses palpated?
top of the feet
5. Where are the posterior tibial pulses palpitated?
Inside of the ankle
6. When auscultating Arteries what should you hear?
7. When auscultating the Carotid artery the Bruit sound indicates__________?
Blockage (Sound is from a continuous, turbulent blood flow)
8. If the Abdominal Aorta can be auscultated it usually indicates_________?
An aneurysm or dissection
9. If the Femoral or Popliteal arteries can be auscultated it usually indicates_______?
10. Where is the Aortic valve auscultated?
- o Right sternal boarder
- o 2nd intercostal space
11. Where is the Pulmonary valve auscultated?
- o Left sternal boarder
- o 2nd intercostal space
12. Where can the Mitral (Bicuspid) Valve be auscultated?
- o Midclavicular line
- o 5th intercostal space
13. Where can the Tricuspid valve be auscultated?
- o Left lower sternal boarder
- o 5th intercostal space
14. Artery that sends blood back to the heart muscle
15. During Systole the muscle of the heart____? (contract or relaxes)
- o Contracts.
- o The chambers become smaller as the blood is ejected
16. During Diastole the heart muscle____? (contracts or relaxes)
- o Relaxes
- o The chambers fill with blood
17. Which circulatory system has...
- Deoxygenated blood pumped into the lungs and
- oxygenated blood returned to the heart?
- o Pulmonary system.
- o (Think oxygen in the lungs. Goes in deoxygenated and out oxygenated)
18. Which circulatory system has...
- Oxygenated blood pumped to all parts of the body by the arteries and
- deoxygenated blood returned to the heart by the veins?
- Systemic Circulation
19. What System has....
- Electrical impulses that signal the heart to beat?
- Conduction System
20. What is Nodal tissue?
21. There are 4 areas of Nodal tissue we are studying can you name them?
- Try naming them in the order of the electrical impulse.
- o SA Node-in the wall of the right atrium
- o AV Node
- o AV bundle-(Bundle of His)
- o Purkinje Fibers
22. Call the 'pacemaker' of the heart. 60-100 bpm
23. Second in line to start electrical impulse if SA Node can't.
AV Node. 40-60 bpm
24. Third in line to start an electrical impulse, it lies between the middle of the heart.
Bundle of His-bpm varies greatly
25. Last in line to start an electrical impulse
Purkinje Fibers-15-30 bpm
26. Electrical activity of the heart is due to movement of _______ across cell membranes.
ions (Na+ K+ Ca)
27. Atrioventricular Valves are between the ___________&___________.
- They are called_________&________ Valves
- Atria & Ventricles
Tricuspid & Mitral (Bicuspid) Valves
28. ________&_______ are Semilunar Valves
Pulmonary and Aortic Valves
29. Valve between right ventricle and pulmonary artery
30. Valve between the left ventricle and aorta
31. Blood vessels that return blood to the heart
32. Vein that drains blood from the head, neck and arms into the right atrium
Superior Vena Cava
33. Vein that transports blood into the right atrium from all parts of the body except the head, neck and arms
Inferior Vena Cava
34. Thickest veins
Superior and Inferior Vena Cava
35. Vein that returns blood from the heart muscle to the right atrium
- (Supplies heart with oxygenated blood)
- Coronary Sinus
36. Vein that returns blood to the left atrium from the lungs
37. Blood vessels that send blood from the heart
38. Artery that sends blood from the right ventricle to the lungs
39. Artery that sends blood from the left ventricle to the body
40. Each ventricle of the heart pumps out approximately ________liters of blood per minute.
41. The heart is usually about the size of a fist. What factors would change this?
- o Age
- o Gender (female smaller)
- o Exercise
- o Heart Disease (larger)
42. Right side of the heart pumps ______________blood (oxygenated or not oxygenated) to the _________?
Not oxygenated blood to the lungs
43. The left side of the heart pumps ____________blood (oxygenated or not oxygenated) to the __________?
Oxygenated blood to all other parts of the body.
44. Inner layer of the heart
- Lines the inside of the heart and valves.
45. Middle layer of the heart
- Responsible for PUMPING action
- o MYOcardium
- o (Think MYO-MUSCLE, it pumps)
46. Outer layer of the heart
47. Area between the heart and the chest wall.
48. Part of the pericardium closest to the heart
- Adheres to the epicardium
49. Part of the pericardium that attaches to the other structures
- Supports the heart in the mediastinum
50. Why are there approximately 30cc'sf fluid between the epicardium and the pericardium?
To reduce friction
51. Chambers of the heart that serve as reservoirs
- o Atrias
- o They have thinner walls
- o They are in the upper areas of the heart
- o so blood flows down mostly by gravity
52. Chambers of the heart that serve as PUMPS for blood
- o Ventricles
- o Thicker walls
- o More Powerful
- o Left is the strongest
53. What are the best positions for cardiac auscultation?
- o Forward leaning (for high pitch)
- o Left lateral recumbent (laying on left side)(for low pitch)
54. What is PITCH of heart sounds?
55. What is INTENSITY of heart sounds?
56. What is DURATION of heart sounds?
How long it lasts
57. What is QUALITY of heart sounds?
Tone (musical, harsh)
58. What is LOCATION of heart sounds?
Where it is
59. What is RADIATION of heart sounds?
When it can be heard in another area too
60. What is a MURMUR and what does it sound like?
- o Blood flow through a narrow opening.
- o It is a vibrating, rolling, blowing, rumbling sound
61. What is a CLICK and what does it sound like?
- o Cords tensing up more than needed.
- o High Pitched Sound
62. What is a SNAP and what does it sound like?
- o Valves are narrowed or stiff.
- o High Pitched
63. What is a RUB and what does it sound like?
- o Inflammation of pericardium or decreased pericardial fluid.
- o Scratchy, scrappy, squeaky sound
64. What are the 4 cardiac enzymes?
- o CKMB
- o Myoglobin
- o Troponin I
- o Troponin II
65. Which enzyme is specific to the heart?
66. Which cardiac enzyme is released the quickest?
Myoglobin (30 min-4 hr)
67. What enzyme will show up if the MI was a week ago?
68. What coagulation study is done for a patient on Heparin?
69. What coagulation studies are done on a patient on Coumadin therapy?
70. What Diagnostic Study graphically records electrical current?
71. What Diagnostic study evaluates patency of vessels and grafts?
72. Why is UOP measured before a Cardiac Cath?
The dye used needs to be excreted through the kidneys.
73. What are the common forms of hemodynamic monitoring?
- o Central Venous Pressure (CVP)
- o Pulmonary Artery Pressure (PAP)
- o Intra-Arterial Blood Pressure (A-line)
74. Used to obtain direct and continuous BP measurements
75. What is the Allen's test in relation to collateral circulation?
- o Putting pressure in the wrist and releasing the ulnar to see if the radial artery is open.
- o It is necessary to have this open for the ulnar artery to be used for A-Line monitoring.
76. Some considerations with A-Line Monitoring
- o Be sure the system is at the appropriate level.
- o Monitor for distal ischemia, blood loss, pain and infection
77. What Coronary Artery supplies the right side of the heart and 30% of the left side?
Right Coronary Artery
78. Which Coronary Artery supplies the Left Ventricle of the heart?
Left Main (also called the Widow Maker)
79. System that causes increased heart rate, increased conduction through the AV node and vasoconstriction.
Sympathetic Nervous System
80. What triggers the SNS?
- o Fear
- o Exercise
- o Anxiety
- o Certain Drugs
81. Vasoconstriction causes the blood pressure to _________?
82. What system causes decrease in heart rate, decreased AV condustion and decreased force of contraction?
Parasympathetic Nervous System
83. What triggers the PNS?
- o Rest
- o Meditation
- o Yoga
- o Prayer
- o Beta Blockers
84. Ability to initiate an electrical impulse.
85. Ability to respond to an electrical impulse
86. Ability to transmit an electrical impulse
87. Ability to contract
88. What is a Wave?
- o Deflection from the baseline.
- o Can be upward, downward or biphasic
89. What is a Complex?
Consists of multiple waveforms.
90. What is a segment?
Area separating a waveform from a complex
91. What is an Interval?
Area combining a waveform and a segment.
92. Small block on an ECG strip =___________seconds?
93. Large block on an ECG paper = ___________seconds?
94. 30 big blocks =_____________seconds?