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what does S1 sounds like? What causes S1?
- closure fo the mitral and tricuspid valves signals the beginning of ventricular systole (contraction)
what does S2 sound like? what causes it?
- closure of the aortic and pulmonic valves signals the beginning of ventricular diastole (relaxation)
what causes and S3 sound? and is i normal? what part of you stethescope is it best heard w/?
- sound is produced by rapid ventriuclar filling and can be normal finding in children and young adults.
what is S4 caused by? is it normal? how is it best heard?
- produced by a strong atrial contraction and can be normal finding in older and athletic adults and children.
what is a murmur? what does it sound like? what part of stethescope do you use? what are the 2 types of murmurs?
- heard when blood vol. is increased int he heart, or the flow of blood is impeded or altered from normal.
- blowing or swishing sound
- Systolic- heard after S1Diastolic- head just after S2
what is a thrill? is it normal?
- palpable vibratons that may be present w/ murmurs or cardiac malformation
- use your ulnar surface of your hand to feel for vibrations
what is a bruit?
produced by obstructed peripheral blood flow and are ehard as a blowing or swishing sound with the bell of the stethescope
Where do you find the aortic site?
right of the sternum @ 2 ICS
where do you find the pulmonic site?
left of the sternum @ the 2nd ICS
where do you find the Erb's point?
left of the sternum @ 3rd ICS
where do you find tricuspid site?
left of the sternum @ 4th ICS
where is the apical/mitral site?
left midclavicular line @ 5th ICS
pulse and bp are indicators of?
what is a heave? is it normal or abnormal?
- visible elevations of the chest wall that are seen with heart failure, and are often located along the left sternal border or at the PMI
how do you inspect the jugular vein?
- hob 30-45 degrees
- assess for right sided heart failure
all pulse sites can be palpated bilaterally to make comparisons except for which pulse site?
name the 7 major pulses and their locations
- carotid- either side of trachea, medial to stenocleidomastoid muscle
- radial- radial side of the wrist
- brachial- antecubitl fossa above the elbow
- femoral- midway between the symphysis pubis and the anterosuperior illiac spine
- popliteal- behind the knee
- dorsalis pedis- top of the foot, along a line w/ the groove between the first toe and the extensor endons of great toe
- posterior tibial- behind and below the medial malleolus of the ankles
what does a brown pigment of the skin indicate?
what does shingy and thin skin w/o hair on toes and foot indicate?
what is the Homan's sign? if its positive what would your suspicion be?
- leg is supported and flexed slightly at the knee while the foot is dorsiflexed. A report of pain in calf would be a + homans
- phlebitis or deep vein thrombosis (DVT)
what are the 3 positions that are best for assessing for heart sounds; normal and abnormal.
- sitting, leaning forward
- lying supine
- turned toward the left side- best position for picking up extra heart sounds or murmurs
whcih of the following should be performed on a client following a total knee replacement to assess the peripheral vascular system of the affected extremity (select all)
presence of lesion
- Skin color
- Skin temp
- capillary refill