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1. Jugular Vein Distention is a symptom of __________ sided heart failure.
Right
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2. Where do you place the stethoscope to listen to the apical pulse?
5th intercostal space mid-clavicular line
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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
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4. Where are the dorsalis pedis pulses palpated?
top of the feet
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5. Where are the posterior tibial pulses palpitated?
Inside of the ankle
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6. When auscultating Arteries what should you hear?
Nothing
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7. When auscultating the Carotid artery the Bruit sound indicates__________?
Blockage (Sound is from a continuous, turbulent blood flow)
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8. If the Abdominal Aorta can be auscultated it usually indicates_________?
An aneurysm or dissection
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9. If the Femoral or Popliteal arteries can be auscultated it usually indicates_______?
Narrowed vessels
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10. Where is the Aortic valve auscultated?
- o Right sternal boarder
- o 2nd intercostal space
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11. Where is the Pulmonary valve auscultated?
- o Left sternal boarder
- o 2nd intercostal space
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12. Where can the Mitral (Bicuspid) Valve be auscultated?
- o Midclavicular line
- o 5th intercostal space
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13. Where can the Tricuspid valve be auscultated?
- o Left lower sternal boarder
- o 5th intercostal space
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14. Artery that sends blood back to the heart muscle
Coronary Artery
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15. During Systole the muscle of the heart____? (contract or relaxes)
- o Contracts.
- o The chambers become smaller as the blood is ejected
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16. During Diastole the heart muscle____? (contracts or relaxes)
- o Relaxes
- o The chambers fill with blood
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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)
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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
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19. What System has....
- Electrical impulses that signal the heart to beat?
- Conduction System
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20. What is Nodal tissue?
Excitable tissue
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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
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22. Call the 'pacemaker' of the heart. 60-100 bpm
SA Node
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23. Second in line to start electrical impulse if SA Node can't.
AV Node. 40-60 bpm
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24. Third in line to start an electrical impulse, it lies between the middle of the heart.
Bundle of His-bpm varies greatly
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25. Last in line to start an electrical impulse
Purkinje Fibers-15-30 bpm
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26. Electrical activity of the heart is due to movement of _______ across cell membranes.
ions (Na+ K+ Ca)
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27. Atrioventricular Valves are between the ___________&___________.
- They are called_________&________ Valves
- Atria & Ventricles
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Tricuspid & Mitral (Bicuspid) Valves
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28. ________&_______ are Semilunar Valves
Pulmonary and Aortic Valves
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29. Valve between right ventricle and pulmonary artery
Pulmonary Valve
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30. Valve between the left ventricle and aorta
Aortic Valve
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31. Blood vessels that return blood to the heart
Veins
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32. Vein that drains blood from the head, neck and arms into the right atrium
Superior Vena Cava
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33. Vein that transports blood into the right atrium from all parts of the body except the head, neck and arms
Inferior Vena Cava
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34. Thickest veins
Superior and Inferior Vena Cava
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35. Vein that returns blood from the heart muscle to the right atrium
- (Supplies heart with oxygenated blood)
- Coronary Sinus
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36. Vein that returns blood to the left atrium from the lungs
Pulmonary Vein
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37. Blood vessels that send blood from the heart
Arteries
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38. Artery that sends blood from the right ventricle to the lungs
Pulmonary Artery
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39. Artery that sends blood from the left ventricle to the body
Aorta
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40. Each ventricle of the heart pumps out approximately ________liters of blood per minute.
5
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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)
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42. Right side of the heart pumps ______________blood (oxygenated or not oxygenated) to the _________?
Not oxygenated blood to the lungs
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43. The left side of the heart pumps ____________blood (oxygenated or not oxygenated) to the __________?
Oxygenated blood to all other parts of the body.
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44. Inner layer of the heart
- Lines the inside of the heart and valves.
- ENDOcardium
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45. Middle layer of the heart
- Responsible for PUMPING action
- o MYOcardium
- o (Think MYO-MUSCLE, it pumps)
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46. Outer layer of the heart
EPIcardium
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47. Area between the heart and the chest wall.
Pericardium
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48. Part of the pericardium closest to the heart
- Adheres to the epicardium
- Visceral
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49. Part of the pericardium that attaches to the other structures
- Supports the heart in the mediastinum
- Parietal
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50. Why are there approximately 30cc'sf fluid between the epicardium and the pericardium?
To reduce friction
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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
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52. Chambers of the heart that serve as PUMPS for blood
- o Ventricles
- o Thicker walls
- o More Powerful
- o Left is the strongest
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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)
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54. What is PITCH of heart sounds?
frequency
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55. What is INTENSITY of heart sounds?
Loudness
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56. What is DURATION of heart sounds?
How long it lasts
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57. What is QUALITY of heart sounds?
Tone (musical, harsh)
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58. What is LOCATION of heart sounds?
Where it is
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59. What is RADIATION of heart sounds?
When it can be heard in another area too
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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
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61. What is a CLICK and what does it sound like?
- o Cords tensing up more than needed.
- o High Pitched Sound
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62. What is a SNAP and what does it sound like?
- o Valves are narrowed or stiff.
- o High Pitched
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63. What is a RUB and what does it sound like?
- o Inflammation of pericardium or decreased pericardial fluid.
- o Scratchy, scrappy, squeaky sound
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64. What are the 4 cardiac enzymes?
- o CKMB
- o Myoglobin
- o Troponin I
- o Troponin II
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65. Which enzyme is specific to the heart?
Troponin I
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66. Which cardiac enzyme is released the quickest?
Myoglobin (30 min-4 hr)
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67. What enzyme will show up if the MI was a week ago?
Troponin
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68. What coagulation study is done for a patient on Heparin?
PTT
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69. What coagulation studies are done on a patient on Coumadin therapy?
PT/INR
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70. What Diagnostic Study graphically records electrical current?
ECG
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71. What Diagnostic study evaluates patency of vessels and grafts?
PET
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72. Why is UOP measured before a Cardiac Cath?
The dye used needs to be excreted through the kidneys.
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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)
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74. Used to obtain direct and continuous BP measurements
A-line
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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.
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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
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77. What Coronary Artery supplies the right side of the heart and 30% of the left side?
Right Coronary Artery
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78. Which Coronary Artery supplies the Left Ventricle of the heart?
Left Main (also called the Widow Maker)
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79. System that causes increased heart rate, increased conduction through the AV node and vasoconstriction.
Sympathetic Nervous System
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80. What triggers the SNS?
- o Fear
- o Exercise
- o Anxiety
- o Certain Drugs
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81. Vasoconstriction causes the blood pressure to _________?
Increase
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82. What system causes decrease in heart rate, decreased AV condustion and decreased force of contraction?
Parasympathetic Nervous System
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83. What triggers the PNS?
- o Rest
- o Meditation
- o Yoga
- o Prayer
- o Beta Blockers
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84. Ability to initiate an electrical impulse.
Automaticity
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85. Ability to respond to an electrical impulse
Excitability
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86. Ability to transmit an electrical impulse
Conductivity
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87. Ability to contract
Contractility
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88. What is a Wave?
- o Deflection from the baseline.
- o Can be upward, downward or biphasic
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89. What is a Complex?
Consists of multiple waveforms.
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90. What is a segment?
Area separating a waveform from a complex
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91. What is an Interval?
Area combining a waveform and a segment.
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92. Small block on an ECG strip =___________seconds?
.04
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93. Large block on an ECG paper = ___________seconds?
0.2
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94. 30 big blocks =_____________seconds?
6
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