POM 2 Module 5 Review
Terms
undefined, object
copy deck
- What structure is located directly behind and below the sternum
- right ventricle
- What forms the left lateral margin of the heart and where is this structure located?
- The left ventricle and it is located behind the right ventricle and to the left.
- What forms the right heart border?
- The right atrium.
- What produces the sound that forms S1?
- Closure of the mitral valve.
- What normally corresponds to the systolic blood pressure?
- Maximal left ventricular pressure.
- What produces the sound that forms S2?
- Closure of the aortic valve.
- What is thought to cause a S3 sound and what can it indicate?
- The sudden deceleration of blood against the left ventricular wall causes S3 and it is thought to be due to decreased ventricular compliance.
- What occurs at the same time as S4 and what is it thought to be caused by?
- Atrial contraction is thought to cause S4 and it is also associated with decreased ventricular compliance.
- What do the P, QRS, and T waves correspond to?
- P=atrial depol, QRS=ventricular depol., T=ventricular repol.
- What is referred to as the ability of the heart muscle, when given a load, to shorten
- contractility
- Why are the pulses in the arms and legs unsuitable for timing things in the cardiac cycle?
- There is a palpable delay between ventricular contraction and peripheral pulses.
- What are the main factors that influence arterial pressure?
- left ventricular stroke volume, distensibility of the aorta, PVR, volume of blood in the arterial system
- Where is the internal jugular vein located and what an it be used to estimate?
- It is deep to the sternomastoid muscles in the neck and its pulsations can be used to estimate the right atrial pressure
- What measurement for JVP separates normal from abnormal?
- A measurement of 4cm above the sternal angle (total of 9cm above right atrium) is abnormal
- What does the "a" wave represent?
- the slight rise in atrial pressure that accompanies atrial contraction -- occurs just before the first heart sound and before the carotid pulse
- What does the "x" descent reflect?
- atrial relaxation.
- What does the "v" wave reflect?
- during systole blood is flowing into the right atrium from teh vena cavae and this fills the atrium and increases the pressure as the tricuspid valve is closed
- What is the "y" descent?
- Early in diastole blood from the right atrium flows passively into the right ventricle and right atrial pressure falls
- When do the "x" and "y" descents happen?
- The "x" descent is more prominent and occurs just before the second heart sound, "y" descent follows the second heart sound, early in diastole
- What does a flow murmur usually denote?
- Often found in children this is thought to denote pulmonic blood flow
- What is a mammary souffle?
- This is a mirmur seen in women who are lactating that is due to increased blood flow in the breasts. Usually systolic and diastolic.
- How is aortic sclerosis different from aortic stenosis?
- aortic sclerosis is just the thickening of the bases of teh aortic cusps with calcification with no obstruction of blood flow while stenosis impedes blood
- Is the systolic murmur of mitral stenosis ever considered innocent?
- no
- Who is a jugular venous hum seen in?
- children through young adults
- What happens to systolic and diastolic blood pressure as one ages?
- Systolic blood pressure rises as one ages and diastolic also rises until about the 6th decade when it begins to remain constant.
- What does sharp pain from the chest that radiates into the back or neck imply?
- aortic dissection
- What arrhythmia can be readily identified at the bedside?
- atrial fibrillation, irregularly irregular.
- What are some pathologic processes indicated by orthopnea?
- left ventricular heart failure, mitral stenosis, and obstructive lung disease.
- What is periorbital puffiness indicate? What about enlarged waistline?
- periorbital puffiness = nephrotic syndrome, enlarged waistline = ascites and/or liver failure
- What are teh optimal levels for LDL, HDL, and total cholesterol?
- LDL<100, total cholesterol<200, and HDL between 40 and 60.
- What is the starvation response and what can be done to counteract this?
- It is the drop in metabolic rate in response to a decrease in caloric intake and exercise can help offset this
- What do prominent "a" waves indicate?
- increased resistance to right atrial contraction as in tricuspid stenosis or the decreased compliance of the right ventricle
- What is indicated by the disappearance of the "a" waves?
- atrial fibrillation
- What do larger "v" waves indicate?
- tricuspid regurgitation.
- What can pressure on the carotid sinus do?
- cause a reflex drop in the pulse rate of blood pressure
- What are bounding pulses usually associated with?
- aortic insufficiency
- What is the normal upstroke of the carotid pulse like and what is associated with a delayed upstroke
- normal is a brisk upstroke and delayed upstroke is seen in aortic stenosis.
- What is the left lateral decubitus position good to listen for?
- good for hearing low-pitched extra sounds like S3, opening snaps, and diastolic rumble of mitral stenosis.
- What is the sitting, leaning forward after full exhalation position good for listening for?
- good for hearing the soft decrescendo diastolic murmur of aortic insufficiency
- When is S1 decreased and when is S2 decreased?
- S1 is decreased in 1st degree heart block, S2 is decreased in aortic stenosis
- What is the bell of the stethoscope good for listening to, both generally and specifically?
- generally it is good for low-pitched sounds, specifically for things like S3, S4, and the murmur of mitral stenosis
- What does the murmur of a patent ductus arteriosus sound like?
- it starts in systole and continues without pause through S2 and into but not necessarily through diastole, it is called a continuous murmur
- What kind of murmur is often heard in mitral stenosis?
- a presystolic murmur
- What kind of murmur is heard in aortic regurgitation?
- an early diastolic murmur
- What kind of murmur is heard in aortic stenosis and innocent flow murmurs
- a midsystolic murmur
- What kind of murmur is heard in mitral regurgitation?
- a pansystolic (holosystolic) murmur