Anatomy Review
• Four chambers separated by valves, whose main purpose is to prevent
backflow of blood
Atria right and left
Ventricles right and left
• Four valves in heart
2 atrioventricular (AV) valves – allow b
...
Anatomy Review
• Four chambers separated by valves, whose main purpose is to prevent
backflow of blood
Atria right and left
Ventricles right and left
• Four valves in heart
2 atrioventricular (AV) valves – allow blood to go forward into the heart,
and inhibit backflow of blood, open and close by pressure changes
Tricuspid – right
Mitral- left
2 semilunar (SL) separate from ventricles from specific structures
Pulmonic – separates pulmonary artery from the left ventricle
Aortic- stops bloods from aorta from the left ventricle
Valves are unidirectional: can only open one way
Valves open and close passively in response to pressure gradients in moving
blood
Subjective Data Collection
Chest pain
Dyspnea
Orthopnea
Cough
Fatigue
Cyanosis or pallor
Edema
Nocturia
Cardiac history
Family cardiac history
Personal habits (cardiac risk factors)
Objective Data
INTERVENTIONS 2
Objective Data Collection: Inspection
Eyes
• Xanthelasma
• Corneal arcus – yellowish/grey ring surrounding the iris associated
with hyperlipidemia
Neck vessels
Neck vessels
-Carotid artery
-Jugular veins
• Internal
• External
Palpation
Note strength
Compare palpation of carotid and auscultation of apical pulse
Position the patient supine with the head of the table slightly elevated
Using the palm of the hand palpate for pulsations going from apex to
LSB to base.
Palpate for apical pulse noting
o location by ICS and distance from the midsternal line
o size of pulsation
o Quality of the apical pulse
Auscultation
Auscultate carotids with the bell listening for a bruit (blowing swishing
sounds, blood flow turbulence)
Ask the patient to stop breathing momentarily.
Listen for a blowing or rushing sound--a bruit. Do not be
confused by heart sounds or murmurs transmitted from the
chest.
Palpate carotid arteries
Note strength
Compare palpation of carotid and auscultation of apical pulse
When auscultating the carotid pulses, what is a normal finding?
1. A soft blowing sound
2. A loud grunting noise
3. A beat simultaneous with the heart rate
4. No sound
INTERVENTIONS 2
Objective Data: Inspection
Objective Data Collection: Auscultation
Auscultate the heart sounds
Identify auscultatory areas
Note the rate and rhythm
Identify S1 and S2
Listen to S1 and S2 separately
Listen for extra heart sounds
Listen for murmurs
Heart sounds
Direction of blood flow
Cardiac cycle
Diastole
Systole
Events in the right and left sides
Heart sounds
First heart sound
Second heart sound
Effect of respiration
Cardiac cycle
S1 Heart Sound
Occurs with closure of AV valves and thus signals beginning of
systole
Mitral component of first sound (M1) slightly precedes
tricuspid component (T1)
Usually hear these two components fused as one sound
Can hear S1 over all precordium, but loudest at apex
S2 Heart Sound
Occurs with closure of semilunar valves and signals end of
systole
Aortic component of second sound (A2) slightly precedes
pulmonic component (P2)
Although heard over all precordium, S2 loudest at base
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