N190 Physical Assessment Cardiovascular & Peripheral Exam with verified detailed solutions

N190 Physical Assessment Cardiovascular &
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Peripheral Exam with verified detailed !Z !Z !Z !Z !Z




solutions

What are the layers of the heart?
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epicardium, myocardium, endocardium !Z !Z




What is the pericardium?
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- thin sac that enclosed the heart
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- compose 3 layers= parietal layer, serous layer, visceral layer
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(epicardium)

What is serous layer of pericardium?
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- Epithelial membrane which secrete serous fluid.
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- In between fibrous pericardium & visceral of pericardium
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What is visceral layer of pericardium?
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- lines the surface of the heart
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What is the location of the heart?
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- lies behind the sternum & extends the the second rib to the 5th
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intercostal space (ICS) !Z !Z




What is a point of maximum impulse (PMI)
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- the heartbeat is most palpated over the apex
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- location: 5th ICS & midclavicular line
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What are the 3 heart walls?
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- epicardium: outer layer, identical to visceral layer of pericardium
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- myocardium: thick muscular layer
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- endocardium: endothelium, a smooth layer that provides inner layer
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for the heart
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What are the 4 chambers of the heart?
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,right atrium, right ventricle, left atrium, left ventricle
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What is the right atrium?
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receives deoxygenated venous blood from systemic circulation via
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superior & inferior vena cava & coronary sinus
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What is the right ventricle?
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- receives deoxygenated blood from right atrium
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- pumps deoxygenated blood to the lungs to pick up O2
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- wall is much thinner than left ventricle that is why it has lower
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vascular pressure !Z




What is left atrium?
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- receives oxygenated blood from the lungs
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- slightly thicker wall than right atrium
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- then, rich 02 blood is pumped via mitral/bicuspid valve into the
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ventricle

What is the left ventricle?
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- pumps oxygenated blood to the body
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- has thicker wall among heart chambers
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What the 4 heart valves?
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- !Z triscuspid valve !Z



- !Z pulmunic valve !Z



- !Z mitral valve !Z



- !Z Aortic valve !Z




What is regurgitation/insufficiency?
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- backflow of blood into the chambers of the heart
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- a valve is not closing completely
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What is stenosis?
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narrowing of valve opening, valves become rigid and fuse together
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Regurgitation & stenosis are assessed as what? !Z !Z !Z !Z !Z !Z




- murmurs
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What are the 2 atrioventricular valves (AV)?
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tricuspid and bicuspid (mitral)!Z !Z !Z

, What are the 2 semilunar valves called?
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Aortic (aka Left Ventricular Outflow Tract - LVOT)
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Pulmonary (aka Right Ventricular Outflow Tract - RVOT)
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- it open in response to rising pressure of the ventricles
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heart sounds are caused by
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closing of heart valves !Z !Z !Z




Heart sound :S1 (LUBB) is created by?
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- when AV valves close
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- ventricles have been filled w/ blood
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Heart sound S2 (Dub) is created by?
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- Semilunar valves (aortic & pulmonic) close
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What sound do you hear in systolic phase?
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S1 (Lubb)
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What sound do you hear in diastolic phase?
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S2 (Dubb)
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What is systole?
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phase of ventricular contraction
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What is diastole?
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- phase of ventricular relaxation & are filled as the atria contract
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What is the S1 heart sound?
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-"Lubb", First sound heard at the start of systole
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-AV valves close
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What is the S2 heart sound?
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- Heard end of systole
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- Both 2nd ICS
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- Position: sitting or supine
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What is the S3 heart sound?
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