NU2011 Exam 2 Guide With
Complete Solution
Where to examine during the cardiac exame - ANSWER 2nd to 5th
intercostal.
Direction of blood flow through the heart - ANSWER blood flows from
inferior vena cava to the superior vena cava- enters the heart in the right
atrium- blood flows from the right atrium to the right ventricle through the
tricuspid valve to the right ventricle.
Blood flows from the right ventricle through the pulmonary semilunar valve
to the pulmonary artery and is taken to the lungs to be oxygenated.
Blood from lungs is taken to the left atria via the pulmonary vein- blood goes
from left atria to the left ventricle through the bicuspid (mitral) valve- blood
goes from the left ventricle to the aorta through the aortic semilunar valve
and enters the aorta and goes into the body.
Heart sounds - ANSWER results from the movements of the valves and blood
flow in the heart.
Normal heart sounds: S1 and S2
- noises they make, when they are heard and where they are heard the
loudest - ANSWER S1: isometric contraction- systole hear "lub" from the AV
valve. heard loudest at mitral and tricuspid areas.
S2: isometric relaxation- diastolic: hear "dub" from the semilunar valve. -
heard loudest at aortic and pulmonic areas.
,*results from movement of valves and blood flow in heart. no extra sounds
should be heard in the heart.
Abnormal Heart sounds: S3 and S4 - ANSWER S3: heart noise heard in rapid
filling phase caused by resistance in the left ventricle. *sounds like Tennessee.
S4: heart noise heard right before S1 is heard- due to increased compliance
of the left ventricle. sounds like *Kentucky
5 Landmarks no where to listen to heart noises (APETM) - ANSWER 1. Aortic
area: right 2nd intercostal
2. Pulmonic: Left 2nd intercostal
3. Erb's pt: Left 3rd intercostal
4. Tricuspid: Left of sternum: 4-5th ICS.
5. Mitral area: Left 5th ICS, medial to midclavicular line.
Inspection:
where you should stand how pt lays
PMI - ANSWER - observe from right side- person should be supine.
- Observe each precordial area for pulsations and also note breathing.
- Pulsation known as apical pulse or point of maximal pulse may be seen in
the mitral area.
Palpation - ANSWER palpate person while supine- palpate precordial area
and apical pulse (might have to have them lay on left side to find the pulse.
Ausculate - ANSWER 1. proceed from one landmark to another- use both bell
and diaphragm.
, 2. listen for rate and rhythm, identify S1 and S2 (lub, dub). Assess for S3 and
S4
Apex and base of heart - ANSWER S1: heard LUB loud at the apex
S2: heard DUP loud at the base.
Arterial pulses (8) - ANSWER 1. temporal
2. carotid
3. brachial
4. radial
5. femoral
6. popiteal
7. Posterior tibialis
8. Dorsalis pedis pulse.
Palpation of arterial areas - ANSWER 1. use fingertips and second fingers.
*carotid
2. Observe rate and rhythm and compare with the apical pulse and note
bounding of pulse, weakness and irregular patterns.
Quality of arterial pulse - ANSWER 0= absent
1+= weak
2+= normal
3+= increased, full volume and bounding.
Jugular vein inspection - ANSWER drains the blood from head and neck- if
Complete Solution
Where to examine during the cardiac exame - ANSWER 2nd to 5th
intercostal.
Direction of blood flow through the heart - ANSWER blood flows from
inferior vena cava to the superior vena cava- enters the heart in the right
atrium- blood flows from the right atrium to the right ventricle through the
tricuspid valve to the right ventricle.
Blood flows from the right ventricle through the pulmonary semilunar valve
to the pulmonary artery and is taken to the lungs to be oxygenated.
Blood from lungs is taken to the left atria via the pulmonary vein- blood goes
from left atria to the left ventricle through the bicuspid (mitral) valve- blood
goes from the left ventricle to the aorta through the aortic semilunar valve
and enters the aorta and goes into the body.
Heart sounds - ANSWER results from the movements of the valves and blood
flow in the heart.
Normal heart sounds: S1 and S2
- noises they make, when they are heard and where they are heard the
loudest - ANSWER S1: isometric contraction- systole hear "lub" from the AV
valve. heard loudest at mitral and tricuspid areas.
S2: isometric relaxation- diastolic: hear "dub" from the semilunar valve. -
heard loudest at aortic and pulmonic areas.
,*results from movement of valves and blood flow in heart. no extra sounds
should be heard in the heart.
Abnormal Heart sounds: S3 and S4 - ANSWER S3: heart noise heard in rapid
filling phase caused by resistance in the left ventricle. *sounds like Tennessee.
S4: heart noise heard right before S1 is heard- due to increased compliance
of the left ventricle. sounds like *Kentucky
5 Landmarks no where to listen to heart noises (APETM) - ANSWER 1. Aortic
area: right 2nd intercostal
2. Pulmonic: Left 2nd intercostal
3. Erb's pt: Left 3rd intercostal
4. Tricuspid: Left of sternum: 4-5th ICS.
5. Mitral area: Left 5th ICS, medial to midclavicular line.
Inspection:
where you should stand how pt lays
PMI - ANSWER - observe from right side- person should be supine.
- Observe each precordial area for pulsations and also note breathing.
- Pulsation known as apical pulse or point of maximal pulse may be seen in
the mitral area.
Palpation - ANSWER palpate person while supine- palpate precordial area
and apical pulse (might have to have them lay on left side to find the pulse.
Ausculate - ANSWER 1. proceed from one landmark to another- use both bell
and diaphragm.
, 2. listen for rate and rhythm, identify S1 and S2 (lub, dub). Assess for S3 and
S4
Apex and base of heart - ANSWER S1: heard LUB loud at the apex
S2: heard DUP loud at the base.
Arterial pulses (8) - ANSWER 1. temporal
2. carotid
3. brachial
4. radial
5. femoral
6. popiteal
7. Posterior tibialis
8. Dorsalis pedis pulse.
Palpation of arterial areas - ANSWER 1. use fingertips and second fingers.
*carotid
2. Observe rate and rhythm and compare with the apical pulse and note
bounding of pulse, weakness and irregular patterns.
Quality of arterial pulse - ANSWER 0= absent
1+= weak
2+= normal
3+= increased, full volume and bounding.
Jugular vein inspection - ANSWER drains the blood from head and neck- if
