N190 Physical Assessment Cardiovascular &
!Z !Z !Z !Z !Z
Peripheral Exam with verified detailed !Z !Z !Z !Z !Z
solutions
What are the layers of the heart?
!Z !Z !Z !Z !Z !Z
epicardium, myocardium, endocardium !Z !Z
What is the pericardium?
!Z !Z !Z
- thin sac that enclosed the heart
!Z !Z !Z !Z !Z !Z
- compose 3 layers= parietal layer, serous layer, visceral layer
!Z !Z !Z !Z !Z !Z !Z !Z !Z !Z
(epicardium)
What is serous layer of pericardium?
!Z !Z !Z !Z !Z
- Epithelial membrane which secrete serous fluid.
!Z !Z !Z !Z !Z !Z
- In between fibrous pericardium & visceral of pericardium
!Z !Z !Z !Z !Z !Z !Z !Z
What is visceral layer of pericardium?
!Z !Z !Z !Z !Z
- lines the surface of the heart
!Z !Z !Z !Z !Z !Z
What is the location of the heart?
!Z !Z !Z !Z !Z !Z
- lies behind the sternum & extends the the second rib to the 5th
!Z !Z !Z !Z !Z !Z !Z !Z !Z !Z !Z !Z !Z !Z
intercostal space (ICS) !Z !Z
What is a point of maximum impulse (PMI)
!Z !Z !Z !Z !Z !Z !Z
- the heartbeat is most palpated over the apex
!Z !Z !Z !Z !Z !Z !Z !Z
- location: 5th ICS & midclavicular line
!Z !Z !Z !Z !Z !Z
What are the 3 heart walls?
!Z !Z !Z !Z !Z
- epicardium: outer layer, identical to visceral layer of pericardium
!Z !Z !Z !Z !Z !Z !Z !Z !Z
- myocardium: thick muscular layer
!Z !Z !Z !Z
- endocardium: endothelium, a smooth layer that provides inner layer
!Z !Z !Z !Z !Z !Z !Z !Z !Z !Z
for the heart
!Z !Z
What are the 4 chambers of the heart?
!Z !Z !Z !Z !Z !Z !Z
,right atrium, right ventricle, left atrium, left ventricle
!Z !Z !Z !Z !Z !Z !Z
What is the right atrium?
!Z !Z !Z !Z
receives deoxygenated venous blood from systemic circulation via
!Z !Z !Z !Z !Z !Z !Z !Z
superior & inferior vena cava & coronary sinus
!Z !Z !Z !Z !Z !Z !Z
What is the right ventricle?
!Z !Z !Z !Z
- receives deoxygenated blood from right atrium
!Z !Z !Z !Z !Z !Z
- pumps deoxygenated blood to the lungs to pick up O2
!Z !Z !Z !Z !Z !Z !Z !Z !Z !Z
- wall is much thinner than left ventricle that is why it has lower
!Z !Z !Z !Z !Z !Z !Z !Z !Z !Z !Z !Z !Z !Z
vascular pressure !Z
What is left atrium?
!Z !Z !Z
- receives oxygenated blood from the lungs
!Z !Z !Z !Z !Z !Z
- slightly thicker wall than right atrium
!Z !Z !Z !Z !Z !Z
- then, rich 02 blood is pumped via mitral/bicuspid valve into the
!Z !Z !Z !Z !Z !Z !Z !Z !Z !Z !Z !Z
ventricle
What is the left ventricle?
!Z !Z !Z !Z
- pumps oxygenated blood to the body
!Z !Z !Z !Z !Z !Z
- has thicker wall among heart chambers
!Z !Z !Z !Z !Z !Z
What the 4 heart valves?
!Z !Z !Z !Z
- !Z triscuspid valve !Z
- !Z pulmunic valve !Z
- !Z mitral valve !Z
- !Z Aortic valve !Z
What is regurgitation/insufficiency?
!Z !Z
- backflow of blood into the chambers of the heart
!Z !Z !Z !Z !Z !Z !Z !Z !Z
- a valve is not closing completely
!Z !Z !Z !Z !Z !Z
What is stenosis?
!Z !Z
narrowing of valve opening, valves become rigid and fuse together
!Z !Z !Z !Z !Z !Z !Z !Z !Z
Regurgitation & stenosis are assessed as what? !Z !Z !Z !Z !Z !Z
- murmurs
!Z
What are the 2 atrioventricular valves (AV)?
!Z !Z !Z !Z !Z !Z
tricuspid and bicuspid (mitral)!Z !Z !Z
, What are the 2 semilunar valves called?
!Z !Z !Z !Z !Z !Z
Aortic (aka Left Ventricular Outflow Tract - LVOT)
!Z !Z !Z !Z !Z !Z !Z
Pulmonary (aka Right Ventricular Outflow Tract - RVOT)
!Z !Z !Z !Z !Z !Z !Z
- it open in response to rising pressure of the ventricles
!Z !Z !Z !Z !Z !Z !Z !Z !Z !Z
heart sounds are caused by
!Z !Z !Z !Z
closing of heart valves !Z !Z !Z
Heart sound :S1 (LUBB) is created by?
!Z !Z !Z !Z !Z !Z
- when AV valves close
!Z !Z !Z !Z
- ventricles have been filled w/ blood
!Z !Z !Z !Z !Z !Z
Heart sound S2 (Dub) is created by?
!Z !Z !Z !Z !Z !Z
- Semilunar valves (aortic & pulmonic) close
!Z !Z !Z !Z !Z !Z
What sound do you hear in systolic phase?
!Z !Z !Z !Z !Z !Z !Z
S1 (Lubb)
!Z
What sound do you hear in diastolic phase?
!Z !Z !Z !Z !Z !Z !Z
S2 (Dubb)
!Z
What is systole?
!Z !Z
phase of ventricular contraction
!Z !Z !Z
What is diastole?
!Z !Z
- phase of ventricular relaxation & are filled as the atria contract
!Z !Z !Z !Z !Z !Z !Z !Z !Z !Z !Z
What is the S1 heart sound?
!Z !Z !Z !Z !Z
-"Lubb", First sound heard at the start of systole
!Z !Z !Z !Z !Z !Z !Z !Z
-AV valves close
!Z !Z
What is the S2 heart sound?
!Z !Z !Z !Z !Z
- Heard end of systole
!Z !Z !Z !Z
- Both 2nd ICS
!Z !Z !Z
- Position: sitting or supine
!Z !Z !Z !Z
What is the S3 heart sound?
!Z !Z !Z !Z !Z
!Z !Z !Z !Z !Z
Peripheral Exam with verified detailed !Z !Z !Z !Z !Z
solutions
What are the layers of the heart?
!Z !Z !Z !Z !Z !Z
epicardium, myocardium, endocardium !Z !Z
What is the pericardium?
!Z !Z !Z
- thin sac that enclosed the heart
!Z !Z !Z !Z !Z !Z
- compose 3 layers= parietal layer, serous layer, visceral layer
!Z !Z !Z !Z !Z !Z !Z !Z !Z !Z
(epicardium)
What is serous layer of pericardium?
!Z !Z !Z !Z !Z
- Epithelial membrane which secrete serous fluid.
!Z !Z !Z !Z !Z !Z
- In between fibrous pericardium & visceral of pericardium
!Z !Z !Z !Z !Z !Z !Z !Z
What is visceral layer of pericardium?
!Z !Z !Z !Z !Z
- lines the surface of the heart
!Z !Z !Z !Z !Z !Z
What is the location of the heart?
!Z !Z !Z !Z !Z !Z
- lies behind the sternum & extends the the second rib to the 5th
!Z !Z !Z !Z !Z !Z !Z !Z !Z !Z !Z !Z !Z !Z
intercostal space (ICS) !Z !Z
What is a point of maximum impulse (PMI)
!Z !Z !Z !Z !Z !Z !Z
- the heartbeat is most palpated over the apex
!Z !Z !Z !Z !Z !Z !Z !Z
- location: 5th ICS & midclavicular line
!Z !Z !Z !Z !Z !Z
What are the 3 heart walls?
!Z !Z !Z !Z !Z
- epicardium: outer layer, identical to visceral layer of pericardium
!Z !Z !Z !Z !Z !Z !Z !Z !Z
- myocardium: thick muscular layer
!Z !Z !Z !Z
- endocardium: endothelium, a smooth layer that provides inner layer
!Z !Z !Z !Z !Z !Z !Z !Z !Z !Z
for the heart
!Z !Z
What are the 4 chambers of the heart?
!Z !Z !Z !Z !Z !Z !Z
,right atrium, right ventricle, left atrium, left ventricle
!Z !Z !Z !Z !Z !Z !Z
What is the right atrium?
!Z !Z !Z !Z
receives deoxygenated venous blood from systemic circulation via
!Z !Z !Z !Z !Z !Z !Z !Z
superior & inferior vena cava & coronary sinus
!Z !Z !Z !Z !Z !Z !Z
What is the right ventricle?
!Z !Z !Z !Z
- receives deoxygenated blood from right atrium
!Z !Z !Z !Z !Z !Z
- pumps deoxygenated blood to the lungs to pick up O2
!Z !Z !Z !Z !Z !Z !Z !Z !Z !Z
- wall is much thinner than left ventricle that is why it has lower
!Z !Z !Z !Z !Z !Z !Z !Z !Z !Z !Z !Z !Z !Z
vascular pressure !Z
What is left atrium?
!Z !Z !Z
- receives oxygenated blood from the lungs
!Z !Z !Z !Z !Z !Z
- slightly thicker wall than right atrium
!Z !Z !Z !Z !Z !Z
- then, rich 02 blood is pumped via mitral/bicuspid valve into the
!Z !Z !Z !Z !Z !Z !Z !Z !Z !Z !Z !Z
ventricle
What is the left ventricle?
!Z !Z !Z !Z
- pumps oxygenated blood to the body
!Z !Z !Z !Z !Z !Z
- has thicker wall among heart chambers
!Z !Z !Z !Z !Z !Z
What the 4 heart valves?
!Z !Z !Z !Z
- !Z triscuspid valve !Z
- !Z pulmunic valve !Z
- !Z mitral valve !Z
- !Z Aortic valve !Z
What is regurgitation/insufficiency?
!Z !Z
- backflow of blood into the chambers of the heart
!Z !Z !Z !Z !Z !Z !Z !Z !Z
- a valve is not closing completely
!Z !Z !Z !Z !Z !Z
What is stenosis?
!Z !Z
narrowing of valve opening, valves become rigid and fuse together
!Z !Z !Z !Z !Z !Z !Z !Z !Z
Regurgitation & stenosis are assessed as what? !Z !Z !Z !Z !Z !Z
- murmurs
!Z
What are the 2 atrioventricular valves (AV)?
!Z !Z !Z !Z !Z !Z
tricuspid and bicuspid (mitral)!Z !Z !Z
, What are the 2 semilunar valves called?
!Z !Z !Z !Z !Z !Z
Aortic (aka Left Ventricular Outflow Tract - LVOT)
!Z !Z !Z !Z !Z !Z !Z
Pulmonary (aka Right Ventricular Outflow Tract - RVOT)
!Z !Z !Z !Z !Z !Z !Z
- it open in response to rising pressure of the ventricles
!Z !Z !Z !Z !Z !Z !Z !Z !Z !Z
heart sounds are caused by
!Z !Z !Z !Z
closing of heart valves !Z !Z !Z
Heart sound :S1 (LUBB) is created by?
!Z !Z !Z !Z !Z !Z
- when AV valves close
!Z !Z !Z !Z
- ventricles have been filled w/ blood
!Z !Z !Z !Z !Z !Z
Heart sound S2 (Dub) is created by?
!Z !Z !Z !Z !Z !Z
- Semilunar valves (aortic & pulmonic) close
!Z !Z !Z !Z !Z !Z
What sound do you hear in systolic phase?
!Z !Z !Z !Z !Z !Z !Z
S1 (Lubb)
!Z
What sound do you hear in diastolic phase?
!Z !Z !Z !Z !Z !Z !Z
S2 (Dubb)
!Z
What is systole?
!Z !Z
phase of ventricular contraction
!Z !Z !Z
What is diastole?
!Z !Z
- phase of ventricular relaxation & are filled as the atria contract
!Z !Z !Z !Z !Z !Z !Z !Z !Z !Z !Z
What is the S1 heart sound?
!Z !Z !Z !Z !Z
-"Lubb", First sound heard at the start of systole
!Z !Z !Z !Z !Z !Z !Z !Z
-AV valves close
!Z !Z
What is the S2 heart sound?
!Z !Z !Z !Z !Z
- Heard end of systole
!Z !Z !Z !Z
- Both 2nd ICS
!Z !Z !Z
- Position: sitting or supine
!Z !Z !Z !Z
What is the S3 heart sound?
!Z !Z !Z !Z !Z
