Cardiac Cycle and Electrical Conduction
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Questions and Answers

What does the 'lub' sound in the cardiac cycle indicate?

  • Closure of the AV valves (correct)
  • Filling of the right atrium
  • Contraction of the left ventricle
  • Closure of the semilunar valves

    • Which structure is known as the pacemaker of the heart?

  • Sinoatrial Node (correct)
  • Purkinje Fibers
  • Atrioventricular Node
  • Bundle of His

    • Where is Erb's point located?

  • 3rd intercostal space at the left sternal border (correct)
  • 2nd intercostal space at the left sternal border
  • 4th intercostal space at the right sternal border
  • 5th intercostal space at the midclavicular line

    • During which phase of the cardiac cycle is the 'dub' sound heard?

    <p>Diastole</p> Signup and view all the answers

    What is the order of blood flow through the heart starting from the right atrium?

    <p>Right Atrium - Tricuspid Valve - Right Ventricle - Pulmonary Arteries</p> Signup and view all the answers

    What type of blood do the pulmonary veins carry?

    <p>Oxygenated blood</p> Signup and view all the answers

    During which position should the patient be to best auscultate heart sounds?

    <p>Supine at 30-45 degrees</p> Signup and view all the answers

    Which of the following correctly identifies the location of the aortic valve?

    <p>At the 2nd intercostal space, right sternal border</p> Signup and view all the answers

    What type of sounds is the bell of the stethoscope used to assess?

    <p>Low-pitched sounds</p> Signup and view all the answers

    What is the normal range for heart rate/pulse?

    <p>60-100 BPM</p> Signup and view all the answers

    Which symptom is commonly associated with a myocardial infarction?

    <p>Chest pain</p> Signup and view all the answers

    In which position should a patient be placed to assess jugular vein distention?

    <p>Semi-fowlers or sitting up</p> Signup and view all the answers

    What does the presence of a palpable vibration during palpation of the precordium indicate?

    <p>A thrill</p> Signup and view all the answers

    Which finding may indicate an acute exacerbation in a patient with congestive heart failure?

    <p>Excessive weight gain despite poor oral intake</p> Signup and view all the answers

    Which common condition might make heart murmurs difficult to hear?

    <p>Obesity</p> Signup and view all the answers

    Which of the following positions should NOT be used when auscultating heart sounds?

    <p>Lying prone</p> Signup and view all the answers

    What is indicated if a patient presents with increased fatigue or difficulty tolerating exercise?

    <p>Possible cardiac event</p> Signup and view all the answers

    What should be done immediately if a patient reports symptoms of chest pain?

    <p>Check vitals and perform cardiac assessment</p> Signup and view all the answers

    During which phase is the closure of the atrioventricular valves associated with the 'lub' sound?

    <p>Systole</p> Signup and view all the answers

    Which structure does the cardiac impulse travel to directly after the SA node?

    <p>Atrioventricular (AV) Node</p> Signup and view all the answers

    What is the primary purpose of using the diaphragm of the stethoscope during a cardiac assessment?

    <p>To assess rhythm and high-medium pitched sounds</p> Signup and view all the answers

    What is the correct sequence of blood flow through the heart starting from deoxygenated blood returning from systemic circulation?

    <p>Right Atrium - Tricuspid Valve - Right Ventricle - Pulmonary arteries</p> Signup and view all the answers

    Which symptom is significant to assess for potential heart attack or myocardial infarction?

    <p>Chest pain that may radiate to the jaw</p> Signup and view all the answers

    In assessing jugular vein distention, which position is appropriate for the patient?

    <p>Semi-Fowler's or sitting up at greater than 45 degrees</p> Signup and view all the answers

    Which heart sound is considered abnormal in individuals older than 40 years and may indicate heart failure?

    <p>S3</p> Signup and view all the answers

    What abnormal finding indicates the presence of a thrill during palpation of the precordium?

    <p>Palpable vibrations</p> Signup and view all the answers

    Where is the best location to auscultate the mitral area of the heart?

    <p>5th intercostal space: L midclavicular line</p> Signup and view all the answers

    Which type of heart valve is the pulmonic valve classified as?

    <p>Semilunar</p> Signup and view all the answers

    Which of the following findings would be expected in a patient with left-sided heart failure?

    <p>Cyanosis and pulmonary problems</p> Signup and view all the answers

    During auscultation, which technique can help improve the ability to hear a murmur?

    <p>Encourage the patient to hold their breath and lean forward</p> Signup and view all the answers

    What is the primary function of the left ventricle in the cardiac cycle?

    <p>Pump oxygenated blood to the aorta</p> Signup and view all the answers

    Which of the following correctly describes the role of the Bundle of His in the heart?

    <p>Conducting impulses from the AV node to the bundle branches</p> Signup and view all the answers

    What is the term for a heart rate that falls below the normal range of 60-100 BPM?

    <p>Bradycardia</p> Signup and view all the answers

    What is the significance of a heave in cardiac assessment?

    <p>It reflects the outward thrust of the ventricle and is considered abnormal</p> Signup and view all the answers

    Which condition is a common cause of difficulty in hearing heart murmurs?

    <p>Obesity</p> Signup and view all the answers

    Which strategy should be implemented if cardiac assessment is needed after a patient reports chest pain?

    <p>Check vital signs and perform a cardiac assessment</p> Signup and view all the answers

    What chamber does deoxygenated blood enter first when returning to the heart?

    <p>Right Atrium</p> Signup and view all the answers

    Which valves close to create the 'dub' sound in the cardiac cycle?

    <p>Aortic and Pulmonic Valves</p> Signup and view all the answers

    What is the sequence of the conduction pathway of the cardiac impulse?

    <p>SA Node - AV Node - Bundle of His - Bundle of Branches - Purkinje Fibers</p> Signup and view all the answers

    Where is the best location to listen for heart sounds associated with the tricuspid valve?

    <p>4th intercostal space: L sternal border</p> Signup and view all the answers

    What is the role of the left ventricle in the heart's function?

    <p>Pumps oxygenated blood to the aorta</p> Signup and view all the answers

    Which heart valve is classified as an atrioventricular valve?

    <p>Mitral (Bicuspid) Valve</p> Signup and view all the answers

    What indicates the closure of the mitral and tricuspid valves during the cardiac cycle?

    <p>S1 heart sound</p> Signup and view all the answers

    Which part of the heart is responsible for the impulse that triggers the heartbeat?

    <p>SA Node</p> Signup and view all the answers

    What is the typical presentation of a heart attack?

    <p>Chest pain that radiates to the jaw</p> Signup and view all the answers

    What is the expected finding when assessing jugular vein distention?

    <p>Elevated neck veins when the patient is sitting up at 90 degrees</p> Signup and view all the answers

    Which pulse amplitude is considered normal?

    <p>+2, regular rhythm</p> Signup and view all the answers

    What condition is indicated by pitting edema?

    <p>Peripheral venous disease</p> Signup and view all the answers

    Which of the following findings may suggest peripheral arterial disease (PAD)?

    <p>Rubor when legs are dangling</p> Signup and view all the answers

    What is a common challenge in auscultating heart murmurs?

    <p>Obesity may make murmurs difficult to hear</p> Signup and view all the answers

    What does the term 'intermittent claudication' refer to?

    <p>Pain that occurs in the legs during exercise and is relieved by rest</p> Signup and view all the answers

    What indicates a possible exacerbation of congestive heart failure?

    <p>Increased fatigue with difficulty tolerating exercise</p> Signup and view all the answers

    What is the appropriate action if you cannot palpate a peripheral pulse?

    <p>Use a doppler machine to assess the pulse</p> Signup and view all the answers

    Which finding is associated with a normal capillary refill time?

    <p>Less than 2 seconds</p> Signup and view all the answers

    What does a weak peripheral pulse indicate?

    <p>Arterial damage or severe peripheral arterial disease</p> Signup and view all the answers

    What may indicate the presence of a thrill upon palpation?

    <p>Palpable vibrations over the precordium</p> Signup and view all the answers

    What role do diaphragm and bell parts of a stethoscope play during auscultation?

    <p>The diaphragm is for high-medium pitched sounds, while the bell is for low-pitched sounds</p> Signup and view all the answers

    What is the direction of blood flow from the right ventricle to the lungs?

    <p>Right Ventricle-Pulmonary valve-Pulmonary arteries-Lungs</p> Signup and view all the answers

    Which vessel carries deoxygenated blood to the right atrium?

    <p>Superior/Inferior Vena Cava</p> Signup and view all the answers

    What abnormal heart sound might be detected in patients older than 40 years?

    <p>S3</p> Signup and view all the answers

    During which part of the cardiac cycle do the semilunar valves close?

    <p>Diastole</p> Signup and view all the answers

    Which structure does the cardiac impulse travel to directly after the Bundle of His?

    <p>Purkinje Fibers</p> Signup and view all the answers

    Where is the best area to auscultate for heart sounds related to the mitral valve?

    <p>5th intercostal space: L Midclavicular line</p> Signup and view all the answers

    Which of the following valves are classified as atrioventricular valves?

    <p>Mitral and Tricuspid</p> Signup and view all the answers

    What is the role of the left atrium in the cardiac cycle?

    <p>Receives oxygenated blood from the lungs</p> Signup and view all the answers

    Which finding is indicative of arterial insufficiency in the peripheral assessment?

    <p>Absence of hair growth</p> Signup and view all the answers

    What would an abnormal heart rate of less than 60 BPM be classified as?

    <p>Bradycardia</p> Signup and view all the answers

    Which physiological finding may be expected in a patient experiencing right-sided heart failure?

    <p>Jugular vein distention</p> Signup and view all the answers

    What symptom is commonly associated with intermittent claudication?

    <p>Cramping in the lower extremities</p> Signup and view all the answers

    Which technique should be employed to best auscultate for heart murmurs?

    <p>Have the patient sit forward and hold their breath</p> Signup and view all the answers

    What is the expected capillary refill time for a healthy individual?

    <p>2 seconds</p> Signup and view all the answers

    What might prolonged capillary refill time indicate?

    <p>Dehydration or circulation issues</p> Signup and view all the answers

    Which of the following findings may indicate venous insufficiency?

    <p>Thick leathery skin</p> Signup and view all the answers

    Which situation would necessitate the use of a Doppler machine?

    <p>If a peripheral pulse cannot be palpated</p> Signup and view all the answers

    What abnormal finding associated with the carotid pulse requires further assessment?

    <p>Thready pulse</p> Signup and view all the answers

    What is Raynaud's phenomenon characterized by?

    <p>Red, white, blue discoloration</p> Signup and view all the answers

    What could a weak pulse indicate during assessment?

    <p>Arterial insufficiency</p> Signup and view all the answers

    What is a key indicator of heart failure to monitor for in a patient?

    <p>Excessive weight gain despite poor intake</p> Signup and view all the answers

    What should be assessed if an irregular pulse is noted?

    <p>Rate, rhythm, and amplitude</p> Signup and view all the answers

    What is the primary role of the left atrium in the cardiac cycle?

    <p>Receiving oxygenated blood from the pulmonary veins</p> Signup and view all the answers

    Which structure in the conduction pathway is directly responsible for transmitting impulses to the ventricles?

    <p>Bundle of His</p> Signup and view all the answers

    Where does the closure of the semilunar valves occur during the cardiac cycle?

    <p>During diastole, at the base of the heart</p> Signup and view all the answers

    Which of the following statements is true regarding the pulmonary veins?

    <p>They carry oxygenated blood from the lungs to the left atrium</p> Signup and view all the answers

    What are the locations associated with the heart valves when auscultating?

    <p>Aortic - 2nd intercostal space, Pulmonic - 2nd intercostal space</p> Signup and view all the answers

    In which sequence does blood flow through the heart starting from the right atrium?

    <p>Right Atrium - Right Ventricle - Pulmonary Arteries - Left Atrium</p> Signup and view all the answers

    What is the primary significance of the SA node in the heart's function?

    <p>It coordinates contraction of the atria</p> Signup and view all the answers

    Which statement best describes the function of the left ventricle during the cardiac cycle?

    <p>It pumps oxygenated blood into systemic circulation</p> Signup and view all the answers

    Which of the following findings indicates a possible peripheral arterial disease?

    <p>Scant hair growth on the legs</p> Signup and view all the answers

    What does a weak pulse amplitude generally indicate?

    <p>Arterial insufficiency</p> Signup and view all the answers

    Which positions are recommended to enhance the assessment of jugular vein distention?

    <p>Sitting upright at greater than 90 degrees</p> Signup and view all the answers

    Which symptom typically radiates from a myocardial infarction?

    <p>Jaw pain</p> Signup and view all the answers

    What aspect of a cardiac assessment might indicate an acute exacerbation of heart failure?

    <p>Excessive weight gain despite poor oral intake</p> Signup and view all the answers

    Which condition is characterized by red, white, and blue discoloration in the extremities?

    <p>Raynaud's phenomenon</p> Signup and view all the answers

    Which finding is suggestive of right-sided heart failure?

    <p>Jugular vein distention</p> Signup and view all the answers

    What indicates the need for follow-up in a patient with potential congestive heart failure?

    <p>Higher levels of fatigue during exercise</p> Signup and view all the answers

    What is the expected finding when assessing capillary refill?

    <p>Less than 2 seconds</p> Signup and view all the answers

    Which of the following findings may suggest venous insufficiency?

    <p>Thick, leathery skin</p> Signup and view all the answers

    What should be done if a peripheral pulse is non-palpable?

    <p>Use a doppler with gel</p> Signup and view all the answers

    What does an absent pulse generally indicate?

    <p>Severe peripheral artery disease (PAD)</p> Signup and view all the answers

    Which finding is normal when palpating the carotid pulse?

    <p>Strong and steady pulse</p> Signup and view all the answers

    Which of the following symptoms may be masked or hindered in diabetic patients due to sensory impairment?

    <p>Pain from arterial wounds</p> Signup and view all the answers

    Which cranial nerve is responsible for the gag reflex?

    <p>CN IX (Glossopharyngeal)</p> Signup and view all the answers

    Which of the following cranial nerves are responsible for eye movements?

    <p>CN III, CN IV, CN VI</p> Signup and view all the answers

    Which cranial nerve innervates the muscles responsible for chewing?

    <p>CN V (Trigeminal)</p> Signup and view all the answers

    Which cranial nerve is primarily responsible for the sensation of taste from the posterior tongue?

    <p>CN IX (Glossopharyngeal)</p> Signup and view all the answers

    Which cranial nerve is responsible for controlling the position and movement of the tongue?

    <p>CN XII (Hypoglossal)</p> Signup and view all the answers

    What is the primary function of the cerebellum?

    <p>Balance and coordination</p> Signup and view all the answers

    Which of the following symptoms is NOT typically associated with a stroke?

    <p>Severe headache</p> Signup and view all the answers

    What would a positive Romberg test indicate?

    <p>Dysfunction of the cerebellum</p> Signup and view all the answers

    During a neurological assessment, when should the nurse begin their evaluation?

    <p>Upon entering the room</p> Signup and view all the answers

    What characterizes decerebrate posturing?

    <p>Outward arm extension</p> Signup and view all the answers

    Which cerebral lobe is responsible for integrating sensory information?

    <p>Parietal lobe</p> Signup and view all the answers

    What type of function is represented by movements such as strength and range of motion (ROM)?

    <p>Motor function</p> Signup and view all the answers

    If a patient exhibits contralateral deficits due to a stroke, where would the stroke likely be located?

    <p>In the opposite hemisphere of the body</p> Signup and view all the answers

    What scale is used to assess mental status and categorize brain injury severity?

    <p>Glasgow Coma Scale</p> Signup and view all the answers

    Which cranial nerve is responsible for the gag reflex?

    <p>Glossopharyngeal Nerve (CN IX)</p> Signup and view all the answers

    Which cranial nerve is involved in moving the tongue from side to side?

    <p>Hypoglossal (CN XII)</p> Signup and view all the answers

    Which cranial nerve facilitates chewing through clenching of the teeth?

    <p>Trigeminal (CN V)</p> Signup and view all the answers

    Which of the following cranial nerves is NOT associated with eye movements?

    <p>Vestibulocochlear (CN VIII)</p> Signup and view all the answers

    What is the primary function of the cerebellum?

    <p>Balance and coordination</p> Signup and view all the answers

    Which cerebral lobe is primarily responsible for processing visual information?

    <p>Occipital lobe</p> Signup and view all the answers

    What are contralateral deficits in terms of stroke?

    <p>Weakness appears on the opposite side of the brain affected</p> Signup and view all the answers

    Which assessment is performed to evaluate balance and coordination involving the cerebellum?

    <p>Romberg test</p> Signup and view all the answers

    In which situation is a complete neurological assessment indicated?

    <p>If the patient exhibits unilateral symptoms potentially indicating a stroke</p> Signup and view all the answers

    What would a positive Romberg test indicate?

    <p>Dysfunction of the cerebellum</p> Signup and view all the answers

    Why is mental status a priority during a neurological assessment?

    <p>It can indicate early signs of neurological issues</p> Signup and view all the answers

    What symptoms are commonly associated with a stroke?

    <p>Slurred speech and facial droop on one side</p> Signup and view all the answers

    What cranial nerve is responsible for the gag reflex?

    <p>Cranial Nerve IX (Glossopharyngeal)</p> Signup and view all the answers

    Which cranial nerves are involved in eye movements?

    <p>Cranial Nerve III, IV, VI</p> Signup and view all the answers

    Which cranial nerve is responsible for chewing?

    <p>Cranial Nerve V (Trigeminal)</p> Signup and view all the answers

    Which cranial nerve is NOT responsible for movement of the tongue?

    <p>Cranial Nerve X (Vagus)</p> Signup and view all the answers

    What equipment is needed to assess the gag reflex?

    <p>Tongue depressor</p> Signup and view all the answers

    What is the primary function of the cerebellum?

    <p>Balance and coordination</p> Signup and view all the answers

    Which cerebral lobe is primarily responsible for hearing and language comprehension?

    <p>Temporal lobe</p> Signup and view all the answers

    In the event of a stroke, which side of the body experiences deficits if the stroke occurs in the right hemisphere?

    <p>The opposite side of the body</p> Signup and view all the answers

    What does a 'positive' Romberg test indicate?

    <p>Swaying or falling while standing</p> Signup and view all the answers

    Which functions are included in the cognitive aspects of neurological function?

    <p>Orientation and memory</p> Signup and view all the answers

    During a neurological assessment, which symptom is NOT indicative of a stroke?

    <p>Chronic headache</p> Signup and view all the answers

    What should the nurse do during a Romberg test for balance?

    <p>Stand beside the patient for safety</p> Signup and view all the answers

    Which of the following is a priority during a neurological assessment in elderly patients?

    <p>Mental status evaluation</p> Signup and view all the answers

    Study Notes

    Cardiac Cycle and Sounds

    • S1 (Lub): Closure of the AV valves (mitral and tricuspid). Heard during systole (contraction). Best heard at the apex (bottom) of the heart.
    • S2 (Dub): Closure of the semilunar valves (aortic and pulmonic). Heard during diastole (relaxation). Best heard at the base (top) of the heart.
    • S3: Normal in young, active adults. Abnormal in those over 40 and associated with heart failure.

    Electrical Conduction Pathway

    • Impulse originates in the SA node.
    • Travels through the right atrium, AV node, Bundle of His, Bundle branches, and Purkinje fibers.

    Cardiac Landmarks (Precordium)

    • Aortic: 2nd intercostal space, right sternal border.
    • Pulmonic: 2nd intercostal space, left sternal border.
    • Erb's Point: 3rd intercostal space, left sternal border.
    • Tricuspid: 4th intercostal space, left sternal border.
    • Apical/Mitral: 5th intercostal space, left midclavicular line.

    Heart Chambers and Blood Flow

    • Deoxygenated blood enters the right atrium.
    • Blood flows: Superior/Inferior Vena Cava → Right Atrium → Tricuspid Valve → Right Ventricle → Pulmonary Valve → Pulmonary Arteries → Lungs → Pulmonary Veins → Left Atrium → Mitral Valve → Left Ventricle → Aortic Valve → Aorta
    • Blood is oxygenated in the lungs.

    Heart Valves

    • Atrioventricular (AV): Mitral (bicuspid) and tricuspid.
    • Semilunar: Aortic and pulmonic.

    Cardiac Assessment

    • Stethoscope: Use both the bell and diaphragm.
      • Bell: Low-pitched sounds (murmurs, S3, S4).
      • Diaphragm: High-medium pitched sounds (S1, S2, rhythm).
    • Positions: Patient supine, 30-45 degrees semi-Fowler, or sitting up.
    • Inspection: Assess jugular vein distention. Look for heaves or lifts (abnormal).
    • Palpation: Use finger pads for landmarks. Feel for pulsations (normal). Don't use the palm of your hand unless for palpable thrills (abnormal).
    • Auscultation: Listen over all cardiac landmarks (with bell and diaphragm). Check for murmurs in all areas, extra heart sounds, and overall heart rhythm.

    Murmurs

    • May be harder to hear in obese patients.
    • If you suspect a murmur, consult with a medical provider.
    • Strategies to hear murmurs may include:
      • Having the patient sit up and hold breath.
      • Auscultate all landmarks thoroughly.
    • Avoid: Prone, right lateral recumbent positions for auscultation

    Congestive Heart Failure (CHF)

    • Possible symptoms: Fatigue, excessive weight gain (despite poor intake), difficulty with exercise (exertional dyspnea).
    • Left-sided CHF: Lung problems (cyanosis, respiratory distress).
    • Right-sided CHF: Peripheral edema (swelling), jugular vein distention, GI issues.
    • Acute exacerbation indicators: Increased fatigue, difficulty tolerating exercise. Excessive weight gain.

    Health History (Cardiac)

    • Important to assess family history for: Hypertension, heart attack, stroke, & peripheral artery disease (PAD).

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    Description

    Test your knowledge on the cardiac cycle, heart sounds, and the electrical conduction pathway of the heart. Understand key concepts such as the events associated with S1 and S2, as well as the important cardiac landmarks and blood flow dynamics. This quiz is essential for those studying cardiology or related health sciences.

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