Cardiovascular System Assessment

The Cardiovascular System

• The cardiovascular system plays a crucial role in the body, delivering oxygenated blood and removing waste products.
• The autonomic nervous system controls the heart's pumping action.
• The vascular network, comprising arteries, veins, and capillaries, carries blood throughout the body, maintaining blood pressure and keeping the heart filled with blood.

The Heart

• The heart is a cone-shaped muscle located centrally in the chest, behind the protective sternum.
• It has four chambers and is a double pump, approximately 12 cm long and 9 cm wide, weighing 250-390 g in adult males and 200-275 g in adult females.

Heart Chambers, Valves, and Circulatory Flow

• The heart has four chambers: the right atrium, right ventricle, left atrium, and left ventricle.
• The right atrium receives deoxygenated blood from the body, the right ventricle pumps it to the lungs, the left atrium receives oxygenated blood from the lungs, and the left ventricle pumps blood into the systemic circulation.
• The heart has four valves: the tricuspid valve, bicuspid (mitral) valve, pulmonic semilunar valve, and aortic semilunar valve.
• The atrioventricular valves (tricuspid and bicuspid) prevent backflow from the ventricles to the atria, while the semilunar valves (pulmonic and aortic) prevent backflow from the arteries to the ventricles.

Heart Sounds

• Heart sounds are produced by valve closure, with valve opening being silent.
• The normal heart sounds are S1 (lub) and S2 (dubb).
• S1 is the result of closure of the atrioventricular valves, correlating with the beginning of systole, and is best heard at the apex of the heart.
• S2 is the result of closure of the semilunar valves, correlating with the beginning of diastole, and is best heard at the base of the heart.
• Extra heart sounds include S3 and S4, which are diastolic filling sounds resulting from ventricular vibration, and murmurs, which are audible and prolonged sounds resulting from turbulent blood flow.

Auscultating Heart Sounds

• The traditional 5 areas for auscultating heart sounds are:
  • Aortic area: 2nd ICS at the right sternal border (base of the heart)
  • Pulmonic area: 2nd or 3rd ICS at the left sternal border
  • Erb's point: 3rd ICS at the left sternal border
  • Tricuspid area: 4th ICS at the left sternal border
  • Mitral area: 5th ICS at the left midclavicular line (apex of the heart)