CVS System Assessment Flashcards

Questions and Answers

What are the 3 parts of the CVS system?

Heart (pump), vessels (pipes), blood (volume)

What are the 3 types of shock for each part of the system?

Heart = cariogenic shock, Vessels = distributive shock (anaphylactic and neurogenic), Blood = hypovolemic shock

What happens during S1 sound?

Systole (full ventricles contract) and closing of AV valves

What happens during S2 sound?

Diastole (ventricles relax) and closing of SL valves Signup and view all the answers

Why would you hear S3? What does it sound like?

Early diastole = passive filling of ventricles; sounds like 'Lup Dup Up' (ventricular gallop) Signup and view all the answers

Why would you hear S4? What does it sound like?

Late diastole/early systole: atrial kick pushes blood into stiff ventricle = 'Te Lub Dup' Signup and view all the answers

What ventricle has the highest pressure?

Left Signup and view all the answers

Which valves are damaged the most?

Mitral and aortic Signup and view all the answers

What is regurgitation?

Some blood flows back into heart because valve does not fully close. Signup and view all the answers

What happens during systole?

Full ventricles contract = blood is pumped into systemic and pulmonic systems. Signup and view all the answers

What happens during diastole?

Ventricles relax and atria contract (atrial kick) = myocardium is perfused. Signup and view all the answers

What changes CO demand?

Exercise, stress, adrenaline, fight or flight: illness, injury, fever. Signup and view all the answers

What contributes to CO supply?

Stroke volume (amount of blood ejected in one cardiac cycle) x HR (BPM) = amount of blood ejected each min. Signup and view all the answers

How much blood is ejected each min in a healthy person?

5 L Signup and view all the answers

If SV decreases, what must the heart do to maintain CO?

Increase Signup and view all the answers

If HR decreases, what must the SV do to maintain CO?

Increase Signup and view all the answers

What is end diastolic volume (EDV)?

Amount of blood in the ventricles at the end of diastole - 120 ml. Signup and view all the answers

What is end systolic volume (ESV)?

Amount of blood that leaves the heart in the ventricles at the end of systole - 50 ml. Signup and view all the answers

How do you calculate stroke volume (SV)?

EDV - ESV = SV 70 ml. Signup and view all the answers

What is ejection fraction (EF)?

SV divided by EDV = % of diastolic volume ejected by heart during systole. Signup and view all the answers

What is a normal ejection fraction range?

50-70% Signup and view all the answers

Where is the point of maximal impulse?

Apical pulse Signup and view all the answers

What is pulse deficit?

Difference between what you hear in your heart and what you feel in the pulse. Signup and view all the answers

What causes a murmur?

Turbulent blood flow from stenosis or regurgitation. Signup and view all the answers

What does a systolic murmur sound like and what causes it?

'Hoot Dub' (ventricles contract and blood is forced against aortic and pulmonic valves); causes include aortic/pulmonic stenosis and AV regurgitation. Signup and view all the answers

What does a diastolic murmur sound like and what causes it?

'Lub Hoot' (during Dub; is always pathological); caused by stenosed mitral/tricuspid valve or SL regurgitation. Signup and view all the answers

What causes a click and what do they sound like?

Aortic stenosis, valve prolapse, prosthetic valve; sounds are short, high pitched heard anytime during cardiac cycle. Signup and view all the answers

What causes pericardial rub?

Inflammation within pericardial space. Signup and view all the answers

Why is an abdominal assessment necessary for cardiac system assessment?

Pulsations at umbilicus = aneurysm. Signup and view all the answers

What is the strength grading for pulses?

0=absent, 1=weak, 2=normal, 3=bounding. Signup and view all the answers

What is the edema grading scale?

+1=mild, +2=moderate, +3=deep, +4=very deep. Signup and view all the answers

What does peripheral edema indicate?

Too much blood volume from heart to pump = usually a result of heart failure. Signup and view all the answers

How do you know if edema is caused by cardiac problems?

Edema in both legs. Signup and view all the answers

Why would you check CSWM?

For patients who have questionable circulation secondary to illness, injury. Signup and view all the answers

What is the purpose of a valve in the venous system?

To prevent backflow. Signup and view all the answers

What happens when venous valves do not close?

Varicose veins. Signup and view all the answers

What are 3 signs of a DVT?

Redness, swelling, warmth. Signup and view all the answers

What test is used to detect DVT?

Homan's sign. Signup and view all the answers

What electrolytes would be observed for a cardiac lab work test and why?

Sodium = abnormal = fluid imbalance; potassium - abnormal = cardiac irritability; calcium = worried about contractility; magnesium = increases absorption of Ca and maintenance of K levels. Signup and view all the answers

What do the terms PT, PTT, and INR refer to?

PT = prothrombin time, PTT = partial prothrombin time, INR = international normalized ratio. Signup and view all the answers

Why would lab tests look at cardiac enzymes?

To see evidence of cardiac damage. Signup and view all the answers

What is a specific cardiac enzyme?

Troponin I and T. Signup and view all the answers

When are serum levels of Troponin I highest?

4-8 hrs after onset of chest pain, peak at 12-16 hrs; returns to baseline within 5-9 days. Signup and view all the answers

Why is myoglobin and creatine kinase (CPK) not specific to cardiac muscle?

Evident from any muscle damage, not just heart. Signup and view all the answers

What enzyme is used to diagnose acute MI?

CK-MB. Signup and view all the answers

What does lipid profiling evaluate risk of?

Atherosclerotic plaque. Signup and view all the answers

What fats does lipid profiling look at?

LDL, HDL, triglycerides (free fatty acids). Signup and view all the answers

What does Brain Natriuretic Peptide (BNP) indicate?

neurohormone that helps regulate BP and fluid volume; secreted by ventricles in response to increased stretch (preload), indicates heart failure. Signup and view all the answers

What does C-Reactive Protein (CRP) indicate?

Produced in liver in response to systemic inflammation; inflammation thought to increase risk of atherosclerosis. Signup and view all the answers

What is homocysteine?

An amino acid thought to increase risk for CAD. Signup and view all the answers

What does a 12 lead ECG tell us?

Rate, rhythm, ST elevation or depression. Signup and view all the answers

What is a stress test (GXT)?

Graded exercise test; monitors HR, rhythm, ischemic changes, BP, skin temp/color and symptoms when HR is at target based on age and gender. Signup and view all the answers

What does a doppler show in an echocardiogram?

Ultrasound; size and shape of cardiac structures; uses color to show blood flow (direction and velocity) and EF ejection fraction. Signup and view all the answers

What is a transesophageal echo (TEE)?

Clear view (less tissue or bone in the way); invasive; not usually done. Signup and view all the answers

What is heart catheterization?

Angiogram; radioopaque dye injected into vessels to assess aorta, coronary arteries, R and L heart flow. Signup and view all the answers

Study Notes

CVS System Overview

The cardiovascular system (CVS) consists of three key components: heart (pump), vessels (pipes), and blood (volume).
Understanding shock types is essential:
- Cariogenic shock (heart dysfunction)
- Distributive shock (vessel issues, includes anaphylactic and neurogenic)
- Hypovolemic shock (blood volume deficit).

Heart Sounds

S1 Sound: Indicates systole where ventricles contract and AV valves close.
S2 Sound: Marks diastole with relaxation of ventricles and closure of semilunar valves.
S3 Sound: Occurs during early diastole from passive filling, described as a "ventricular gallop" (Lup Dup Up).
S4 Sound: Represents late diastole caused by atrial contraction against stiff ventricles, creates a "Te Lub Dup" sound.

Cardiac Pressure and Valves

The left ventricle generates the highest pressure.
Damage is most common in mitral and aortic valves.

Cardiac Dynamics

Regurgitation: Occurs when a valve fails to close completely, allowing blood to flow back.
Systole: Full contraction of ventricles pumps blood into systemic and pulmonary systems.
Diastole: Relaxation of ventricles and contraction of atria, also known as atrial kick, allowing myocardial perfusion.

Cardiac Output and Stroke Volume

Cardiac output (CO) changes with exercise, stress, adrenaline, illness, injury, and fever.
CO is influenced by stroke volume (SV) and heart rate (HR): CO = SV x HR.
A healthy person typically ejects about 5 L of blood per minute.

Volume Measures

End Diastolic Volume (EDV): Amount of blood in ventricles at diastole's end (approximately 120 ml).
End Systolic Volume (ESV): Blood remaining in ventricles post-systole (approximately 50 ml).
Stroke Volume (SV) is calculated as EDV - ESV, resulting in approximately 70 ml.

Ejection Fraction

Ejection fraction (EF) quantifies the percentage of diastolic volume ejected during systole: EF = SV/EDV.
Normal EF ranges from 50% to 70%.

Cardiac Assessment Indicators

Pulse deficit: Discrepancy between heart rate and pulse rate due to extra beats from stimulants.
Murmur: Caused by turbulent blood flow and indicates valve issues; categorized into systolic and diastolic murmurs based on timing.
Edema: Indicates excess blood volume, typically linked to heart failure, particularly if present in both legs.

Electrolytes and Cardiac Labs

Key electrolytes:
- Sodium: Fluid imbalance indicator.
- Potassium: Impact on cardiac irritability.
- Calcium: Contractility concerns.
- Magnesium: Maintains potassium levels and calcium absorption.
Cardiac enzymes, such as Troponin I and T, are specific to cardiac muscle damage.

Diagnostic Procedures

12-lead ECG: Used to assess heart rate, rhythm, and presence of ST changes.
Stress Test (GXT): Monitors cardiovascular response under exercise conditions.
Echocardiogram: Uses ultrasound to evaluate heart structure and function, including direction and velocity of blood flow.
Transesophageal Echo (TEE): Provides a clearer, more detailed view of the heart but is invasive.

Additional Tests and Indicators

Brain Natriuretic Peptide (BNP): Secreted in response to increased ventricular stretch; indicates heart failure.
C-Reactive Protein (CRP): Marker of systemic inflammation associated with atherosclerosis risk.
Lipid profile: Evaluates risk for cardiovascular disease by measuring LDL, HDL, and triglycerides.

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Description

Test your knowledge on the cardiovascular system with these flashcards. This quiz covers the three parts of the CVS system, types of shock, and heart sounds. Perfect for students studying nursing or medicine.