Health Assessment
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| Cardiac Assessment: | show 🗑
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| Precordium: | show 🗑
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| Base: | show 🗑
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| show | inferior aspect of the heart.
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| show | returns unoxygenated blood to the heart.
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| show | return the freshly oxygenated blood to the left side of the heart.
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| Aorta: | show 🗑
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| show | numerous layers.
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| show | tough, fibrous, double-walled sac that surrounds and protects the heart.
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| show | muscular wall of the heart that does the pumping.
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| show | thin layer of endothelial tissue that lines the inner surface of the heart chambers and valves.
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| show | are separated by swinging door like structures, called valves, whose main purpose is to prevent back flow of blood.
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| The Valves: | show 🗑
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| Atrioventricular Valve (AV): | show 🗑
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| Semilunar Valve (SL): | show 🗑
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| Direction of Blood Flow: | show 🗑
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| show | 4)Lungs oxygenate blood; pulmonary veins return fresh blood to LA. 5)From LA, arterial blood travels through mitral valve to LV ejects blood through aortic valve into aorta. 6)Aorta delivers oxygenated blood to body
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| Cardiac Cycle: | show 🗑
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| Diastole: | show 🗑
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| Systole: | show 🗑
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| show | first heart sound (S1) & second heart sound (S2)
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| show | occurs with closure of the AV valves and thus signals the beginning of systole.
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| show | occurs with closure of the semilunar valves and signals the end of systole.
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| Extra Heart Sounds: | show 🗑
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| Third Heart Sound (S3): | show 🗑
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| show | Occurs at the end of diastole, at presytole, when the ventricle is resistant to filling.
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| show | is a gentle, blowing, swooshing sound that can be heard on the chest wall. Velocity of blood increases (flow murmur) (exercise, thyrotoxicosis) Viscosity of blood decreases (anemia).
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| show | Structural defects in the valves (narrowed valve, incompetent valve) or unusual openings occur in the chambers (dilated chamber, wall defect)
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| Tips for Identifying Murmurs and Characteristics: | show 🗑
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| Tips for Identifying Murmurs and Characteristics: (cont) | show 🗑
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| Subjective Data: | show 🗑
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| show | Past cardiac history, Family cardiac history, Personal habits (cardiac risk factors): Nutrition, Smoking, ETOH, Exercise, Medications/Drugs.
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| Subjective Data - Pediatrics: | show 🗑
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| Objective Data: | show 🗑
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| Carotid Pulse: | show 🗑
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| show | for presence of a bruit.
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| Observe jugular venous pulse: | show 🗑
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| show | Precordium (inspection & palpation)
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| show | Describe location of apical impulse or PMI (point of maximal impulse). location - occupies only one interspace, the 4th - 5th, medial or midclavicular at apex. Size - 1cm - 2cm
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| show | Amplitude - short, gentle tap. Duration - short, occupies only first have of systole
Note any heave (lift) or thrill.
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| Objective Data - Auscultation: | show 🗑
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| show | Identify anatomic areas where you listen with both diaphragm (better for picking up the high pitched sounds) and bell (low pitched sounds). Note rate and rhythm of heartbeat. Identify S1 and S2 and note any variation.
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| show | Listen in systole and diastole for any extra heart sounds. Listen in systole and diastole for any murmurs. Repeat sequence with bell
Listen at the apex with person in left lateral position. Listen at the base with person in sitting position.
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| Cardiovascular - Pediatrics: | show 🗑
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| show | Indicators of heart disease: poor weight gain, developmental delay, persistent tachycardia, tachypnea, DOE, cyanosis, clubbing. Venous hum-continuous low pitched hum throughout cycle…nl.
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