5866966
Description
Flashcards by Rachel Nall, updated more than 1 year ago
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Created by Rachel Nall
over 8 years ago
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| Question | Answer |
| What does the first heart sound represent? What does it sound like? | Closure of the AV valves at the beginning of systole. Sounds like "lub." |
| What is the second heart sound? What does it sound like? | Closure of the semilunar valves (aortic & pulmonic) & the end of systole. Sounds like "dub." |
| What is the third heart sound? What does it sound like? | A weak rumble occasionally heart at the beginning of the middle 1/3 of diastole. Sounds like Kentucky. |
| What does a 3rd heart sound potentially indicate? | 1. Significant left ventricular dysfunction 2. 1st sign of CHF 3. Blood entering and distending a relatively non-compliant LV. |
| What does the fourth heart sound represent? What does it sound like? | Inrushing of blood into the ventricles when atria contract - atrial contraction late in diastole. Sounds like "Tennessee" |
| What patients can you hear a fourth heart sound with? | Hypertensive patients with a thick left ventricle |
| What is the name of the condition that causes rheumatic fever? | Group A hemolytic streptococci |
| What is the most damaged valve in rheumatic fever? The second-most damaged? | Most frequently: MV 2nd-Most Frequently: AV |
| Name some causes of heart murmurs. | 1. Infectious lesions (bacterial endocarditis): drug use, dental decay. 2. Congenital defects: Stenosis or lack of one or more leaflets and congenital bicuspid aortic valve. 3. Degenerative defects. (Calcific aortic stenosis) |
| Choose from pressure/volume problems: Stenotic lesions Regurgitant/Insufficiency lesions | Stenotic: pressure Regurgitant: volume |
| What does an aortic stenosis murmur sound like? | Loud systolic ejection murmur that may be transmitted to the neck. |
| Aortic stenosis (systolic murmur); most often heard at the right sternal border. | |
| What is the normal aortic valve area? | 2.5 to 3.5 centimeters squared |
| What is severe stenosis that would indicate the need for aortic valve replacement? | Pressure gradient greater than 50 mmHg and valve size less than 1 cm2. |
| What is the triad associated with aortic stenosis? | SAD: syncope, angina, and dyspnea. Happens in 80 percent of males. |
| What lesions are due to pressure overload? What kind of hypertrophy does this cause? How do the sarcomeres replicate? | Aortic and mitral stenosis. Causes concentric hypertrophy, which causes parallel replication of sarcomeres. |
| Aortic regurgitation murmur | |
| What are the examples of volume overload lesions? Is this eccentric or concentric? How does it affect the sarcomeres? | Aortic and mitral regurgitation. Eccentric hypertrophy, which results in serial replication of sarcomeres. |
| How do AS and AR affect net stroke volume output? | Net stroke volume output from the LV is reduced. |
| What is a high-pitched, blowing murmur heard throughout systole? | Mitral regurgitation |
| Where is mitral regurgitation most heard? | The apex of the heart. It transmits to the left atria, which is deep in the chest. |
| Mitral regurgitation murmur | |
| What conditions can mitral regurgitation precipitate? | Atrial fibrillation Pulmonary edema |
| When is mitral stenosis heard? | During the last third of diastole |
| Mitral stenosis murmur | |
| What is the normal size for the mitral valve? | 4 to 6 cm2; typically becomes symptomatic when less than 50 percent reduction in valve orifice. |
| What are the effects of mitral stenosis? | Increased LA volume leads to AFib Increased LA pressure leads to pulmonary edema Decreased pulmonary compliance can lead to increased RV pressures & subsequent RV failure. |
| How are cardiac output and MAP affected in mitral stenosis compared with aortic stenosis? | In mitral, the LV is normal. Cardiac output and MAP aren't as affected in mitral stenosis as they are in aortic stenosis. |
| What are the effects of blood flow in mitral stenosis and regurgitation? | Mitral regurgitation: Blood that has flowed into the LV during diastole leaks back into the LA during systole. Mitral stenosis: Blood flow from the LA to the LV is impeded. |
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