Join our Nursing Review Community! Subscribe below. Its Free!

Join NurseReview.Org Community!

Get Connected With Other Nurses All Over The World! Its Free!! Enter your email to receive the Nursing Board Exam NLE Quick Result!


         Nursing Board Exam Result Subscribers PRC December NLE Quick Results Subscription

NurseReview.Org helps nurses all over the world keep in touch with each other. We provide an interactive environment where nurses can share their experience, ask questions regarding issues, provide assistance, etc.

If you want to be informed through email regarding NLE RESULTS, Nursing News, Retrogression Updates, New Nursing Board Exam Question & Answer, Latest Updates Regarding Nclex, please subscribe to us by filling in your email address above.

NOTE: You email address will be kept private and will not be distributed to spammers.
com/albums/dd234/jben501/philippinenurses/need_help_nursing.jpg" border="0" width="400" height="400" />

Tuesday, May 6, 2008

Heart & Neck Vessels

If you're new here, you may want to subscribe to our RSS feed. One advantage of subscribing to RSS feeds is that you don't have to constantly re-visit this site to check for updates within specific sections you might be interested in because your browser or Feed reader will do this for you automatically on a regular basis plus you can even get email notification. Thank you so much. Enjoy!

Heart & Neck Vessels Slide Transcript
Slide 1: Heart and Neck Vessels

Slide 2: Cardiovascular System • Heart & Blood Vessels • Pulmonary Circulation • Systemic Circulation

Slide 3: • Precordium – area of chest overlying heart and great vessels. – Arteries & veins connected to the heart – Heart & Great vessels are b/t lungs in the middle 1/3 of the thoracic cage = Mediastinum

Slide 4: Heart • Location- Heart extends from the 2nd to 5th ICS & from the Rt. Sternal border to the Lt. MCL • Base broader – upside down  • Apex – points down & to the Lt. • Rt. Side anterior • Lt. Side posterior • 4 Chambers

Slide 5: • Apical Pulse = during contraction, apex beats against the chest wall. Usually palpable in the Lt., 5th ICS, MCL

Slide 6: Great Vessels • Above Base of the heart • Superior & Inferior Vena Cava return unoxygenated venous bld. to the Rt atrium • Pulmonary Artery leaves the Rt. Ventricle, bifurcates & goes to the lungs • Pulmonary Veins return oxygenated bld. to the Lt. Atrium • Aorta carries the bld. to the body

Slide 7: • The aorta ascends from the Lt. Ventricle arches back @ the sternal angle and descends behind the heart • Remember arteries always away from the heart; veins always toward the heart – Pulmonary artery to lungs, pulmonary veins to heart

Slide 8: Heart Wall • Pericardium – tough, fibrous, double-walled sac, surrounds & protects the heart – Has 2 layers containing pericardial fld. – Adherent to great vessels, esophagus, sternum, & pleurae & is anchored to the diaphragm • Myocardium- muscular wall of the heart. It doesw the pumping. • Endocardium – thin layer of endothelial tissue , lines the inner surface of the heart chamber & valves

Slide 9: Chambers of the Heart • Right side – pumps blood to the lungs • Left side – pumps blood to the body • Septum- impermeable wall • 2 Atria- holding chambers • 2 Ventricles- muscular pumping chambers – RA; RV; LA; LV

Slide 10: • Valves – separate the 4 chambers – Prevent backflow – Unidirectional – Open & close passively in response to pressure gradients in the moving bld.

Slide 11: Heart Valves There are 4 heart valves • 2 Atrioventricular – AV valves- separate the atria & ventricles • Rt. AV. = tricuspid • Lt. AV. = mitral (bicuspid) • Diastole = the heart’s filling phase; AV valves open, ventricles fill with bld. • Systole = pumping phase, AV valves close to prevent backup

Slide 12: • Semilunar valves – b/t ventricles & arteries – The SL valves are: – Pulmonic valve- rt. Side of the heart – Aortic valve – lt. Side of the heart – These valves open in systole (during pumping)

Slide 13: Cardiac Cycle • 2 Phases – Diastole – ventricles relaxed, tricuspid & mitral valves open • The ventricles fill, the AV valves close= S1 (lub) or the 1st heart sound (remember the atria are filled, the ventricles are empty creating the pressure gradient)

Slide 14: Cardiac cycle – Systole- ventricles are full, heart contracts, bld is pumped to lungs & body

Slide 15: Heart Sounds • S1 – 1st heart sound • S2 – 2nd heart sound • Extra Sounds – 3rd heart sound – S3 – Ventricular Gallop – 4th heart sound – S4 – Atrial Gallop

Slide 16: Heart Murmurs • What are they? • What causes a heart murmur?

Slide 17: Heart Automaticity • Conduction • SA node – pacemaker • AV node • ECG • Electrical impulse slightly precedes mechanical events.

Slide 18: Pumping Ability • 4-6 liters blood/min. – Cardiac output – Stroke volume

Slide 19: Neck Vessels • Carotid Artery • Jugular Veins – Internal – External • Jugular Venous Pressure – Measurement – Angle of Louis – Normal JVP = 2cm or <

Slide 20: Peripheral Vascular System • Blood and Lymph Transportation • Disease of Vascular System causes problems with delivery of nutrients & oxygen to tissues and removal of wastes.

Slide 21: Arteries • Oxygenated blood to all body tissues • Strong & tough • Elastic fibers • Muscle fibers

Slide 22: Pulses • Temporal • Carotid • Brachial • Radial • Ulnar • Femoral • Popliteal

Slide 23: Pulses • Dorsalis pedis • Posterior tibial • Veins – Greater # – Closer to skin surface

Slide 24: Lymphatics • Separate vessel system • Excess fluid from tissue • Prevents edema

Slide 25: Worksheet # 6

Slide 26: Subjective Data • Chest pain • Dyspnea, orthopnea, cough, fatigue, cyanosis, pallor, edema, nocturia • Past Cardiac History • Last EKG • Family history • Personal habits

Slide 27: • Leg pain / cramps • Swelling or skin changes • Lymph node enlargement • Medications

Slide 28: Objective Data • Measure B/P in both arms – lying, sitting, standing • Palpate pulses bilaterally – Temporal – Carotid * important to only palpate one side at a time * – Brachial – Radial – ulnar

Slide 29: – Femoral – Popliteal – Dorsalis pedis – Posterior tibial

Slide 30: Jugular Venous Pressure JVP Supine- HOB 30-45 degrees, remove pillow Turn head away from examiner, shine light across neck to highlight pulsation Locate Angle of Louis & position a vertical ruler on reference point 2nd ruler horizontal to level of pulsation

Slide 31: Read level on vertical ruler Normal JVP = 2cm. or <  Inspect Precordial Area for Retraction or Bulging pulsation

Slide 32: • Palpate – use palmar aspect of fingers or ulnar surface of hands to search for other pulsations – Sternoclavicular – Epigastric – Aortic – right 2nd interspace – Pulmonary – lt. 2nd interspace

Slide 33: – Right ventricular – lt. Lower sternal border, 5th interspace – Apical – 5th interspace left MCL

Slide 34: Percussion • To outline heart’s borders • Limited benefit with lg. Breasts, obese, muscular chest wall • Readily available

Slide 35: Percuss for Cardiac Enlargement • Lt. Anterior axillary line 5th intercostal space & toward the sternal border • Resonance over lung – dull over heart • Normal – lt. Border of cardiac dullness 5th interspace MCL: @ 2nd interspace dullnes coincides with the lt. Sternal border • 2nd interspace to 5th MCL

Slide 36: Auscultate • Inch stethoscope in a Z pattern from base of heart, across & down to Apex Aortic – 2nd rt. Interspace Pulmonary – 2nd lt. Interspace Erb’s Point – 3rd lt. Interspace Tricuspid – 5th interspace lt. Lower sternal border Apical – 5th interspace lt. MCL APE To Man

Slide 37: Note during auscultation • Rate • Rhythm • S1- Apex S2 – Base • Other sounds? • Murmurs

Slide 38: • Auscultate – Left side lying – Sitting leaning forward • Observe skin, mucus membranes, nails and chest

Slide 39: • Carotid Arteries – Bruits – Neck in neutral position – Bell over carotid @ 3levels • Angle of jaw • Midcervical area • Base of neck

Slide 40: Peripheral Vascular System • Arms – Inspect • Skin color, nail beds • Temperature • Texture & turgor • Lesions, edema, clubbing (160 degree angle base = Normal) • Capillary refill <2sec. • symmetry

Slide 41: Palpate • Rate, rhythm, elasticity, force Grade force as : 1 - 4 0 = absent 4 = bounding Brachial, radial, ulnar Edema

Slide 42: Allen Test • Used to determine the patency of the ulnar & radial artery Hands on knees, palms up Compress both radial arteries Instruct to open & close fists several times Open hands. Results = pink color – ulnar artery patent Repeat occluding ulnar artery

Slide 43: Legs • Inspect – Symmetry – Color – Hair distribution – Venous pattern – Measure calf circumference

Slide 44: Palpate Legs • Femoral • Popliteal • Dorsalis pedis • Posterior tibial • Inguinal lymph nodes

Slide 45: • Edema – Grade scale 1+ to 4+ • 1+ slight indentation = 1cm. • 2+ moderate = 2cm • 3+ deep = 3cm. • 4+ very deep = 4cm • ( more accurate to classify by depth)

Article copyright - #1 source of information to update nurses all over the world. All rights reserved. No part of an article may be reproduced without the prior permission.


Philippine Nurses in Action

Search for Nursing Jobs Abroad!

Quick Nursing Facts:

NLE Results December 2011 Results

December 2011 Nursing Board Exam Successful Examinees for the December NLE 2011

Nursing Board Exam July 2010 NLE PRC

July 2011 Nursing Board Exam Successful Examinee PRC

List of Successful Examinees for Nursing Licensure Examination July 2011 Conducted by the PRC

We are one of the few websites to post results right after the Philippine Regulatory Board have release the list of successful examinees

Results for July 2011 NLE Board Exam

July 2011 NLE Nursing Licensure Examination Results List Of Passers

Recommended Books

Filipino Nurse Tag Rolls

NursingReview.Org Disclaimer

© 2008-2009 NurseReview.Org This site contains links to other Web sites. The owner of this blog has no control over the content or privacy practices of those sites. The information provided here is for general information purpose only. Comments are moderated. If in any case the owner approves a comment, it should not be taken as an endorsement of that comment. The owner doesn't claim full ownership of all photos or articles posted on this site. If the respective copyright owners wish for their photos or articles to be taken down, feel free to e-mail me and it will be taken down immediately.