Cardiovascular System Anatomy, Assessment, and Nursing Interventions

Comprehensive vocabulary flashcard set covering cardiac anatomy, circulation, physical assessment techniques, risk factors, metabolic syndrome, and nursing interventions.

Function of the Cardiovascular System

Primary function is to act as a transport system, delivering blood containing oxygen, nutrients, metabolites and hormones to every cell in the body.

Anatomy of the Heart

The structural makeup of the heart comprising four chambers (right and left atria, right and left ventricles), four valves, and major blood vessels delivering oxygenated and deoxygenated blood.

Pericardium

The double-walled sac that encloses and protects the heart.

Epicardium

The thin outer superficial layer of the heart wall, forming the visceral layer of the pericardium.

Myocardium

The thick middle muscular layer of the heart wall responsible for pumping blood.

Endocardium

The smooth inner endothelial membrane lining the chambers and valves of the heart.

Traditional Auscultatory Landmarks

Precordial assessment landmarks: Aortic area (2nd right interspace), Pulmonic area (2nd left interspace), Tricuspid area (left lower sternal border), and Mitral area (5th interspace MCL).

Tricuspid Valve

The right atrioventricular valve located between the right atrium and right ventricle. It prevents backflow of blood into the atrium during ventricular contraction.

Mitral Valve

The left bicuspid atrioventricular valve located between the left atrium and left ventricle. It prevents backflow of blood into the atrium during ventricular contraction.

Aortic Valve

The semilunar valve situated between the left ventricle and the ascending aorta. It prevents the backflow of blood into the ventricle during diastole.

Pulmonic Valve

The semilunar valve situated between the right ventricle and the pulmonary artery. It prevents backflow of blood into the ventricle during diastole.

Pumping Cycle of the Heart

The sequential mechanical phases consisting of Diastole (ventricles fill), Atrial Systole (atria contract), and Ventricular Systole (ventricles contract and pump blood).

Systole

The contraction phase of the cardiac cycle when blood is ejected into the major arteries. Ventricle pressure is higher than the atria. Mitral and tricuspid valves swing shut.

Diastole

The resting phase of the cardiac cycle during which the ventricles relax, atrioventricular (AV) valves open, pressure in the atria is higher than in the ventricles, and fill with blood.

Cardiac Output (CO)

The total volume of blood pumped by the heart each minute, determined by multiplying heart rate by stroke volume (CO=HR x SV).

Stroke Volume (SV)

The volume of blood ejected from a ventricle with each contraction. Depends on the accommodation of incoming blood volume by heart, contractility of heart muscle, and resistance to blood flow in the circulatory system.

Systemic Circulation

The vascular network delivering oxygenated blood and perfusion of blood to body tissues from the left heart through aorta, arteries, arterioles, capillaries, venules, and veins back to the vena cava.

Perfusion

The passage of blood through systemic capillaries delivering oxygen and nutrients to tissues.

Cardiac Impulse Conduction System

The electrical pathway consisting of the SA node, internodal pathways, AV node, Bundle of His, bundle branches, and Purkinje fibers.

Sinoatrial (SA) Node

The primary natural pacemaker of the heart, located in the right atrium, which initiates electrical impulses.

Atrioventricular (AV) Node

Specialized cardiac tissue located between atria and ventricles that delays the electrical impulse before ventricular depolarization.

Bundle of His

The electrical conduction tract transmitting impulses from the AV node down the interventricular septum.

Purkinje Fibers

Specialized conductive fibers distributing electrical impulses throughout the ventricular myocardium.

Electrocardiogram (ECG)

A graphic recording of cardiac electrical activity displaying P wave, QRS complex, T wave, and U wave mapped to phases of diastole and systole.

Telemetry

Continuous remote ECG recording and transmission of cardiac electrical signals using a wireless transmitter.

Chest X-Ray

An imaging technique that uses radiation to create pictures of the heart and lungs, providing information about heart size, shape, and any abnormalities.

Echocardiography

A non-invasive imaging technique that uses ultrasound waves to create real-time images of the heart's structure and function, allowing assessment of heart chambers, valves, and blood flow.

Cardiac Catherization

A medical procedure that involves threading a catheter through blood vessels to the heart. It is used to diagnose and treat cardiovascular conditions by measuring pressures, visualizing coronary arteries, and potentially delivering interventions.

Angiography

An imaging technique that uses X-rays to visualize the inside of blood vessels and organs, particularly the heart and major arteries, by injecting a contrast radiopaque dye.

Electrophysiology

A branch of cardiology that studies the electrical activities of the heart, including rhythm disorders, and involves techniques to diagnose and treat these conditions.

Carotid Artery

Major artery in the neck supplying oxygenated blood to the brain, head, and neck.

Jugular Veins

Neck vessels (internal and external jugular) returning deoxygenated blood from the head back to the superior vena cava.

Adult and Older Adult Considerations

Age and disease-induced cardiovascular system changes may lead to decreased activity tolerance and decreased endurance.

Age and Lifestyle Factors

May contribute to the processes of calcification, fatty degeneration, and diminished elasticity of the blood vessels and resultant higher blood pressure and decreased cardiac output.

Factors Affecting Cardiovascular Function

Includes cigarette smoking, high blood pressure, nutrition, sedentary (little exercise) lifestyle, diabetes, obesity, medical/family history, medications/drug use, stress, personality types, and community factors.

9 Modifiable Factors

Includes high blood pressure, smoking, serum cholesterol, obesity, type 2 diabetes mellitus, psychosocial factors, lack of fruits and vegetables, alcohol use, and lack of physical exercise.

Signs of Altered Cardiovascular Function

Includes changes in vital signs, changes in skin, decreased cardiac output, alterations in the blood vessels, and decreased tissue perfusion.

Metabolic Syndrome (Syndrome X)

A grouping of risk factors related to glucose and fat metabolism that significantly increases the risk for cardiovascular disease.

Risk Identification

Includes past cardiovascular conditions, current medications, nonmodifiable and modifiable risk factors, and metabolic syndrome.

Dysfunction Identification

Includes stroke screening and chest or leg pain along with the activity level associated with pain or other associated subjective complaints

Stroke

A sudden neurological deficit caused by impaired blood supply to a region of the brain.

Chest Discomfort Initial Assessment Questions

Questions evaluating pain quality, radiation, aggravation by breathing/movement, severity (0 to 10 scale), onset, triggering activity, and associated symptoms.

Physical Assessment of Cardiac & Peripheral Vascular System

An evaluation process that includes inspecting, palpating, and auscultating the heart, neck vessels, and peripheral vascular extremities to assess their function and detect abnormalities.

Inspection

A physical examination technique involving a visual assessment of behavior, cognition, consciousness, skin, nail beds, and neck vessels such as the right external jugular to identify abnormalities, conditions, or signs of disease.

Palpation

A physical examination technique that involves using the hands to feel for abnormalities, pulse, or vibrations in the body.

Auscultation

A physical examination technique that involves listening to the internal sounds of the body, typically using a stethoscope, to evaluate the function of the heart, lungs, and other organs.

Physical Assessment of Neck Vessels

Includes palpating the carotid artery, auscultating the carotid artery, and inspecting the jugular venous pulse.

Physical Assessment of Precordium

Includes inspecting the anterior chest for heave or lift, palpating the apical impulse and across the precordium for thrill, and auscultation of heart sounds.

Dyspnea

A subjective sensation of difficulty or discomfort in breathing, often indicating respiratory or cardiac issues.

Orthopnea

Difficulty breathing while lying flat, often relieved by sitting up. It is commonly associated with heart failure.

Cyanosis

A bluish discoloration of the skin and mucous membranes, typically indicating insufficient oxygenation of the blood.

Acrocyanosis

Mottled bluish discoloration of extremities caused by sluggish peripheral blood circulation.

Clubbing

Bulbous enlargement of fingertips accompanied by loss of normal nail angle due to chronic tissue hypoxia.

Jugular Vein Distention (JVD)

Visible bulging of the right external jugular vein; abnormal when height of jugular pressure exceeds $3\,\text{cm}$ above the sternal angle at a $45^\circ$ angle.

Precordial Landmarks for Valvular Sounds

Chest anatomical sites where heart valve sounds are referred and heard along the direction of blood flow.

Bruit

An abnormal blowing or swishing sound heard on auscultation of an artery indicating turbulent blood flow.

Thrill

A palpable vibration felt over a heart region or blood vessel, indicating turbulent blood flow.

Heave

A forceful sustained outward lifting movement of the chest wall felt during palpation, associated with ventricular enlargement.

Apical Impulse

The point of maximal impulse (PMI) felt at the 5th intercostal space, left midclavicular line.

S1 Heart Sound

First heart sound ('lub') caused by closure of AV valves (tricuspid and mitral) at the onset of systole.

S2 Heart Sound

Second heart sound ('dub') caused by closure of semilunar valves (aortic and pulmonic) at the onset of diastole.

Pulse Deficit

The numerical difference between simultaneous apical heart rate and peripheral radial pulse counts.

Arteries of the Peripheral Vascular System

Includes temporal artery, carotid artery, brachial artery, femoral artery, popliteal artery, dorsalis pedis artery, and posterior tibial artery.

Veins of the Peripheral Vascular System

Includes jugular veins, superficial and deep veins (in the arm), femoral veins (deep), popliteal veins (deep), great saphenous vein (superficial), and small saphenous vein (superficial).

Inspecting and Palpating the arms

Involves capillary refill, palpating radial and brachial pulses, and allen test.

Allen Test

A test that assesses the adequacy of blood flow to the hand by temporarily blocking the radial and ulnar arteries and observing the hand's color restoration.

Inspecting and Palpating the legs

Includes measuring the calf circumference, any skin changes (discolorations, ulcers, gangrene), temperature, locating peripheral vsacular system (femoral, popliteal, posterior tibal, dorsalis pedis), and pretibial edema.

Right Lymphatic Duct

Empties into the right subclavian vein. It drains the right side of the head and neck, right arm, right side of thorax, right lung and pleura, right side of the heart, and right upper section of the liver.

Thoracic Duct

Drains the rest of the body and empties into the left subclavian vein. It collects lymph from the left side of the head and neck, left arm, left side of the thorax, both lower limbs, and abdominal organs.

Function of the Lymphatic System

To conserve fluid and plasma proteins that leak out of the capillaries, form a major part of the immune system that defends the body against disease, and absorb lipids from the small intestine.

Plasma

The liquid portion of blood carrying electrolytes, trace minerals, nutrients, and metabolic wastes.

Lymph Nodes

Small, oval clumps of lymphatic tissue located at intervals along the vessels that are arranged in groups, deep or superficial, filter the fluid before it is returned to bloodstream, and filter out microorganisms that could be harmful.

Subjective Data

Includes leg pains or cramps, skin changes on arms or legs, swelling in arms or legs, lymph node enlargement, medications, and smoking history.

Raynaud Phenomenon

A vascular condition characterized by episodic vasospasms of peripheral arteries causing coldness, numbness, and skin color changes.

Lymphedema

High-protein tissue swelling resulting from an obstruction in lymphatic drainage.

Peripheral Vascular Disease

A circulatory condition characterized by narrowed blood vessels reducing blood flow to the limbs, commonly resulting in leg pain, ulcers, or even gangrene.

Gangrene

The death of body tissue due to a lack of blood flow, often caused by infection or injury. It typically affects extremities and can lead to serious complications.

Ulcers

Open sores or lesions that form on the skin or mucous membranes, often due to poor circulation or injury, and can become infected.

Aterial Ulcer

A type of ulcer that occurs as a result of inadequate blood flow through the arteries, often presenting as painful, deep sores on the lower extremities. These ulcers may not heal properly and can lead to serious complications.

Venous Ulcer

A type of ulcer resulting from poor blood return from the veins, typically characterized by shallow, irregular sores on the lower legs. These ulcers are often painless and may ooze or develop a crust.

Superficial Varicose Veins

Enlarged, twisted veins located just beneath the surface of the skin, often appearing bulging and blue in color. They are caused by weakened valves and can lead to discomfort or complications such as venous ulcers.

Deep Vein Thrombophlebitis

A condition characterized by the formation of a blood clot (thrombus) in a deep vein, most commonly in the legs. It can cause inflammation, pain, and swelling, and poses a risk of serious complications such as pulmonary embolism.

Thrombus

A stationary blood clot formed inside a blood vessel or heart chamber.

Occulsions

Blockages in blood vessels that impede blood flow, typically leading to tissue ischemia and potential complications such as thrombosis or infarction.

Aneurysms

A localized, abnormal dilation of a blood vessel, usually an artery, caused by weakness in the vessel wall. Aneurysms can lead to serious complications if they rupture, resulting in hemorrhage.

Capillary Refill

An assessment of peripheral tissue perfusion where color return to a blanched nail bed should take $\le 2\,\text{seconds}$.

Grading Scale for Pulses

A clinical rating scale for pulse amplitude: 0 = Absent, 1+ = Diminished/thready, 2+ = Normal, 3+ = Increased full volume, 4+ = Bounding hyperkinetic.

Peripheral Pulse Sites

Key anatomical locations for pulse palpation: Temporal, Carotid, Apical, Brachial, Radial, Femoral, Popliteal, Dorsalis Pedis, and Posterior Tibial.

Doppler Ultrasound Probe

A handheld diagnostic transducer used to locate and amplify blood flow signals in peripheral blood vessels with nonpalpable pulses.

1+ Pitting Edema

Mild edema indentation ($2\,\text{mm}$) with normal contours and interstitial fluid volume $30\%$ above normal.

2+ Pitting Edema

Deeper edema pit ($4\,\text{mm}$) lasting longer than 1+ with fairly normal contour.

3+ Pitting Edema

Deep edema pit ($6\,\text{mm}$) remaining several seconds after pressing, with skin swelling obvious on general inspection.

4+ Pitting Edema

Very deep edema pit ($8\,\text{mm}$) remaining for a prolonged time (possibly minutes) after pressure, with frank swelling.

Brawny Edema

Non-pitting edema secondary to excessive interstitial fluid accumulation; tissue is firm or hard, and skin appears shiny, warm, moist, and discolored.

Venous Insufficiency

Impaired venous return causing increased pressure in veins, brawny non-pitting edema, brown skin pigment discoloration, and irregular weeping ulcers.

Arterial Insufficiency

Inadequate arterial blood supply causing tissue ischemia, intermittent claudication, cool pale skin, diminished pulses, and deep punched-out ulcers.

CBC

Also known as complete blood count, a blood test that provides information on red and white blood cells, hemoglobin, hematocrit, and platelets on oxygen carrying ability.

Cardiac Biomarkers (Cardiac enzymes)

Proteins such as myoglobin, CK-MB, and troponin released into the bloodstream from cells when tissue damage occurs.

Myoglobin

A protein found in muscle tissue that binds oxygen, often measured to assess muscle injury.

Creatine Kinase (CK-MB)

An enzyme found in the heart and skeletal muscle, measured to diagnose myocardial infarction and assess muscle damage.