Cardiovascular Assessment - Chapter 21

Vocabulary flashcards covering key cardiovascular anatomy, physiology, assessment, and diagnostic concepts from the lecture notes.

Endocardium

Inner lining of the heart chambers.

Myocardium

Muscular middle layer of the heart wall responsible for contractions.

Epicardium

Outer layer of the heart wall; also known as the visceral pericardium.

Right atrium

Chamber that receives deoxygenated blood from the body via the superior and inferior vena cavae.

Right ventricle

Chamber that pumps deoxygenated blood to the lungs via the pulmonary artery.

Left atrium

Chamber that receives oxygenated blood from the lungs via the pulmonary veins.

Left ventricle

Chamber that pumps oxygenated blood to the body through the aorta.

Tricuspid valve

Right AV valve; allows blood to flow from the right atrium to the right ventricle and closes to prevent backflow.

Mitral valve

Left AV valve; allows blood to flow from the left atrium to the left ventricle and closes to prevent backflow.

Aortic valve

Semilunar valve between the left ventricle and the aorta; opens during systole.

Pulmonic valve

Semilunar valve between the right ventricle and the pulmonary artery; opens during systole.

Coronary arteries

Arteries that supply oxygenated blood to the heart muscle.

Cardiac conduction system

Electrical system that coordinates heart rhythm and rate.

Sinoatrial (SA) node

Natural pacemaker of the heart; initiates impulses at about 60–100 bpm.

Atrioventricular (AV) node

Secondary pacemaker that conducts impulses from atria to ventricles.

Bundle of His

AV bundle that transmits impulses to the bundle branches.

Bundle branches

Right and left pathways conducting impulses to the ventricles.

Conduction myofibers

Muscle fibers involved in conducting electrical impulses within the heart.

Systole

Phase of the cardiac cycle when the ventricles contract and eject blood.

Diastole

Phase of the cardiac cycle when the ventricles relax and fill with blood.

Preload

Volume of blood in the ventricles at end of diastole (end-diastolic volume).

Afterload

Resistance the ventricle must overcome to eject blood; linked to systemic vascular resistance.

Contractility

Intrinsic ability of the myocardium to contract; influenced by calcium, nerves, oxygenation.

Frank-Starling Law

Relationship that increased preload (strech) increases stroke volume up to a limit.

Stroke volume

Volume of blood pumped by the ventricle with each heartbeat.

Cardiac Output (CO)

Volume of blood pumped by each ventricle per minute; CO = Stroke Volume × Heart Rate.

Ejection Fraction (EF)

Percentage of blood ejected from the left ventricle with each beat; normal >55%.

Heart rate

Number of heartbeats per minute; regulated by autonomic nervous system and cardiac centers.

Cardiac Cycle

Sequence of events in one heartbeat; includes systole and diastole; normal HR 60–100 bpm; ~0.8 seconds per cycle.

Preload determinants

Factors like venous return that determine end-diastolic volume and stretch.

Afterload determinants

Forces like systemic vascular resistance that the heart must overcome to eject blood.

Baroreceptors

Pressure-sensing nerves that help regulate heart rate and blood pressure via the autonomic nervous system.

Jugular venous distension (JVD)

Bulging of the jugular vein indicating elevated central venous pressure; assessed at 45°.

Capillary refill

Time for color to return to capillaries after blanching; normally less than 2 seconds.

Pitting edema grades

Scale (1+ to 4+) describing the depth and duration of leg/ankle edema pits.

Xanthelasma

Cholesterol-rich deposits around the eyes indicating lipid abnormalities.

Pulse pressure

Difference between systolic and diastolic pressures; normally about 40 mmHg.

Orthostatic hypotension

BP drop with standing; evaluated by comparing supine, sitting, and standing readings.

Pulsus paradoxus

Weakening of peripheral pulse during inspiration; varies with respiration.

Pulsus alternans

Alternating strong and weak pulses; sign of severe cardiac dysfunction.

Jugular venous pressure assessment landmarks

Landmarks used to estimate CVP via the external jugular vein path.

Heart sounds (S1, S2, S3, S4)

Audible sounds associated with valve closures and heart dynamics; abnormal sounds may indicate pathology.

Auscultation windows for auscultation

Locations to listen to heart sounds and murmurs (aortic, pulmonic, tricuspid, mitral areas).

Cardiac biomarkers

Laboratory markers of cardiac injury: troponin, CK-MB.

BNP (B-type natriuretic peptide)

Hormone elevated in heart failure; normal <100 pg/mL.

Troponin I

Cardiac-specific protein; highly sensitive and specific marker of myocardial injury.

CK-MB

Creatine kinase-MB isoenzyme; rises with myocardial injury but less specific than troponin.

12-lead ECG

Electrical recording across multiple leads; detects arrhythmias, ischemia.

Holter monitor

24–48 hour continuous ECG monitoring for intermittent events.

Echocardiography (TTE/TEE)

Ultrasound assessment of heart structure and function, including EF.

Cardiac catheterization

Invasive catheter-based procedure to assess chamber pressures and coronary anatomy.

Swan-Ganz catheter (PA catheter)

Pulmonary artery catheter for hemodynamic monitoring, including balloon and ports.

Central venous pressure (CVP)

Pressure in the thoracic vena cava near the right atrium; reflects preload.

Pulmonary artery pressure (PAP)

Pressure measured in the pulmonary artery; part of hemodynamic monitoring.

Pulmonary capillary wedge pressure (PAWP/PCWP)

Left atrial pressure estimate obtained via PA catheter.

Right heart catheterization

Catheterization measuring pressures in right heart structures and PA.

Left heart catheterization

Catheterization with contrast to visualize coronary arteries and LV function.

Ex: Capillary refill test in nursing assessment

Quick test of peripheral perfusion by blanching a nail bed and timing color return.

Hypervolemia

Increased blood volume that can raise preload.

Hypoxemia

Low blood oxygen levels that can decrease contractility.