C. 20 and 21 definitions

aginia pectoris

acute chest pain that occurs when myocardial demand exceeds the oxygen supply

aortic regurgitation

(aortic insufficiency) incompetent aortic valve that allows backward flow of blood into the left ventricle during diastole.

aortic stenosis

calcification of aortic valve cusps that restrict forward flow of blood during systole.

Aortic valve

the left semilunar valve separating the left ventricle and the aorta

apex of the heart

tip of the heart pointing down toward the 5th left intercostal space

apical impulse

point of maximal impulse (PMI); pulsation created in the left ventricle rotates against the chest wall during systole, normally at the 5th intercostal space in the midclavicular line

base of the heart

broader area of hearts outline located at the 3rd right and left intercostal spaces

Bell of the stethoscope

cup-shaped end piece used for soft, low pitched heart sounds.

bradycardia

slow heart rate, less than 50 beats per minute in the adult

clubbing

bulbous enlargement of distal phalanges of fingers and toes that occur with chronic cyanotic heart and lung conditions

cyanosis

dusky blue mottling of the skin and mucous membranes due to excessive amount of reduced hemoglobin in the blood

diaphragm of the stethoscope

flat end piece of the stethoscope used for hearing relatively high-pitched heart sounds

diastole

the hearts filling phase

dyspnea

difficult, labored breathing

edema

swelling of legs or dependent body part due to increased interstitial fluid

erb’s point

traditional auscultatory area in the 3rd left intercostal space

first heart sound S1

occurs with the closure of the atrioventricular valves signaling the beginning of systole

fourth heart sound S4

gallop, atrial gallop; very soft, low-pitched ventricular filling sound that occurs in the late diastole

gallop rhythm

the addition of a 3rd or 4th heart sound; makes the rhythm sound like the cadence of a galloping horse

inching

technique of moving the stethoscope incrementally across the precordium through the auscultatory areas while listening to the heart sounds

left ventricular hypertrophy LVH

increase in thickness of myocardial wall that occurs when the heart pumps against chronic outflow obstruction (eg. aortic stenosis)

midclavicular line MCL

imaginary vertical line bisecting the middle of the clavicle in each hemithroax

mitral regurgitation

mitral insufficiency; incompetent mitral valve allows regurgitation of the blood back into the left atrium during systole

mitral stenosis

calcified mitral valve impedes forward flow of blood into the left ventricle during diastole

mitral valve

left atrioventricular valve separating the left atrium and ventricle

palpitation

uncomfortable awareness of rapid or irregular heart rate

pericardial friction rub

high-pitched, scratchy extra cardiac sound heard when the precordium is inflamed

physiologic splitting

normal variation of S2 heard as two separate components during inspiration

precordium

area of the chest wall overlying the heart and great vessels

pulmonic regurgitation

pulmonic insufficiency; back flow of blood through incompetent pulmonic valve into the right ventricle

pulmonic stenosis

calcification of pulmonic valve that restricts forward flow of blood during systole

pulmonic valve

right semilunar valve separating the right ventricle and pulmonary artery

second heart sound S2

occurs with closure of the semilunar valves, aortic and pulmonic; signals the end of systole

summation gallop

abnormal mid-diastolic heart sounds heard when both the pathologic S3 and S4 are present

syncope

temporary loss of consciousness due to decreases cerebral blood flow (fainting); caused by ventricular asystole, pronounced bradycardia, or ventricular fibrillation

systole

the hearts pumping phase

tachycardia

rapid heart rate, greater than 95 beats per minute in the adult

third heart sound S3

soft, low pitched ventricular filling sound that occurs in the early diastole (S3 gallop) and may be an early sign of heart failure

thrill

palpable vibration on the chest wall accompanying severe heart murmur

tricuspid valve

right atrioventricular valve separating the right atrium and ventricular

Allen test

test that determines the latency of the radial and ulnar arteries by compressing one artery site and observing return of skin color as evidence of patency of the other artery

aneurysm

defect or sac formed by dilation in artery wall due to arteriosclerosis, trauma, or congenital defect

arrhythmia

variation from the heart’s regular rhythm

arteriosclerosis

plaques of fatty deposits formed in the inner layer (intimate) of the arteries

bruit

blowing, swooshing sound heard through a stethoscope when an artery is partially occluded.

ischemia

deficiency of arterial blood to a body part due to contraction or obstruction of a blood vessel

lymph nodes

small oval clumps of lymphatic tissue located at grouped intervals along lymphatic vessels

lymphedema

swelling of extremity due to obstructed lymph channel, nonsplitting

pitting edema

indentation left after examiner depresses the skin over swollen edematous tissue

profile sign

viewing the finger from the side to detect early clubbing

pulse

pressure wave created by part heartbeat, palpable at body sites where the artery lies close to the skin and over a bone

pulsus alternans

regular rhythm, but force of pulse varies with alternating beats of large and small amplitude

pulsus bigeminus

irregular rhythm; every other beat is premature ; premature beats have weakened amplitude

pulsus paradoxus

beats have weaker amplitude with resp inspiration, stronger with expiration

thrombophlebitis

inflammation of the vein associated with thrombus formation

ulcer

open skin lesion extending into dermis, with sloughing of necrotic inflammatory tissue

varicose veins

dilated tortuous veins with incompetent valves