Heart, Peripheral Vascular, Lungs & Breast – Key Vocabulary

Vocabulary flashcards covering main anatomical structures, clinical concepts, assessment tools, abnormal findings, and procedures discussed in the lecture.

Cardiac Cycle

The rhythmic sequence of diastole and systole that propels blood through the heart.

Diastole

Ventricular relaxation and filling phase; takes up two-thirds of the cardiac cycle.

Systole

Ventricular contraction phase; blood is ejected to the pulmonary and systemic circuits.

Pericardium

Tough, double-walled sac surrounding and protecting the heart; contains serous fluid for friction-free movement.

Myocardium

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

Endocardium

Thin endothelial inner lining of the heart chambers and valves.

Tricuspid Valve

Right atrioventricular (AV) valve separating right atrium and right ventricle.

Mitral (Bicuspid) Valve

Left AV valve separating left atrium and left ventricle.

Semilunar (SL) Valves

Valves between ventricles and great arteries (pulmonic and aortic).

Pulmonic Valve

Right-sided SL valve that opens during systole to send blood into the pulmonary artery.

Aortic Valve

Left-sided SL valve that opens during systole to send blood into the aorta.

Point of Maximal Impulse (PMI)

Location where the apical impulse is palpated—5th left intercostal space, midclavicular line.

Auscultatory Valve Areas

Specific chest sites—Aortic (2nd RICS), Pulmonic (2nd LICS), Tricuspid (LLSB), Mitral (5th LICS MCL)—where heart sounds are best heard.

S1

First heart sound caused by closure of AV valves; loudest at the apex and marks start of systole.

S2

Second heart sound caused by closure of SL valves; loudest at the base and marks end of systole.

Ventricular Gallop (S3)

Extra diastolic sound after S2; indicates heart failure when heard in adults over 40.

Atrial Gallop (S4)

Extra diastolic sound just before S1; reflects decreased ventricular compliance.

Pericardial Friction Rub

High-pitched, scratchy extracardiac sound of pericarditis, best heard with patient leaning forward.

Murmur

Turbulent blood-flow sound across valves; graded by intensity and timing (systolic or diastolic).

Aortic Stenosis

Systolic ejection murmur due to narrowed aortic valve ("Mr. ASS" mnemonic).

Mitral Regurgitation

Systolic murmur from backflow through incompetent mitral valve ("Mr. ASS").

Mitral Stenosis

Diastolic rumble due to narrowed mitral valve ("Ms. ARD").

Aortic Regurgitation

Diastolic murmur from backflow through incompetent aortic valve ("Ms. ARD").

Braden Scale

Tool to assess pressure-ulcer risk; lower scores mean higher risk.

FLACC Scale

Pain assessment tool for non-verbal children; not used for pressure-ulcer risk.

Systolic Pressure

Top blood-pressure number representing peak ventricular contraction.

Diastolic Pressure

Bottom blood-pressure number representing ventricular relaxation.

Pulse Pressure

Difference between systolic and diastolic pressures; indicates stroke volume.

Orthopnea

Dyspnea occurring when lying flat; relieved by sitting up.

Nocturia

Excessive urination at night; may signify heart failure.

Cyanosis

Bluish skin discoloration from inadequate oxygenation.

Motivational Interviewing

Counseling style that enhances patient motivation through empathy and open-ended questions.

Five A’s of Smoking Cessation

Ask, Advise, Assess, Assist, Arrange—framework for tobacco counseling.

Ankle-Brachial Index (ABI)

Doppler comparison of ankle and arm pressures to detect peripheral arterial disease.

Edema Grading 1+–4+

Scale describing depth and persistence of pitting swelling; 4+ is deepest, prolonged pit.

Arterial Insufficiency

Inadequate arterial blood flow causing cool skin, delayed capillary refill, and possibly arterial ulcers.

Venous Insufficiency

Pooling of blood in veins leading to edema, brawny skin, and venous stasis ulcers.

Deep Vein Thrombosis (DVT)

Clot in a deep vein causing unilateral warmth, swelling, pain; risk for pulmonary embolism.

Lymphedema

Non-pitting, thickened limb swelling due to lymphatic obstruction; positive Stemmer sign.

Carotid Bruit

Blowing, swishing sound over carotid artery indicating turbulent flow or stenosis.

Tactile Fremitus

Palpable vibrations transmitted through lung tissue when patient speaks; decreased with obstruction.

Egophony

Voice sound change where patient’s “E” is heard as “A” over consolidated lung tissue.

Bronchophony

Abnormally clear transmission of spoken words through lungs, suggesting consolidation.

Whispered Pectoriloquy

Clear audible whisper over lung field indicating lung consolidation.

STOP-BANG

Eight-question screening tool for obstructive sleep apnea risk.

Letter	Stands For	Question
S	Snoring	Do you snore loudly (louder than talking or heard through doors)?
T	Tired	Do you often feel tired, fatigued, or sleepy during the day?
O	Observed	Has anyone observed you stop breathing during sleep?
P	Pressure	Do you have or are you being treated for high blood pressure?
B	BMI	Is your BMI over 35 kg/m²?
A	Age	Are you age 50 or older?
N	Neck	Is your neck circumference > 40 cm (15.75 in)?
G	Gender	Are you male?

Barrel Chest

Increased AP diameter (1:1) commonly seen in COPD and emphysema.

COPD

Chronic obstructive pulmonary disease featuring airflow limitation, wheezing, and barrel chest.

Gynecomastia

Benign enlargement of male breast tissue during puberty or with low testosterone.

Breast Self-Examination (BSE)

Monthly self-palpation of breasts, ideally shortly after menses to detect changes early.

Central Axillary Nodes

Primary lymph nodes high in the axilla receiving >75% of breast drainage.

Pectoral Nodes

Anterior axillary lymph nodes along pectoralis major’s lateral edge.

Subscapular Nodes

Posterior axillary lymph nodes along the lateral edge of the scapula.

Lateral Nodes

Axillary nodes along the humerus on the upper arm.

Point Grading of Pulses 0-3

0 absent, 1 weak, 2 normal, 3 bounding pulse strength scale.

Posterior Tibial Artery

Pulse located behind and just below the medial malleolus.

Popliteal Artery

Pulse palpated in the popliteal fossa behind the knee.

Dorsalis Pedis Artery

Pulse on dorsum of foot, lateral to extensor tendon of big toe.

Midclavicular Line

Vertical reference line bisecting the clavicle; landmark for PMI and lung auscultation.

Midaxillary Line

Vertical line from apex of axilla; reference for thoracic and lung assessments.

Resonance (Percussion)

Normal low-pitched, hollow sound over healthy lung tissue.

Tympany

High-pitched, drum-like percussion tone over air-filled structures such as stomach.

Pulse Oximetry

Non-invasive measurement of arterial oxygen saturation (SpO₂).

Right-Sided Heart Failure

Systemic venous congestion causing JVD, peripheral edema, ascites, hepatosplenomegaly.

Left-Sided Heart Failure

Pulmonary congestion leading to crackles, orthopnea, paroxysmal nocturnal dyspnea.

NYHA Classification

I–IV scale categorizing heart-failure limitation, from none (I) to symptoms at rest (IV).

Ischemia

Insufficient oxygenated blood to tissues due to partial blockage of arteries.

Pericarditis

Inflammation of pericardium often producing a pericardial friction rub.

Anasarca

Generalized body edema associated with severe heart or renal failure.

Hyperresonance

Percussion tone louder and lower than resonance; may indicate emphysema or pneumothorax.

Orthostatic Hypotension

Drop in BP upon standing, causing dizziness or fainting.

Z-Pattern Auscultation

Systematic route for listening to heart valves from base to apex in a “Z” shape.

NORMAL HEART SOUNDS:

Sound	Valves Closing	Phase	What’s Happening	Sound
S1	Mitral & Tricuspid	Systole	💥 Blood is pushed OUT to lungs/body	"LUB"
S2	Aortic & Pulmonic	Diastole	💧 Heart relaxes, blood fills	"DUB"

EXTRA SOUNDS (Not normally heard in healthy adults):

Sound	When You Hear It	What It Means	Common Cause
S3	Right after S2 ("Lub-dub-ta")	🩸 Too much fluid in a floppy ventricle	Heart failure (ventricular gallop)
S4	Right before S1 ("Ta-lub-dub")	💪 Stiff ventricle walls from pressure overload	Long-term hypertension (atrial gallop)

• S1 = LUB = first sound, mitral closes

• S2 = DUB = second sound, aortic closes

• S3 = floppy HF = Slosh-ing-in

• S4 = stiff ventricle = A-stiff-wall

Heart Rate: What’s Normal?

Age Group	Normal HR (resting)
Adults (18+)	60–100 bpm
Well-trained athletes	40–60 bpm (can be normal for them)

Vital Sign	Normal Range	Below = Low 💙	Above = High ❤
Respiratory Rate (RR)	12 – 20 breaths/min	<12 = Bradypnea	>20 = Tachypnea
Heart Rate (HR)	60 – 100 bpm	<60 = Bradycardia	>100 = Tachycardia

Murmur Grading Scale (Grades I–VI)

Grade	Description	Easy Way to Remember
I/VI	Very faint, barely heard even with concentration	"I think I hear it" 👂
II/VI	Quiet, but clearly audible	"It's soft but definitely there"
III/VI	Moderately loud, no thrill felt	"Now it’s obvious" 🔊
IV/VI	Loud with a palpable thrill (vibration)	"Feel the thrill!" ✋
V/VI	Very loud, heard with stethoscope partially off the chest, still has thrill	"Almost hovering" 🩺✨
VI/VI	Extremely loud, heard without the stethoscope touching the chest	"Whoa — no stethoscope needed!" 😮