Denise Coffey MSN, RN

Anatomy Review
Anatomy Review
 Chambers
Atria right and left
Ventricles right and left
 Valves
Atrioventricular
○ Tricuspid
○ Mitral
Semilunar
○ Pulmonic
○ Aortic
Review Anatomy
Heart sounds
 Direction of blood flow
 Cardiac cycle
Diastole
Systole
Events in the right and left sides
 Heart sounds
First heart sound
Second heart sound
Effect of respiration
Heart Sounds
 Extra heart sounds
 Third heart sound
 Fourth heart sound
 Murmurs
 Characteristics of sound
 Frequency (pitch)
 Intensity (loudness)
 Duration
 Timing
 Conduction
Neck vessels
 Neck vessels
Carotid artery
Jugular veins
○ Internal
○ External
Review Anatomy
Subjective Data Collection
 Chest pain  Edema
 Dyspnea  Nocturia
 Orthopnea  Cardiac history
 Cough  Family cardiac
 Fatigue history
 Cyanosis or pallor  Personal habits
(cardiac risk factors)
Objective Data Collection
 Carotid arteries
Palpate
Auscultate for bruit
 Jugular veins
Inspect the jugular venous pulse
Objective Data Collection
 Auscultate the heart sounds
 Identify auscultatory areas
 Note the rate and rhythm
Identify S1 and S2
Listen to S1 and S2 separately
Listen for extra heart sounds
Listen for murmurs
Landmarking for Heart Sounds
Peripheral Vascular System
Arteries
 Temporal artery
 Carotid artery
 Arteries in the arm
 Brachial
 Ulnar
 Radial
 Arteries in the leg
 Femoral
 Popliteal
 Dorsalis pedis
 Posterior tibial
Peripheral Vascular System
Veins
 Jugular veins
 Veins in the arm
 Veins in the leg
 Deep veins
 Femoral
 Popliteal
 Superficial veins
 Great saphenous
 Small saphenous
 Perforators (connecting veins)
Peripheral Vascular System
Peripheral Vascular System
Peripheral Vascular System
Lymphatic System
Subjective Data
 Leg pain or cramps
 Skin changes on arm or legs
 Swelling
 Lymph node enlargement
 Medications
Objective Data
Objective Data
Legs—Inspect and  Popliteal pulse
palpate  Posterior tibial pulse
 Skin and hair  Dorsalis pedis pulse
 Symmetry  Pretibial edema
 Temperature  Leg veins
 Assess while patient
 Calf muscle
stands
 Inguinal lymph
nodes
 Femoral pulse
Objective Data Femoral Pulse
Objective Data Popliteal Pulse
Objective Data Posterior Tibial
Objective Data Dorsalis Pedis
Objective Data Pitting Edema
Abnormalities
 Arms
Raynaud’s syndrome
Lymphedema
 Legs
Arteriosclerosis—ischemic ulcer
Venous (stasis) ulcer
Superficial varicose veins
Deep vein thrombophlebitis
 Occlusions
 Aneurysms