- Pericardium: outer layer, tough, fibrous, double wall. Has fluid in between that helps
the heart beat without friction
- Myocardium: muscular part that does the pumping
- Endocardium: lines walls of chambers and arteries
what type of system does the heart possess?
two pump system (pulmonary circulation: blood leaves heart, goes to lungs for oxygen,
then goes to heart and pumped to rest of the body) and systemic circulation
What is valves?
- unidirectional (only open in one direction, move blood in one direction)
- open/close in response to pressure gradients in moving blood
pulmonary congestion. there will be fluid in the lungs and we will hear crackles.
THINK: L for left sided and lungs
What are the heat sounds?
lub and dub
what are the first heart sounds?
- S1 (lub)
- beginning of systole, closure of the AV valves
- loudest at the apex of the heart
what are the second heart sounds?
- S2 (dub)
- end of systole, closure of SV valves
- loudest at the base of the heart
, what are the effects of respiration?
during inspiration, intrathoracic pressure is decreased which results in split S2 that
occurs with inspiration but this is normal
what are the third heart sounds?
- S3
- diastole is usually quiet
- ventricles resistant to filling which causes vibration and an extra sounds to occur
immediately after S2
- loudest at the apex
- usually hear this in patients with heart failure or when mitral or aortic valve isn't
working properly
- sounds like a galloping horse
what are the fourth heart sounds?
- S4
- occurs at the end of diastole, closer to S1 than the S2
- ventricles cause vibration
- occurs just before S1
- loudest at the apex
- occurs normally after exercise
- sounds like a gallop but slightly different than S3
What is a heart murmur?
soft, blowing, swooshing sound heard over the chest wall. created when conditions
cause turbulent blood flow passing through an artery and conflicting currents. Bruit
across the heart
what is a bruit?
whooshing sound heard over a partially obstructed artery
how do we describe heart sounds?
- frequency and pitch: high or low
- intensity or loudness: loud or soft
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