NURS 2715 Study Guide - Fall 2018, Comprehensive Midterm Notes - Muscle, Central Nervous System, Urinary Incontinence
NURS 2715
MIDTERM EXAM
STUDY GUIDE
Fall 2018
Clinical Integration I Readings
Week 5
The cardiovascular system consists of the heart and the central blood vessels (primarily the
pulmonary, coronary, and neck arteries and veins. The peripheral vascular system includes
those arteries and veins distal to the central vessels, extending all the way to the bran and
to the extremities.
The heart is assessed through inspection, palpation, and auscultation, in that sequence.
In the average adult, most of the heart lies behind and left of the sternum. A small portion
(the right atrium) extends to the right of the sternum. The upper portion of the heart (both
atria), referred to as its base, lies posteriorly. The lower portion (the ventricles), referred
to as its apex, points anteriorly. The point where the apex touches the anterior chest wall
(near fifth left intercostal space) is known as the point of maximal impulse (PMI). The
point of maximal impulse refers to the point at which the apical impulse is most readily
seen or felt.
The pericardium, the area of the chest overlying the heart, is inspected and palpated
simultaneously for the presence of abnormal pulsations or lifts of heaves. The terms lift
and heave, often used interchangeably, refer to a rising along the sternal border with each
heartbeat.
Heart sounds can be heard by auscultation. The normal first two heart sounds are
produced by closure of the valves of the heart. The first heart sound S1, occurs when the
atrioventricular (A-V) valves close and is best heard in the apex. After the ventricles empty
their blood into the aorta and pulmonary arteries, the semilunar valves close, producing
the second heart sound, S2, described as dub. S has a higher pitch than S and is also
shorter. The S2 is best heard in the aortic and pulmonic areas.
Associated with these sounds is systole and diastole. Systole is the period in which the
ventricles contract. It begins with the first heart sound and ends at the second heart sound.
Systole is normally shorter than diastole. Diastole is the period in which the ventricles
relax. It starts with the second sound and ends at the subsequent first sound.
The carotid arteries supply oxygenated blood to the head and neck.
A bruit (a blowing or swishing sound), best heard with the diaphragm of the stethoscope,
is created by turbulence of blood flow created by either a narrowed arterial lumen (a
common development in older people) or to a condition, such as anemia or
hyperthyroidism that elevates cardiac output.
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A thrill, which frequently accompanies a bruit, is a vibrating sensation, similar to the
purring of a cat or water running through a hose. It, too, indicates turbulent blood flow
because of arterial obstruction.
The jugular veins drain blood from the head and neck and directly into the superior vena
cava and right side of the heart.
Perfusion - blood supply to an area
Body Temperature
Body Temperature reflects the balance between the heat produces and the heat lost from
the body. The body has two temperatures: the core temperature and the surface
temperature.
Core temperature is the temperature of the deep tissues of the body, such as the cranium,
thorax, abdominal cavity, and pelvic cavity.
Surface temperature is the temperature of the skin, subcutaneous tissue, and fat. It, in
contrast to core temperature, fluctuates in response to the environment and is much less
invasive to measure.
The normal core body temperature of an adult is variable and generally ranges between
36.7-37 degrees Celsius. Measured orally, the normal range is 36.5-37.5.
When the amount of heat produced by the body exactly equals the amount of heat lost, the
person is said to be in heat balance.
Heat is lost from the body through radiation, conduction, convention, and vaporization.
Radiation is the transfer of heath from the surface of one object to the surface of another
without contact between the 2 objects, mostly in the form of infrared rays.
Conduction is the transfer of heat from one molecule to a molecule of lower temperature.
Conductive transfer cannot take place without contact.
Convection is the dispersion of heat by air currents. (Use of fans)
Evaporation is continuous vaporization of moisture from the respiratory tract, from the
mucosa of the mouth, and from skin. This continuous and unnoticed water loss is called
insensible water loss, and the accompanying heat loss is called insensible heat loss.
The hypothalamic integrator, the centre that controls the core temperature, is located in
the anterior region of the hypothalamus.
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Document Summary
The cardiovascular system consists of the heart and the central blood vessels (primarily the pulmonary, coronary, and neck arteries and veins. The peripheral vascular system includes those arteries and veins distal to the central vessels, extending all the way to the bran and to the extremities. The heart is assessed through inspection, palpation, and auscultation, in that sequence. In the average adult, most of the heart lies behind and left of the sternum. A small portion (the right atrium) extends to the right of the sternum. The upper portion of the heart (both atria), referred to as its base, lies posteriorly. The lower portion (the ventricles), referred to as its apex, points anteriorly. The point where the apex touches the anterior chest wall (near fifth left intercostal space) is known as the point of maximal impulse (pmi). The point of maximal impulse refers to the point at which the apical impulse is most readily seen or felt.
