Download Ch16 Summary

Ch16 Summary
The uppermost portion of the heart is known as the base. The base of the heart contains
the left and right atria, the aorta, the pulmonary arteries, and the superior and inferior
vena cavae. The apex is the lower portion of the heart and contains the ventricles. The
pericardium is the sac that covers the heart. The parietal layer lies close to the fibrous
tissues, and the visceral layer lies against the heart. There are two atrioventricular valves
(tricuspid and mitral) and two semilunar valves (aortic and pulmonic). The tricuspid
valve is located between the right atrium and the right ventricle. The mitral valve is
located between the left atrium and the left ventricle. The aortic valve lies between the
left ventricle and the aorta, whereas the pulmonic valve lies between the right ventricle
and the pulmonary artery.
The coronary arteries supply blood to the myocardium. The left main coronary
artery branches into the left circumflex and left anterior descending coronary arteries.
The left circumflex artery supplies blood to the left atrium and portions of the left
ventricle. The left anterior descending artery supplies blood to the anterior wall, a portion
of the left ventricle, and the interventricular septum. The right coronary artery supplies
blood to the right atrium, right ventricle, and inferior wall of the left ventricle.
The cardiac cycle consists of systole and diastole. During systole, the ventricles
contract and force blood to either the pulmonary or the systemic vasculature. The
ventricles fill during diastole. Atrial kick occurs during the final phase of diastole, when
the atria contract and force the remaining blood volume into the ventricles. The
electrocardiogram records the electrical activity of the heart. The S-A node is the normal
pacemaker of the heart; it initiates impulses at the rate of 60 to 100 per minute. The A-V
node is the back-up pacemaker of the heart; it initiates impulses if the S-A node fails to
deliver an impulse. Normally, the cardiac impulse initiates in the S-A node, which travels
to the A-V node, down the right and left bundle branches, and to the Purkinje fibers.
Common chief complaints of the cardiovascular system include chest pain,
syncope, palpitations, peripheral edema, and claudication. Common medications that
individuals with cardiovascular disease may take include antianginals, anticoagulants,
antihypertensives, antilipemics, diuretics, inotropics, and thrombolytics. It is important to
assess for these common chief complaints and to determine whether the patient is using
any of these medications.
The American Heart Association recommends the heart smart diet for most
Americans. The guidelines for the heart smart diet include a total fat intake of <30%
(<10% from saturated fat, <10% from polyunsaturated fat, 10% to 15% from
monounsaturated fat); total carbohydrate intake of 55% to 60%; total protein intake of
10% to 15%; total cholesterol intake of <300 mg/day; and total sodium intake of <2400
mg/day.
Assessment of the heart includes inspection and palpation of the aortic, pulmonic,
midprecordial, tricuspid, and mitral areas. You will assess for the presence of pulsations,
thrills, or heaves. Auscultate each area for heart sounds and for the presence of a murmur
or a gallop.
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