The semi lunar valves separate the ventricles from the arteries. The atrioventricular valves separate the atria andventricles. The septum separates the right atria from the left atria. The vena Cava is not separated by a valve from the right atrium; the pulmonary veins are not separated by a valve from the left atrium. Jugular venous pressure is a reflection of the heart's ability to pump blood. If the pressure is elevate, heart failure is Suspected.During pregnancy the blood volume increases by 30 to 40%; this creates an increase in stroke volume and cardiac output and an increased pulse rate of 10 to 15 beats per minute. The arterial blood pressure decreases in pregnancy as a result of peripheral Vasodilatation. S1 coincides with the carotid artery pulse.When auscultating the heart of a newborn, you should expect to hear a continuous sound that mimics the sound of a machine, which is due to nonclosure of the ductus arteriosus. This sound should change to the familiar lub dup within 10-15 hours after birth, but may take up to 48 hours. An exaggerated splitting of the S1 and increased loudness of the S1 is commonly associated with the pregnant woman. The presence of an S4 would be expected finding when performing a cardiac assessment on this 86 year old patient, as this extra heart sound often occurs in older people who have no known cardiac disease. Systolic murmurs are common in over 50% of aging adults.The top of the heart is the broader part termed the base. There are no valves between the right atrium and both the superior and inferior vena cava. In addition, there are no valves between the pulmonary veins and the left atrium.A diastolic murmur always indicates heart disease.During inspiration, intrathoracic pressure is decreased. This pushes more blood into the vena cava, increasing venous return to the right side of the heart, which increases right ventricular stroke volume. The increased volume prolongs right ventricular systole and delays pulmonic valve closure. Peripheral vasodilation in pregnancy causes a decrease in arterial blood pressure despite the increased cardiac output associated with this condition. Blood volume increases by 30-40% during pregnancy.
Paroxysmal nocturnal dyspnea (PND) occurs with heart failure. Lying down increases volume of intrathoracic blood, and the weakened heart cannot accommadate the increased load. Classically, the person awakens after two hours of sleep with the perception of needing fresh air. Left ventricular dilatation (volume overload) displaces the impulse down and to the left, and increases size more than one space. S1 coicides with the carotid artery pulse. Feel the carotid gently as you auscultate at the apex; the sound you hear as you feel each pulse is S1. S1 coicides with the R wave.
- Fall '18