2.1.2 Normal Heart Exam Flashcards
What is different between arteries and veins upon palpation?
Arteries will palpate and veins will not
Where is the mitral area?
Left side of patient 5th intercostal space between the mid clavicular line and the anterior axillary line
Following palpation, sustained precordial movements may indicate what?
Aortic stenosis, Volume overload, Severe cardiomyopathy, Ventricular aneurysm
What are the characteristics of mitral regurgitation murmur?
Holosystolic murmur that is best heard at the apex of the heart. It also radiates to the axilla.
Where is a mitral regurgitation murmur going to be heard best?
In the mitral area at the apex
What do you do?
This patient has mitral valve stenosis
What is the proper positioning for a cardiac exam?
The patient should be 30 degrees from horizontal and the physician should be on the patients right side
Where is an aortic stenosis murmur going to be heard best?
In the aortic area - second intercostal area on right side of chest
Where is a venous hum murmur going to be heard best?
About the head of the clavicle
What type of murmurs may radiate to the carotid?
Aortic Valve murmurs
Where is the tricuspid area?
Left side of patient fifth intercostal space between the sternum and mid clavicular line
What are you looking for when you auscultate the carotid arteries?
Carotid bruits, which are a sign of turbulent flow due to stenosis
What are the main peripheral pulses in the lower extremities?
Femoral - groin area, Dorsalis Pedis, Posterior Tibial - Ankle area
What are some special maneuvers to decrease venous return?
Valsalva Squatting to standing Increases outflow tract murmurs
What is occurring at S1?
Beginning of systole - closing of the mitral and tricuspid valves
What is a venous hum murmur?
It is continuous murmur through systole and diastole. It is associated with high flow states - pregnancy, anemia and pediatric age
What are the characteristics of mitral stenosis murmur?
Mid - diastolic murmur that is low pitched so use the bell of the stethoscope.
What are the 7 categories when characterizing a heart murmur?
Timing - systolic/diastolic, early/middle/late
Location of maximum intensity
Shape
Grade - 1 to 6
Radiation
Pitch - high/medium/low
Quality - blowing/harsh/rumbling/musical
What is the sound when percussing the heart?
It should sound dull (lecturer wasn’t too fond of percussion in a cardiac exam)
Where is a mitral stenosis murmur going to be heard best?
In the mitral area at the apex
What is the location of the pulmonic area?
Left side of patient second intercostal space between the sternum and mid clavicular line
What are the main peripheral pulses in the upper extremities?
Radial and brachial
What is an S3 sound?
Abnormal early diastolic “filling” sound Ventricular gallop - apex with the bell Heart failure
What is edema?
Swelling that persists after pressure is released
