Cardiac

Question 1

THE NECK
Assessment

Answer 1

1. Auscultation Carotid artery
   - jaw line
   - mid clavicular
   - base of neck
   - bell of stethoscope
   - bruits, trubulent blood flow, occlusion artery >1/2
2. Palpation carotid artery
   - one side at a time
3. Jugular venous pressure
   - ruler in the sternal notch
   - tangential light
   - turn patient head away
   - straight edge where pulse disappears

Question 2

THE PERICORDIUM
Assessment

Answer 2

1. Inspection
   - Inspection lifts, heaves
   - inspection apcial pulse (5th ICS, MCL)
2. Palpation
   - thrills
   - Palpation apical pulse
3. Aucultation
   - Z pattern
   - diaphragm then bell
   - lying down, L side, sitting up (exhale and hold)
   - R sternal boarder, 2 ICS : aortic
   - L sternal boarder, 2 ICS: pulmonic
   - L sternal boarder, 5th ICS: tricuspid
   - 5th ICS, MCL: mitral

L side lying
- sometimes the only position you hear the S3, S4, or murmurs

Question 3

PERIPHERAL VASCULAR SYSTEM
Assessment

Answer 3

Upper and then lower body

1. INtegumentary system
   - skin, nails, hair
2. Temperature, turgor, texture
3. CRT, Pulses, Edema (grading)
   - CRT < 3 seconds
   - pulses 2+ (Radial, brachial, dorsal pedalis, posterior tibialis, popliteal, femoral)
   - no edema

Question 4

Special test
Arterial insufficiency

Answer 4

Patients legs up 45 degrees
drain blood
sit up
monitor how fast blood returns