Cardiac Examination

Question 1

CARDIO Introduction and up to face

Answer 1

Intro, patient ID, explain, consent, pain? Position patient 45 and adjust bed, remove clothing, offer towel

End of bed; fit and well? Oxygen? Sputum pot? Medications? NEWS chart?

Hands; tar staining, warmth, cyanosis, anaemia, clubbing, splinter haemorrhages, cap refill

Arms; fine tremor, track marks,

Radial pulse - rate, rhythm, volume, character and test for collapsing pulse

Head; malar flush of face, conjunctivae pallor/anaemia, xanthelasmata, corneal arcus, lips/tongue central cyanosis, angular stomatitis , sore red

Question 2

CARDIO Leg Inspection to Chest Palpation

Answer 2

Legs; pitting oedema, temp, hair, cap refill, varicose veins

JVP; neck muscles relaxed, head turned slightly to the left

Precordium; chest deformities, scars, pacemaker, visible pulsation

Palpation; tracheal position, pacemaker, apex beat, heaves (left of sternum), thrills (apex and both sides of sternum)

Question 3

Chest auscultation

Answer 3

Listen in all 4 valve areas with diaphragm then bell at same time palpate carotid

Radiation of murmurs; AORTIC STENOSIS aortic area again and then both carotids with diaphragm
MITRAL REGURG apex then left axilla with diaphragm

MITRAL STENOSIS; ask roll onto left side and listen at apex with bell, breath held on expiration

AORTIC REGURG; ask patient sit up leaning forward hold breath expiration, listen lower left sternal edge

Question 4

Peripheral Pulses

Answer 4

Radial
Brachial
Carotid
Femoral (radio femoral delay)
Popliteal
Posterior Tibial
Dorsalis pedis
Auscultate for bruits ; carotid and femoral arteries using diaphragm

Question 5

CARDIO Closure

Answer 5

thank patient, make more comfortable, clean hands