Cardiac Surface Anatomy and Heart Ausculatation Flashcards
List the superficial landmarks for the boundaries of the heart
- 2nd L rib
- 3rd R rib
- 6th R rib
- 5th intercostal space at the midclavicular line
superficial landmark for the base of the heart
2nd intercostal space
superficial landmark for the apex of the heart?
projects into the 5th intercostal space at the level of the midclavicular line
superficial landmark for the pulmonary valve
upper level of 3rd L costal cartilage
superficial landmark for the aortic valve
at the level of 3rd costal cartilage, medial and below the pulmonary valve
superficial landmark of the mitral valve (left AV valve)
4th costal cartilage
superficial landmark of the tricuspid valve (right AV valve)
4th costal caritlage on the R side
superficial landmark for the ascending aorta
- beginning at the level of the lower border of the L 3rd costal cartiglage
- up to the R 2nd costal cartilage
- at the sternal angle
it passes obliquely upward, forward and to the right
superficial landmarks for the aortic arch
- behind the lower half of the manubrium
- upper convex border
- marked by a line that begins at the R end of the sternal angle, arches upward and the left through the centre of the manubrium
- ends at the sternal end of the L 2nd costal cartilage
superficial landmarks for the descending thoracic aorta
- descending thoracic aorta is marked by 2 parallel lines 2.5 cm apart
- begins at the sternal end of the L 2nd costal cartialge
- passes downwards and medially
- ends in the medial plane 2.5 cm above transpyloric plane (Addison’s plane)
superficial landmarks for the Superior Vena Cava
- lower border of the R 1st costal cartilage to the upper border of the 3rd R costal cartilage
superficial landmarks of the Inferior Vena Cava
- situated opposite the upper margin of the 6th R costal cartilage about 2 cm from the midsternal line
Auscultation site for the aortic area
2nd IC space close to and to the R of the sternum
Auscultation site for the Pulmonary Area
2nd IC space and the to L of the sternum
Erb’s Point/Murmurs
3rd IC and to the L of the sternum
Auscultation site for the Tricuspid area
4th or 5th IC space and lower L sternal border
Auscultation site for the apex of the heart
5th IC space medial to the mid-clavicular line
Normal Heart sounds
S1 (Lub)
S2 (Dub)
what is the S1 heart sound?
mitral and tricuspid valves closing
(heard best at mitral area and tricuspid area)
What is the S2 heart sound?
Aortic and pulmonic valves closing
(heard best at aortic area but be heard anywhere)
Abnormal heart sounds
3rd and 4th heart sounds
what is the 3rd heart sound?
- a rare extra heart sound that occurs soon after the normal 2 “lub-dub” heart sounds (S1 and S2).
- Associated with HF
- Occurs at the beginning of the middle 3rd of diastole
- this rhythm produces a rhythm classically compared to the cadence of the word “Kentucky” with the final syllable CKY
what is the 4th heart sound?
- a rare extra heart sound that occurs immediately before the normal 2 “lub-dub” heart sounds
- occurs just after atrial contraction and immediately before the systolic S1
- caused by the atria contracting forcefully in an effort to overcome an abnormally stiff or hypertrophic ventricle
- classically compared to the cadence of the word “Tennesse”
- One can also use the phrase “A stiff wall” to help with the cadence
- A = S4
- stiff = S1
- wall = S2
what factors are we taking note of when taking a pt’s pulse?
- Rate
- normal
- tachycardia
- bradycardia
- Character
- bounding
- weak
- Pulse Rhythm
- regular
- irregular
- intermittent
Locations for taking a pulse
- Radial
- Brachial
- Femoral
- Popliteal
- Posterior Tibial/Tibialis Posterior
- Dorsalis Pedis
