Cardio Flashcards
ECG limbs
Red- R arm
Yellow- L arm
Green- L leg
Black- R leg
Inspection of hands and arms
Tar staining Warmth hands Cyanosis or anaemia Clubbing Splinter haemorrhage Cap refil Fine tremor Pulse- rate, rhythm, volume and character Track marks of arms
Blood pressure
Check sphygmomanometer is at level or heart Select cuff size Squeeze out air Dial at 0 Reconnect tubules Feel for systolic and add 30 Listen and record systolic and diastolic
ECG chest
Red- R sternum Yellow- L sternum Green- 4th intercostal Brown- 5th intercostal almost mid clavic Black- 5th beside apex beat Purple- 4th in axilla (ish)
Mitral stenosis
Roll onto L side and listen at apex with bell
Comms questions- 6
Short of breath Palpitations Chest pain Claudication Varicose Veins Oedema/swelling
Extra tests
Aortic stenosis Mitral Regurgitation Mitral stenosis Aortic regurgitation Listen at bases of lungs for crackles Liver palpation Ascities- shifting dullness
Mitral Regurgitation
Listen over apex then L axilla
Peripheral pulses
Radial Brachial Carotid Femoral Radio- femoral delay Popliteal Posterior tibial Dorsalis pedis Bruits over carotid and femoral
To count rate on ECG
Large squares between each QRS divided by 300
So if 4 large squares- 300 / 4 = 75bpm
Chest/precordium
Examine JVP Kyphoscoliosis Pectus excavatum Scars Pacemaker Visible pulsation
Lower limbs
Pitting oedema Temp Hair distribution Cap refil Ulcers or gangrene Varicose veins
Palpation
Tracheal position
Apex beat
Heaves
Thrills
Head
Malar flush Pallor Signs of anaemia in conjunctivae Central cyanosis of tongue Angular stomatitis Colour of tongue
Aortic stenosis
Over aortic valve area then over both carotid arteries
Aortic regurgitation
Sitting up and leaning forward listen at lower L sternal edge when holding breath on expiration
4 areas of auscultation
Aortic valve - R sternum
Pulmonary valve- L sternum
Tricuspid valve- below pulm in 4th intercostal
Mitral valve- apex beat
Auscultation
Use diaphragm and bell
Listen for S1 and S2
Added sounds
Murmurs
ECG interpretation
ARI BAR Any electrical activity Rate of QRS Is QRS regular or irregular Broad or narrow QRS Any atrial activity Relationship between atrial activity and ventricle
