Cardio Exam

Question 1

What to inspect in heart exam?

Answer 1

• Inspect chest wall for pulsations, lifts, heaves,

- Inspect for cyonosis cap refill

Question 2

What to palpate on heart exam?

Answer 2

• base of heart
• L and R sternal border
• Apex
• epigastrium
• point of maximal impulse of the apex
• need more to list the rest

Question 3

Land marks for apical pulse?

Answer 3

Mid clavicle, 5th inter-coastal space

Question 4

Do we percuss the heart?

Answer 4

No

Question 5

Auscultation of the heart includes?

Answer 5

• rate, rhythm, duration of cycle, timing, intensity, frequency, splitting or murmurs, and quality.
• isolate each sound
• auscultation of carotid arteries for bruits or murmurs
• percardial friction rub ( can be easily mistaken for cardiac-generated sounds)

Question 6

Positions for listening to heart?

Answer 6

• left lateral recumbent
• supine
• sitting

Question 7

Ascultation technique

Answer 7

• aortic valve (second right intercostal space)
• pulmonic (2nd-3rd left intercostal)
• mitral valve (
• tricuspid (4th left intercostal)
• ## 5th left intercostal space

Question 8

Basic heart sounds?

Answer 8

• S1/S2- most distinct

    - S1 is the closure of the mitral/tricuspid valve
    - S2- is the closure of aortic/ pulmonic valve 

-S3/S4- hard to hear- not good- pt over 40 YO

    - S3 hear early diastole 
    - S4 hear late diastole

Question 9

Normal heart rate per TG?

Answer 9

60-90

Question 10

How to describe a murmur?

Answer 10

• grade scheme 1-6
• pattern- crescendo/decrescendo
• Mitral snaps