Cardio OSCE Flashcards
bullet points on what to include in a cardio exam. Findings and managements. to be completed in order.
what should you do at the start?
wash hands, introduce self, identify patient, gain consent
what is the general inspection showing?
patient at rest, comfortable?
medications around bed, monitors etc.
what is being found in the hands of the patient
clubbing, tar staining, janeway lesions and oslers nodes, splinter haemorrhages, tendon xanthomas, peripheral cyanosis, sweating hands, temperature
how to check the radial pulse
check both simultaneously
assess rate and rhythm in RHS
which pulses do you check
radial, brachial, carotid.
how to check for collapsing pulse
feel radial and brachial pulse. check no pain in arm, raise it quickly
what do you do with carotid pulse
assess character and volume (both sides, one side at a time)
moving on to the face what are you assessing for in the eyes?
subconjuctival pallor, corneal arcus, xanthelasmata
cardiac signs in the face
malar flush (mitral stenosis)
cardiac signs in the mouth
central cyanosis, high arched palate, dental caries
how to assess JVP
sit pt at 45deg, normal is 2-4cm from sternal angle. low JVP can be assessed using the hepatojugular reflex. high JVP is assessed by sitting pt upright and looking near ear lobes for venous pulsation.
what does palpation involve
assess apex beat, heaves, thrills
what does a thrill show
palpable murmur
what does auscultation involve
aortic, pulmonary, tricuspid and mitral areaswhe
when should you palpate carotid to time with first and second heart sound
if extra sounds are heard- tells you if its S0 or s3. start of pulse= s1
