Cardio - Peripheral Exam Flashcards
What would we look for in the hands?
Tar staining Warmth - Cool or warm/clammy Colour - Cyanosis or anaemia Clubbing Splinter haemorrhages Capillary refill Fine tremor
What can the warmth of a patient’s hands tell you?
Cool hands may be poor CO e.g. HF or Hypovolemia
Warm sweating hands associated with ACSs
What are signs of clubbing?
- Nail bed angle loss
- Greater pulp of finger tip
- Nailbed fluctuation
What can the colour of the fingers tell you?
Dusky blue - cyanosis
Pale nails - anaemic
How do we test capillary refill?
Press nail bed for 5 seconds
Refill time should be <5 seconds
What do we comment on in the radial pulse?
Rate
Rhythm
Character
Volume
What are the types of Radial pulse rhythm?
Regular
Regularly Irregular - Ectopic beats
Irregularly irregular - AF
How do we describe the volume of a radial pulse?
Normal Bounding Full Thready Low volume
How would we test the character of the radial pulse?
Normal or Slow rising in normal position
Raise arm above head to feel a collapsing or Water-hammer pulse - Rises hard and early then drops off rapidly
What could cause a collapsing pulse?
Fever, Pregnancy, PDA. Thyrotoxicosis etc.
What do you look for in a patient’s face?
Malar Flush - Plum red cheeks Conjunctivae - Pallor/anaemia Xanthelasmata & corneal arcus Central cyanosis -Tongue/lips Angular stomatitis Sore red tongue - Iron deficient anaemia
What is a malar flush indicative of>?
Mitral Stenosis
What would you look for in the chest as part of a peripheral (not precordial) exam?
Crackles at the lung bases
Indicates Left HF
What do you inspect on the abdomen?
- Liver palpation
- Shifting Dullness
What does a tender, enlarged and pulsatile liver tell you?
Cardiac Failure
