Cardio-respiratory examination

Question 1

How can you find a raised JVP?

Answer 1

• Patient lays at 45 degree
  angle
• Turn head to left
• Can see flutter under SCM
• Angle of sternum
• Measure vertically
• Measure horizontally from top
  of JVP to sternal angle
• Raised JVP = more than 3cm

Question 2

What does JACCOL stand for?

Answer 2

Jaundice
Anaemia
Clubbing
Cyanosis
Oedema
Lymphadenopathy

Question 3

What is tactile fremitus?

Answer 3

Its palpation of the chest wall to detect changes in the intensity of vibrations created with certain spoken words in a constant tone and voice indicating underlying lung pathology

Question 4

How do you do the tactile fremitus test?

Answer 4

Place hands bilaterally on chest

Ask pt to say 99 at normal conversation level
Do this posterior and anterior

Question 5

What does increased vibrations for tactile fremitus indicate?

Answer 5

Consolidation eg:pneumonia

Question 6

What does decreased vibration for tactile fremitus indicate?

Answer 6

Presence of fluid or air outside lung - pneumothorax

Question 7

What and where is the apex beat?

Answer 7

Point of maximal impulse
5th intercostal space

Question 8

What is the HEAVES test?

Answer 8

A test to see if the pt has right ventricular hypertrophy.

Question 9

How is the HEAVES test carried out?

Answer 9

• Use palm of hand in same area of
  apical beat
• Lateral to sternum – hand vertical
• Feel for your hand being lifted with
  each systole