cardiology

Question 1

what are the 4 corners of the heart?

Answer 1

1cm right 3rd costal cartilage
right 6th costal cartilage
2.5cm left 2nd intercostal space
midclavicular line 5th intercostal space

Question 2

where do you auscultate for heart valves?

Answer 2

aortic valve - right 2nd intercostal space
pulmonary valve - left 2nd intercostal space on sternal border
tricuspid valve - left 5th intercostal space
mitral valve - left 5th intercostal space in midclavicular line

Question 3

which part of the stethoscope do you use for heart valves auscultation?

Answer 3

diaphragm

for mitral valve, start with bell then diaphragm

Question 4

how do you assess radial, ulnar, brachial and carotid pulse?

Answer 4

radial - laterally on wrist
ulnar - medially on wrist
brachial - in cubical fossa, mid arm medially
carotid - anterior to sternocleidomastoid muscle

Question 5

for how long do you measure pulse rate?

Answer 5

30s in OSPE
times by 2

mention that you will normally measure for 1min

Question 6

what is the normal pulse rate and how do you describe pulse rate?

Answer 6

60-100bpm

normal or irregular

Question 7

how do you palpated apex beat of the heart?

Answer 7

sternal angle -> 5th intercostal space -> lateral to midclavicular line -> move medially

palm of hand
3 fingers with middle finger along intercostal space

Question 8

where are the sites for venepuncture?

Answer 8

median cubical vein

antebrachial vein

Question 9

what are the borders of cubical fossa?

Answer 9

brachioradialis
pronator teres
imaginary line between 2 epicondyles

Question 10

what structures are within cubical fossa?

Answer 10

radial nerve (lateral)
biceps brachial tendon
median cubical vein
brachial artery
median nerve (medial)

Question 11

what are the surface markings of aortic arch?

Answer 11

right 2nd costal cartilage -> midway between jugular notch and sternal angle -> left 2nd costal cartilage

Question 12

where are the internal jugular vein and common carotid artery (left and right)?

Answer 12

identify where sternocleidomastoid muscle is by turning head
anterior border, under muscle

right common carotid artery - join sternoclavicular joint and right earlobe
left common carotid artery - join sternal angle and left earlobe

internal jugular vein - join sternoclavicular joint and earlobe
lateral to artery

Question 13

what are the main coronary vessels?

Answer 13

left coronary artery -> circumflex artery -> atrium, left posterior lateral ventricle
-> left anterior descending artery -> left anterior ventricle, anterior interventricular septum
right coronary artery -> marginal artery -> right ventricle
-> right posterior descending artery -> posterior third interventricular septum

coronary sinus