Cardiovascular Flashcards
What are the key assessments for the cardiovascular system?
Assess the jugular venous pressure and pulsation, assess the carotid upstroke, palpate heaves, lifts, thrills and the point of maximal impulse (PMI), auscultate heart sounds and murmurs in 6 positions on the chest wall, identify S1 and S2, distinguish from diastole, identify extra sounds such as S3 and S4, and correctly identify valvular murmurs such as mitral and aortic.
What does the jugular venous pressure reflect?
It reflects pressure in the right atrium (central venous pressure) and provides information about volume and cardiac function.
How can you identify the internal jugular venous pulsation?
It has a soft undulating pulsation, usually with 3 elevations per heartbeat, is rarely palpable, and the level falls during inspiration.
What characterizes the carotid pulse?
It shows a vigorous thrust, is always palpable, unchanged by positions, and not affected by inspiration.
What information does the carotid pulse provide?
It provides information about valvular heart disease and detecting aortic stenosis or aortic insufficiency.
What should be assessed when palpating the carotid artery?
Assess the amplitude and contour of the carotid upstroke, auscultate for bruits from turbulent blood flow, and compare both right and left carotid arteries.
What does the presence of a bruit indicate?
A bruit may suggest atherosclerotic narrowing and is common in middle-aged or older adults or if cerebrovascular disease is suspected.
What should you observe during the inspection of the heart?
Observe for heaves or lifts and identify the location of the apical impulse.
What does a diffuse apical impulse suggest?
It suggests left ventricular dilatation, often found in heart failure.
What indicates left ventricular hypertrophy?
A sustained tapping impulse found in hypertension and aortic stenosis.
What vital signs should be assessed in the cardiovascular examination?
Blood pressure, pulse (carotid and radial), breathing rate, and temperature.
What are practical tips for assessing pulse?
Count pulse rate when the patient is at rest, use finger pads to palpate, compare bilaterally, ensure the patient does not smoke or drink coffee, and refer to GP if pulse rate is <50 BPM (non-athlete) or >120 BPM (resting).
What is the normal respiratory rate?
Normal is 12-20 BPM, rapid (tachypnea) is >28 BPM, and slow (bradypnea) is <10 BPM.
What should be considered when assessing temperature?
Use the right or left posterior sublingual pocket, consider mouth breathers may have lower temperatures, and elevated temperatures may require a referral to a GP.
What should you examine in the patient’s hands?
Look for peripheral cyanosis, clubbing, and capillary refill.
What should you examine in the patient’s arms?
Look for track marks indicating IV drug use and possible heart valve infection.
What should you examine in the patient’s head and face?
Check lips, gums, and oral mucosa for central cyanosis.
What should you look for in the lower limbs?
Examine for the presence of pitting edema.
What is assessed during palpation of the anterior chest wall?
Palpate thorax, suprasternal notch, clavicle, trachea, first rib, ribs 2-10, manubrium, sternum body, xiphoid process, costal chondral cartilages, pec major and minor, SCM, and intercostal muscles.
What is assessed during auscultation?
Assess heart sounds such as bruits and murmurs, including thrills (palpable vibration caused by turbulent blood flow), murmurs (thickening of the aortic valve), and bruits (audible sound associated with turbulent blood flow).
