Cardiovascular Assessment Flashcards
Cardiovascular Inspection Topics
- Hands/Feet
- Capillary Refill
- Face
- Thorax/Precordium
- JVP
- Legs
JVP Assessment
- pt should be at a 45° with head tilted to the left
- measure from the bottom of the clavicle to the small pulsation(not sick so won’t see)
- normal 4-6cm
- decreased = hypovolaemia
- RVF or leaky valve
Legs Inspection
- oedema (HF, venous disease)
- think sacral oedema if bed bound/immobile
- signs of peripheral vascular disease
Thorax/Precordium
- Observe for shape and symmetry
- scarring?
- kyohosis or scoliosis
- pectus excavatum/carinatum
- rashes, swelling, redness, bruising
- deformities or masses
- medication or fitted devices
- visible pulsations
Face Inspection
- General colour and appearance
- malaria flush.= valve problem
- Pink conjunctiva? Pale = anaemia
- mucous membrane should be oink
- Central cyanosis?
- xanthelasma = cholestral buildup
- graves disease = Assoc with AF
Inspection Hands/Feet
- colour of hands?
- warm to touch, clammy
- peripheral cyanosis? = hypoxia
- splinter haemmorhage? = endocarditis
- marfans syndorome = increased risk of aneurysms
- oslers nodes/Janeway lesions (oslers=ouch) = endocarditis
- signs of ranauds
- nicotine staining?
Palpation Topics Cardio
- Palpate the pulses for rhythm, rate, strength ext
- Palpate the precordium
Palpating the Pulses
- palate the radial, carotid and pedal
- palate both radials for differences = artery stenosis
- palate radial and carotid together for differences = aortic problem
- check rate for full minute
- feel for regularity, strength and rate
Palpation of the Precordium
- feel for heaves and thrills with hand
Heaves = forceful ventricular contraction - push against hand
Thrills = palpable heart murmur - cat purring - murmurs are caused by turbulent flow. Can be systolic, diastolic or continous
- systolic - between S1 and S2
- diastolic - between S2 and S1
Auscultation Topics
- Bruits
- Pulmonary Uascultation
- Discern Sounds
Pulmonary Auscultation Assessment
- auscultate the lungs normally but especially at bases
Bilateral fluids = HF
Unilateral fluids = pneumonia
Heart Sounds Meaning (Discerning Sounds)
S1 = beginning of ventricular systolic - closing of mitral and tricuspid valves (LUB)
S2 = end of ventricular systolic - closing of aortic and pulmonary valve (DUB)
S3 = low pitches. Rapid ventricular filling phase during early systole (only heard with Bell after S2, normal in >30, pregnant women, post MI)
S4 = low pitched. Occurs during atrial ‘kick’ phase of ventricular filling. Heard before S1 with Bell. Caused by atrial contraction, cases of hypertrophy, HTN. Always pathological
Bruit Auscultation
- indicates blood flowing through a narrowed artery that could be blocked
- Auscultate aorta, just above umbilicus
- Auscultate carotid on both sides. Carotid massage ca be use in SVT but plaque can break off causing stroke
