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R - FoCM (Unknown) > cardiovascular exam > Flashcards

cardiovascular exam Flashcards

1
Q

where are the 4 places used on the cardiovascular exam

A

atrial
pulmonary
tricuspid
mitral

always pay tra…velers money

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2
Q

where can you examine the aortic valve from

A

the upper right sternal border of the right intercostal space

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3
Q

where can you examine the pulmonary valve

A

upper left sternal border at the level of the 2nd left intercostal space

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4
Q

where can you examine the tricuspid valve

A

lower left sternal angle of the left 4th intercostal space

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5
Q

where can you examine the mitral valve

A

over the apex beat point - 5th left intercostal space along the mid-clavicular line

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6
Q

where do you find the carotid pulse

A

in the neck, medial to the sternocleidomastoid muscle

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7
Q

where do you find the brachial pulse

A

2cm above the elbow joint - medially, beside/ underneath biceps tendon

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8
Q

where do you find the radial pulse

A

proximal to the wrist joint, on the radial side

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9
Q

where do you find the femoral pulse

A

half way between the hip and mid way in the crease in the leg and push in (and a bit up)

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10
Q

where do you find the popliteal pulse

A

behind knee join, halve them bend knee, once in position ask to take their legs weight

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11
Q

where do you find the posterior tibial pulse

A

inside of the leg, behind the ankle joint

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12
Q

where do you find the dorsalis pedis pulse

A

on the bone 3cm (ish) up between the big and 2nd toe

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13
Q

how is rate calculated

A

15 seconds multiply

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14
Q

how can be rhythm described

A

regular, regularly-irregular, irregularly-irregular

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15
Q

what can the volume of the radial pulse be described as

A

normal, bounding, full, thread, low volume

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16
Q

what are you looking for on the hands and arms of a patient in the cardiovascular exam

A 
tar staining 
warm and sweaty hands 
peripheral cyanosis 
clubbing 
splinter haemorrhages 
capillary refill 
fine tremor
iv tract marks
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17
Q

what should you be looking for when examining the head in the cardiovascular exam

A

malar flush

anaemia - lower eyelids

look for sings of xanthelasmata

corneal arcus

look for central syanosis

iron deficiency - angular sotmatits

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18
Q

what should you look for on the lower leg examination of the cardiovascular exam

A

pitting odema

atrial disease

varicose veind

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19
Q

what should you be looking for when examining the head in the cardiovascular exam

A

malar flush

anaemia - lower eyelids

look for sings of xanthelasmata

corneal arcus

look for central cyanosis

iron deficiency - angular stomatitis

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20
Q

what is xanthelasmata

A

sharply demarcated yellowish deposit of cholesterol underneath the skin - linked to atherosclerosis

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21
Q

what is corneal arcus

A

where white arcs appear on the cornea (coloured part of eye) makes the bored look fuzzy

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22
Q

what is angular stomatitis

A

erythema and maceration (redness and broken skin) of the skin adjacent to the angle of the mouth.

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23
Q

what should you look for on the lower leg examination of the cardiovascular exam

A

pitting oedema

atrial disease

varicose veins

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24
Q

how do you examine for pitting oedema

A

inside of the leg - couple of inches above the ankle

firm pressure with thumb - for 15 seconds

should leave indentation

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25
Q

what are you looking for to suggest atrial disease

A

cold, smooth, hairless skin

with increased capillary refill time in the toe, and arterial leg ulcers

26
Q

how do you examine for varicose veins in the legs

A

ask the patient to stand and look on both the front and back of legs

27
Q

what is the normal range for JVP

A

under 4cm

28
Q

what does JVP stand for

A

jugular venous pulse

29
Q

how is JVP measured

A

vertical height of the flickering column from the sternal angle

30
Q

what must be done when looking for the JVP

A

the patient must be at 45 degrees

when palpated you should not feel a pulse (making sure its not the carotid)

relaxes their head and leans it to their left

31
Q

where is the JVP located

A

it lies between the sternal and clavicular heads of the sternocleidomastoid muscle

32
Q

what is the best way to see the JVP

A

from a lateral angle - even from a bit behind the patient

33
Q

what are you doing in the inspection of the precordium (front of chest) in the cardiovascular exam)

A

inspectiong palpating and ascultating

34
Q

what are you looking for on inspection of the precordium

A

any chest deformities - kyphoscoliosis or pectus excavatum

any scars

any pace maker - left infra-clavicular area

visible pulsation

35
Q

what are you examining on palpation

A

trackeal position

cardiac pacemaker

apex beat

heaves

thrills

36
Q

what are you examining on palpation

A

tracheal position

cardiac pacemaker

apex beat

heaves

thrills

37
Q

what is the apex beat

A

the most lateral and inferior palpable pulsation

38
Q

what are heaves

A

when the hand is easily lifted with the chest

39
Q

what are thrills

A

a palpable buzz - usually a systolic murmur

40
Q

how do you examine for heaves

A

press flat hand firmly on to the left side of the sternum

41
Q

how do you examine for thrills

A

place hand on apex beat and both sides of the sternum

42
Q

what are the 3 parts to auscultation during the cardiovascular exam

A

listen to all 4 valve areas (diaphragm and bell0

listen for left side systolic murmurs

listen for left side diastolic murmurs

43
Q

what is the S1 sounds

A

mitral and tricuspid valve closure (onset of systole)

44
Q

what are the S2 sounds

A

aortic and pulmonary valve closes (onset of diastole)

45
Q

when are 3rd heart sounds heard

A

heard in diastole

46
Q

when are 4th heart sounds heard

A

less common and occurs just before S1

47
Q

when should you listen for murmurs

A

listen between S1 and S2 (systolic)

listen between S2 and S1 (diastolic)

48
Q

what are the 4 valve areas

A

atrial
pulmonary
tricuspid
mitral

49
Q

what should you do when auscultating the 4 valve areas

A

palpate the carotid pulse - pulses at the same time as S1

50
Q

what to things are you listening for when looking for left side systolic murmurs

A

aortic stenosis

mitral regurgitation

51
Q

how do you examine for aortic stenosis

A

DIAPHRAGM

listen over aortic valve again, then over both carotid arteries

for murmur and high pitched injection (systolic between S1 and S2)

52
Q

how do you examine for mitral regurgitation

A

DIAPHRGM

listen again over the apex beat and then the left axilla for pansystolic murmur

53
Q

when/ how do you auscultate for bruits

A

when preforming the pheriferal pulsese

asculcultate with diaphragm over femoral and carotid

54
Q

what are bruits

A

the wooshing sound that is made whn blood rushes past a obstruction

55
Q

how do you measure radial femoral delay

A

take both the femoral and radial pulse and feel for delay - there shouldn’t be one

56
Q

how do you check for a collapsing pulse

A

find radial pulse

ask patient if they have any pain in their arm or shoulder

raise arm above head while taking pulse

57
Q

what is a pansystolic murmur

A

a murmur that last through both systole and diastole

58
Q

what are the two things examined when listening for left side diastolic murmurs

A

mitral stenosis

aortic regurgitation

59
Q

how do you examine for mitral stenosis

A

USING THE BELL

place stethoscope on apex beat - get patient to roll onto left side

and listen while the patient is holding their breath on expiration

60
Q

what would mitral stenosis sound like

A

a low pitched ‘‘rumbling’’ mid-diastolic murmur

61
Q

how would you examine for atrial regurgitation

A

USING THE DIAPHRAGM

ask the patient to sit up, and listen to the lower left sternal edge

while the patient holds their breath on expiration

R - FoCM (Unknown) (10 decks)

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