cardiovascular exam

Question 1

face, eyes and mouth

Answer 1

-Pallor
-Flushes on cheek
-Yellow cholesterol deposits in eyes
-Look up and retract lower eyelid- signs of anaemia if pale
-Patient lifts up tongue (central cyanosis- due to hypoxia)
-Look for dental hygiene
-Xanthomata (fats build up under the surface of the skin)
-Diabetic retinopathy

Question 2

hands

Answer 2

-Examine patient’s hands
-Inspect finger nails for splinter haemorrhages (lay parallel to long axis of nail- signs of trauma) and clubbing (tips of the fingers enlarge and the nails become extremely curved)
-Skin temperature
-Tremours

Question 3

radial pulse

Answer 3

-Palpate radial pulse (just below styloid processes)
-Assess the rate, rhythm and character of pulse
-Establish bpm (60-100)
-Rhythm: atrial fibrillation (irregularly irregular), slow- rising pulse (delayed up stroke), jerky pulse (hypertrophic cardiomyopathy)
-Compare radial pulse to carotid pulse (medial to mandible), femoral pulse (groin), popliteal pulse (knee), dorsalis pedis pulse (midfoot) and posterior tibial pulse (ankle)

Question 4

precordium

Answer 4

(space in thorax in front of heart)
-Inspect for scars and pacemaker sites
-Palpate apex beat, heaves and thrills (A thrill is a palpable murmur whereas a heave can be a sign of right ventricular hypertrophy)
-Auscultate the 4 valves for heart sounds, added sounds and murmurs
-Mitral (5th/6th rib, mid clavicular line)
-Tricuspid (medial to sternum from mitral valve)
-Aortic (2nd/ 3rd ribs, near sternum on right side)
-Pulmonary valve (2nd intercostal space near sternum)
-My tits are perfect

Question 5

blood pressure

Answer 5

Normal= 120/80
Pre= 135/85
High= 140/90
Use sphygmomanometer to measure patients arterial blood pressure
-Wrap cuff around patients arm- tight enough for 2 fingers to fit under
-Inflate cuff until radial pulse can’t be detected
-Release slowly
-Reflate cuff to 30mmHg above systolic blood pressure and deflate slowly till a sound is heard in stethoscope in artery
-Continue to deflate till sounds disappear (diastolic blood pressure)

Question 6

jugular venous pressure

Answer 6

neck 45 degrees and rotate neck. look for pressure. 3cm or less is okay
near sternal/ clavicular heads

Question 7

exmplanations

Answer 7

valves= help us appreciate structure and functionality on them
radial pulse= screening tool for presence of cardiac arrhythmias
blood pressure= have a clear picture of risk for heart disease and stroke
jugular venous pressure= reflects elevated pulmonary capillary wedge pressure from left heart failure