Cardiovascular exam Flashcards
What is the large and small part of the stethoscope called?
Diaphragm and bell
What does it mean when they are barrel chested?
COPD
What is the word for pigeon chested?
pectus carinatum
Funnel chest?
pectus excuvatum
What is PMI and what is it used for?
point of maximal impulse
-used to estmate location location of apex
How do you percuss the heart?
-use when PMI is not detectable
start from far left
where resonant and move medially to find cardiac “dullness”
What is systole and diastole?
Ventricular contraction and ejection
-Ventricular relaxation and filling
How do you ascultate the heart?
All Physicians Teach Medicine
- Aortic, Pulmonic, Tricuspid, and mitral valves
- start at right of their sternum and make that “Z” shape
Describe the heart sounds
S1- colsure of tricuspid and mitral valves
S2- closure of Aortic and Pulmonic valves
S3- Dull, low pitch, best heard with bell. Due to high pressures and abrupt deceleration of inflow across the mitral valve at the end of the rapid filling phase (Kent-Tuck-Y)
S4- Dull, low pitch, use bell… Atrial gallop from forceful contraction of atria against a stiffened ventricle. can be normal in trained atheletes (Ten-Nes-See)
What are the different types of heart murmurs and how do we document them?
-Systolic murmur fall between S1 and S2
-Diastolic murmurs fall between S2 and S1
-Grades:
1 is very faint
2 quiet, but head easily with steth
3 moderately loud
4 loud with palpable thrill
5 Very loud w/ thrill- may be heard with stethoscope partly off chest
6 Heard with stethoscope entirely off the chest
How do we assess the carotid pulse?
Medial to the Sternocleidomastoid. Asssess for thrill and bruits.
*DO NOT assess both carotid pulses simultaneously! Pressure on the Carotid baroreceptors may cause a hypotensive reflex and possible fainting
What are all of the peripheral pulses?
Radial Brachial Femoral Popliteal Dorsalis Pedis Posterior Tibial
How do we grade the peripheral Pulses?
on a scale of 0-4
-2 is normal
What is the capillary refill?
Test of digital perfusion
- Apply pressure to the finger/toe nail for several seconds, let go, and note the time it takes for the color to return
- Normally, it should be 2 seconds or less
How do we examine for edema?
-examined by pressing firmly for 5 seconds over the dorsum of the foot, anterior tibia, or behind medial malleolus
