Cardiovascular Exam Flashcards
What is the position of the patient during the cardiovascular exam?
You will want the patient to be lying on the couch, at a 45 degree angle.
What is the exposure of the patient during the cardiovascular exam?
The patient will need to be exposed from the waist upwards, however if possible you should offer the patient a blanket so they will only be exposed when appropriate, and if relevant patients do not need to remove their bras.
What inspection is there during the cardiovascular exam?
You should perform a general inspection from the end of the bed, in your later years you will be taught more in depth for the signs in the hands, arms and face.
Where may arterial pulses be felt?
Arterial pulses may be felt in any artery that lies near the surface of the body, especially when it can be compressed against bone or any firm structure.
Which fingers should be used to palpate the pulse?
You should use the index and the middle fingers (the ring finger is optional) to palpate the pulse.
Which fingers should not be used to palpate the pulse?
You must not use your thumb or the little finger.
How is the pulse rate assessed?
Usually assessed by palpating right radial pulse and expressed in beats per minute.
How is the rhythm of the pulse assessed?
Usually assessed by palpating right radial pulse.
What can the rhythm of the pulse be?
The rhythm can be regular or irregular.
What is an irregular rhythm due to?
Irregular rhythm is usually due to cardiac problems such as atrial fibrillation or ectopic beats.
How is the character and volume of the pulse assessed?
Usually assessed by palpating the right carotid artery pulse which is closest to the heart than the radial pulse.
How is the symmetry of pulses assessed? [name]
Symmetry – of radial, brachial, femoral, popliteal, and pedal pulses can be assessed by comparing pulses on both sides.
What might be observed between major arteries? are these normal?
Radio-femoral delays between major arteries might observed and are abnormal.
What are the upper limb pulses to palpate in order?
- Radial pulse
- Ulnar pulse
- Brachial pulse
- Common carotid pulse
Where should the radial artery be palpated? location, access, uses
Should palpated at the wrist over the distal end of radius lateral to the tendon of flexor carpi radialis muscle. The radial artery lies superficial and easily accessible. It is the most common artery used to measure patient’s pulse rate and rhythm.
Where should the ulnar artery be palpated? location
You can palpate the ulnar artery pulse at the wrist over the distal end of the forearm lateral to the tendon of flexor carpi ulnaris muscle.
Where should the brachial artery be palpated? location
The brachial is also palpable on the medial side of the tendon of biceps muscle and it is easier to palpate the pulse when the elbow is fully extended.
Where should the axillary artery be palpated? location
You can palpate the axillary artery pulse on the medial side of humerus (lateral wall of the axilla), posterior to the tendon of the short head of biceps.
Where should the common carotid artery be palpated? location, strength, uses
- Can be palpated in the neck, between the lateral side of thyroid cartilage and medial border of sternocleidomastoid muscle. 2. This is the strongest pulse of all.
- The carotid pulse is ideal for the assessment of the amplitude, shape and volume of the pulse that are important in the diagnosis of underlying heart disease.
Where should the superficial temporal artery be palpated? location, branch type
Can be palpated the in front of the tragus of the ear. This vessel is a terminal branch of the external carotid artery.
Where should the subclavian artery be palpated? location, use
Can be palpated in the supraclavicular fossa region, at the angle between clavicle and sternocleidomastoid muscle. At this site you can compress and occlude the artery completely.
Where should the femoral artery be palpated?
Can be palpated at the mid inguinal point
Where should the popliteal artery be palpated? location
Can be palpated with the knee semi flexed and the fingers of both hands palpating in the inferior part of the popliteal fossa, compressing the artery against the posterior surface of the tibia
Why is the popliteal artery pulse the most difficult to palpate or feel of all pulses in the body?
Because it is located very deep in the popliteal fossa on the back of the knee.
Where should the dorsalis pedis artery be palpated? location
Can be palpated on the mid dorsum of the foot, just lateral to the tendon of the flexus hallucis longus
Where should the posterior tibial artery be palpated? location
Can be palpated 1/3 of the way from the medial malleolus to the calcaneus
What is the apex beat caused by?
The apex beat is a pulsation (either visible or palpable or both) caused by the apex of the left ventricle of the heart when it is forced against the anterior chest wall during contraction.
Where do you feel the apex beat of the heart [by definition]?
By definition, the most lateral and inferior point at which the palpating fingers raise with each systole defines the position of the apex beat.
