cardiovascular examination Flashcards
1- examination sequence:
Inspection (—)
Palpation (—-)
Percussion ( —)
Auscultation (—)
2- general examination:
Introduce yourself and explain your role
Obtain the patient’s name
Consent: gain consent to proceed with the examination
Hygiene: Wash hands and clean stethoscope with alcohol wipes
Position patient lying on bed at a 45 degree angle
Expose the patient to the waist and remove shoes and socks
Remember examination is done from right hand side of bed!
looking
feeling
tapping
listening
general inspection:
-End of bed moving to the — hand side of the bed
-General impression of the patient and their immediate environment
-Does the patient appear:
Well/unwell?
Distressed/in pain/breathless?
Any pallor or cyanosis?
Obviously under or overweight?
Any chest scars or abnormal pulsations visible?
Bedside :check for bedside items
cardiac monitors
oxygen mask or nasal prongs
IV drips
medications.
other
right
inspection:
HANDS:
Ask patient to hold hands out in front of them.
Examine dorsal aspect for:
- —
- — cyanosis
- tar —
-Splinter —
Examine palmar aspect for:
—- of the palmar creases and —
clubbing
cyanosis
tar staining
splinter haemorrhage
palloe
xanthomata
examination of radial pulse:
- —
- —
- — (carotid pulse)
- – (carotid pulse)
inspection/ examination of the —:
Xanthelasma
Conjunctival pallor
Corneal arcus
examination of the — :
Cyanosis
Central – check under —
Peripheral – may affect skin around –
Dental hygiene
rate
rhythm
volume
character
tongue
lips
inspection - examination of the neck:
Jugular Venous Pressure:
- — of patient
- Identification of —
- —
Carotid Pulse
— to the sternocleidomastoid muscle
— and — of pulse
examination of the praecordium:
- —
- Visible —-
- —
-Cardioverter-Defibrillator box
position
pulsation
measurement
medial
character and volume
scars
pulsation
pacemaker
palpation:
Apex beat
- The most — and — point at which the palpating fingers are raised with each —
- Determine position by beginning in — and identifying pulsation using – finger
-Confirm position using — landmarks e.g. 5th left intercostal space, (1cm — to) the midclavicular line
- pracordial impulses:
–> – parasternal —
—> — (palapable murmer)
lateral and inferior
systole
axilla
one
anatomical
medial
left
heave
thrill
ausuculatation:
What are you listening to?
Heart Sounds 1 & 2 (normal)
HS1- is caused by — of the — and — valves
HS2- is caused by — of the — and — valves
Where do you listen?
Using the bell and the diaphragm listen over the following areas:
Mitral area- –th intercostal space, – side, —
Tricuspid area- –th intercostal space, — of the —
Pulmonary area —nd intercostal space, – of the —
Aortic area – intercostal space, — of the —
Always palpate — pulse when auscultating!!!
Murmurs/ Additional Heart sounds /Dynamic manoeuvres covered
in Senior Cycle
closure
mitral and tricuspid
closure
aortic and pulmonary
5th
left
midclvaicular
4th
left
sterum
2nd
left
sterum
2nd
right
sterum
radial
check slide 37
to complete exam:
As appropriate to case:
To complete the exam I would like to…:
Exam and auscultate the posterior lung fields
Exam and palpate the lower legs
Obtain a Blood pressure read/ECG etc
Thank the patient
Allow privacy to dress
Hand Hygiene
Summarise findings
