Cardiovascular System Flashcards
What pulses should be palpated?
- radial artery
- ulner artery
- brachial artery
- common carotid artery
- apex beat
Whats the range for a normal heart rate?
60-100
Where is the radial artery?
between the:
- tendon of the flexor carpi radialis
- tendon of the brachioradialis
Where is the ulnar artery?
between the:
- flexor digitorum superficialis
- flexor carpi ulnaris
Where is the brachial artery?
medial to the biceps tendon
What position should the patient be in for a cardiovascular exam?
- 45 degree angle
- exposed from the waist up
Where is the common carotid artery?
- medial border of the sternocleidomastoid muscle
- lateral border of the thyroid cartilage
What can be detected from the common carotid artery?
character and volume
Where is the apex beat?
5th intercostal space, mid-clavicular line
Where should you start palpating for the apex beat?
from the lateral side (mid-axillary line) towards the mid-clavicular line
What can cause a displaced apex beat?
cardiomegaly
What can cause an absent apex beat?
- pericardial effusion
- obesity
- pleural effusion
- emphysema
What is a parasternal heave?
precordial impulse that is palpable
How do you palpate for heaves?
place hand parallel to the left sternal edge
What would be a positive sign for heaves?
the heel of your hand being lifted with each systole
What are parasternal heaves associated with?
right ventricular hypertrophy
What is a thrill?
palpable vibration caused by turbulent blood flow through a heart valve
Where should you assess thrills?
each heart valve (same sites as auscultation)
place hand horizontally
What valves are heard in auscultation?
- pulmonary
- tricuspid
- mitral
- aortic
Where do you auscultate for the aortic valve?
- right sternal border
- 2nd intercostal space
Where do you auscultate for the pulmonary valve?
- left sternal border
- 2nd intercostal space
Where do you auscultate for the tricuspid valve?
- left 5th costo-sternal border
Where do you auscultate for the mitral valve?
- left 5th intercostal space at apex beat
What can cause an ejection systolic murmur?
- aortic stenosis
- pulmonary stenosis
- aortic sclerosis
- hypertrophic obstructive cardiomyopathy
- atrial septal defect
What manoeuvres can be done to accentuate aortic stenosis?
- ask patient to hold their breath
- auscultate the carotid arteries
What manoeuvres can be done to accentuate aortic regurgitation?
- sit patient forwards
- auscultate over the aortic area during expiration
What can be done to investigate an mitral valve regurgitation?
- auscultate the mitral area
- pansystolic murmur during expiration
- auscultate into the axilla to identify radiation
What can be done to investigate an mitral stenosis?
- bell, auscultate the mitral area
- mid-diastolic murmur heard during expiration
What position should the patient be in for suspected mitral regurgitation/stenosis?
left lateral decubitus position
What type of murmur is heard in aortic stenosis?
ejection systolic murmur
What type of murmur is heard in aortic regurgitation?
early diastolic murmur
What type of murmur is heard in mitral stenosis?
mid-diastolic murmur
What type of murmur is heard in mitral regurgitation?
pansystolic murmur
What arteries can be palpated in the lower limb?
- femoral
- dorsalis pedis
- posterior tibial artery
- popliteal artery
Where can the femoral pulse be palpated?
the mid-inguinal point
Where is the mid-inguinal point?
midpoint between the anterior superior iliac spine (ASIS) and the pubic symphysis
Where can you palpate the popliteal pulse?
inferior region of the popliteal fossa
How do you palpate the popliteal pulse?
- thumbs on the tibial tuberosity
- passive knee flexion to 90 degrees
- curl fingers into the popliteal fossa
- compress the popliteal artery against the tibia
Where is the posterior tibial pulse?
posterior to the medial malleolus of the tibia
Why should the posterior tibial pulse be palpated?
- confirm presence
- comparison to the dorsal pedis pulse
Where is the dorsal pedis pulse?
- dorsum of the foot
- lateral to the extensor hallucis longus tendon
Where is the right upper border of the heart?
- 3rd costal cartilage
- 1cm from the sternal edge
Where is the left upper border of the heart?
- 2nd intercostal space
- 2.5cm from the sternal edge
Where is the right lower border of the heart?
- 6th costal cartilage
- 1cm from the sternal edge
Where is the left lower border of the heart?
- 5th intercostal space
- mid-clavicular line
Where can you palpate the superficial temporal artery?
in front of the tragus of the ear
Where can you palpate the subclavian artery?
the supraclavicular fossa region
How does Type A aortic dissection typically present?
severe chest pain (anterior and posterior)
How does Type B aortic dissection typically present?
- back pain
- chest and abdominal pain
