Cardiovascular system Flashcards
Demonstrate the surface markings of the upper/right/inferior/left borders of the heart
Upper Left: 2nd CC 2.5cm from left sternal border
Upper RIght: 3rd CC 1cm from right sternal border
Lower right: 6th CC 1cm from right sternal border
Lower left: left 5th ICS @ MCL
Demonstrate where you would auscultate for aortic/pulmonary/mitral/tricuspid valves using a stethoscope
Aortic: right 2nd ICS near sternum (dub)
Pulmonary: left 2nd ICS near sternum (dub)
Mitral: left 5th ICS @ MCL (= apex beat) (lub)
Tricuspid: left 5th costosternal border (lub)
Describe the surface marking of the apex beat of the heart
Caused by apex of LV when it is forced against the anterior chest wall during contraction
Location varies from 4th ICS in children to 5th ICS in adults
~6-10cm from MSL
Examine the radial/ulnar/brachial (2 sites)/ carotid pulse
Carotid: neck, between lateral side of thyroid cartilage + medial border of sternocleidomastoid
Radial: palpate at wrist over distal end of radius (closest to thumb)
Ulnar: palpated on wrist at little finger side
Brachial (in cubital fossa): palpate on the medial side of tendon of biceps on a fully extended elbow
Brachial(mid-arm): palpate along middle 3rd of humerus, in the medial bicipital groove behind the medial border of biceps
Palpate the arteries with the pulps of index + middle finger
Describe the pulse (rate and rhythm)
Rate:
Normal = 60-100
Bradycardia = <50
Tachycardia = >100
Rhythm:
Irregular: when rhythm doesn’t have an even pattern, time between beats may change or strength of beats may change, or both
Intermittent: When strength doesn’t vary greatly but a beat is skipped at regular or irregular rhythms
Describe palpation of apex beat of the heart
Subject should sit on edge of couch
Palpate with the palm + middle 3 fingers of right hand, aligning middle finger in the left 5th ICS + other 2 fingers in ICS’s above + below.
Start palpating from the lateral side (from near MAL) + move anteriorly towards MCL
Male nipple is in 4th ICS, lateral to MCL
Females: hand should be laid beneath breast along its lower border.
Demonstrate the site of routine venipuncture (antebrachial vein in the cubital fossa).
Median cubital vein in cubital fossa: connects cephalic + basilic veins at level of the elbow
Describe and demonstrate the surface marking of the arch of the aorta
Its 3 main branches (brachiocephalic trunk, left common carotid + left subclavian arteries) arise within the superior mediastinum.
Arch begins + ends at the level of the sternal angle.
Beginning of arch (from ascending aorta) at level of right 2nd CC
End of arch (becomes thoracic aorta) at level of left 2nd CC
Top of arch midway between jugular notch + sternal angle.
Describe and demonstrate the surface markings of the internal jugular vein and common carotid artery
IJV is just lateral to the common carotid artery for each side + reaches sternoclavicular joints.
RCC: turn their head to left. RCC runs from right sternoclavicular joint to right ear lobe
LCC: turn their head to right. LCC runs from aortic arch to left sternoclavicular joint. Continues along left side of trachea + along anterior border of left sternocleidomastoid muscle to left ear lobe.
What is the significance of the lub and dub sounds of the heart valves?
Lub: Closure of atrioventricular valves
Dub: Closure of aortic/ pulmonary valves
