Clinical Skills Flashcards
CVS Exam - Hand Inspection
1- Clubbing
2- Splinter Haemorrhages
3- Osler Nodes
4- Janeway Lesions
5- Xanthomata
Why does Clubbing occur?
Chronic Hypoxia
Why do Splinter Haemorrhages occur?
Infective Endocarditis
Why do Osler Nodes occur?
Infective Endocarditis
(Tenderness)
Why do Janeway Lesions occur?
Infective Endocarditis
(No Tenderness)
Why does Xanthomata occur?
High levels of blood lipids = Risk Factor
CVS Exam - Face Inspection
Eyes - Jaundice + Xanthelasmata
Face - Mitral Facies + Cyanosis
Mouth - High Arched Palate
Why does Jaundice occur DUE to CVS reasons?
Right Heart Failure –> Hepatic Venous Congestion –> Impair bile excretion
Why does a High Arched Palate occur?
Connective tissue disorder = Marfans
Suggest risk for Aortic Aneurysm + Dissection
CVS - Neck Region
Palpate Carotids
Listen Carotids –> Bruits
JVP + Hepatojugular Reflex
Where is Carotid Examination important?
Can tell us about murmurs –> Valve Stenosis + Regurg
What does the JVP incdiate?
Presence of RHF
CVS - Chest examination
Palpate Apex Beat (only palpable in 50% of adults)
Heaves - Sternum
Thrills - Palpable murmur = must do to all valves
What do Thrills indicate?
Stenosis of valves = more turbulent flowH
What do Heaves indicate?
Valvular hypertrophy, due to forceful + sustained outward movement
CVS - Chest Auscultation
All valves
Special Manouvres
- Aortic = Forward + exhale
- Pulmonary = Forward + Inhale
- Tricuspid = Straight + Inhale
- Mitral = Left + Exhale
CVS - Leg Exam
Cyanosis
Oedema (pitting?)
What does the type of Oedema reveal in a CVS Exam?
Non-pitting = Chronic Lymphodema
Pitting = Heart Failure
