CV Exam

Question 1

General components of CV exam

Answer 1

1. Vitals: HR, BP
2. Inspect/palpate precordium + neck (JVP)
3. Auscultate
4. Inspect and palpate extermities
5. Pulses

Question 2

Inspect/palpate precordium

Answer 2

 Inspect/expose chest
 Palpate for costochrondral joint tenderness
 Find the apical impulse/PMI
 Lifts/heaves and thrills
 Jugular venous pressure when appropriate*

Question 3

Auscultation with diaphragm

Answer 3

Auscultate with diaphragm at least 4 sites with patient supine
 2nd interspace at right sternal border (aortic)
 2nd/3rd interspace at left sternal border (pulmonic)
 4th/5th interspace at left sternal border (tricuspid)
 Apex

Auscultate with diaphragm in at least 2 sites with patient sitting
 4th/5th interspace at left sternal border (tricuspid)
 Apex

Question 4

Auscultation w/bell

Answer 4

Auscultate with bell in at least 2 sites with patient supine
 4th/5th interspace at left sternal border (tricuspid)
 Apex

Auscultate with bell in 1 site with patient supine in left lateral decubitus position
 Apex

Question 5

Inspect/palpate extremities

Answer 5

Inspect and Palpate extremities (patient in the sitting position):
 Capillary refill bilaterally
 Cyanosis
 Edema
 Skin discoloration and abnormal hair growth

Question 6

Pulses

Answer 6

Pulses (compare side to side):
  Carotid (auscultate for bruits first, then palpate each side)
  Brachial
  Radial
  Femoral
  Popliteal
  Posterior tibial
  Dorsalis pedis