CVS

Question 1

Where would you palpate the Ulnar pulse?

Answer 1

Expose the patient’s wrist and supinate

Press index and middle fingers on the ulnar side of the wrist

Proximal to the pissiform under the flexor carpi ulnaris tendon

Question 2

How would you describe a pulse?

Answer 2

Rate:

Normal is between 60-100bpm

Rhythm:

Regularly regular

Regularly irregular

Irregularly irregular

Question 3

What are the surface markings of the borders of the heart?

Answer 3

Right border:

3rd right cc 1cm from the sternal border to the 6th right cc

Inferior border:

6th right costal cartilage to the 5th ICS MCL

Left border:

5th ICS MCL to the 2nd left ICS 2.5 cm from the sternal border

Superior border:

2nd left ICS 2.5 cm from the sternal border to the 3rd right cc 1cm left of the sternum.

Question 4

Where would you palpate the Brachial pulse?

Answer 4

2 locations

1. Mid arm = Medial side of the arm between the biceps brachii and the triceps brachii tendons
2. Cubital fossa = Relax the arm and palpate medial to the biceps brachii tendon

Question 5

What marks the apex of the heart?

Answer 5

Left 5th ICS MCL

Question 6

Where would you palpate the radial pulse?

Answer 6

Expose the patient’s wrist and supinate

Press index and middle fingers lateral to the flexor carpi radialis tendon

Question 7

What are the surface markings of the arch of the aorta?

Answer 7

• The beginning of the arch is at the level of the right 2nd cc
• End of the arch is at the level of the left 2nd cc
• top of the arch is midway between the jugular notch and the sternal angle

Question 8

Where would you ascultate the heart valves?

Answer 8

Aortic = right 2nd ICS sternal border

Pulmonary = Left 2nd ICS sternal border

Tricuspid = Left 5th ICS sternal border

Mitral = Left 5th ICS MCL

Question 9

Where would you palpate the Carotid pulse?

Answer 9

Put your index and middle finger between the trachea and the SCM muscle aprox at the level of the laryngeal prominence

Question 10

How do you demonstrate the common sites for routine venepuncture?

Answer 10

Find the tendon of biceps brachii

Median cubital vein is medial to this

Question 11

What are the surface markings of the Internal jugular vein?

Answer 11

Run just lateral to the carotids

Draw a line from the sternoclavicular joint to the ear lobe

Question 12

What are the surface markings of the common carotid artery?

Answer 12

Ask the patient to turn their head to the left/right for the SCM becomes more prominent

Draw a line along the medial border of SCM from the sternoclavicular joint to the earlobe

Question 13

What are the borders of the cubital fossa?

Answer 13

Lateral - brachioradialis

Medial - Pronator teres

Superior - imaginary line between 2 humeral epicondyles