CVS EXAM

Question 1

HANDS AND ARM LIST ALL

Answer 1

hands - 
tar staining
warmth of hands 
peripheral cyanosis 
clubbing 
splinter haemorrhages 
capillary refill time 
tremor

Question 2

describing pulse ?

Answer 2

rate -

rhythm - irregular and regular

volume - full, normal

Question 3

head list all?

Answer 3

conjunctivae - anaemia

Question 4

lower limbs list all?

Answer 4

pitting oedema - from ankle up - apply pressure with fingers
look for arterial disease - ischaemia - ulcers/cold
varicose veins - venous insufficiency

Question 5

jvp explain?

Answer 5

lying at 45 degrees
head turned to left
look at double flicker

pressure - vertical height of flickering above sternal angle - normally 3/4 fingers

Question 6

front of chest ? list all

Answer 6

inspection - look fro any chest deformities - convex/concave sternum

palpation - tracheal posiition

check for pacemaker - feel left clavicular area

apex beat

heaves - flat hand on left of sternum -

thrills - flat hand on both sides of sternum AND APEX AOF HEART

Question 7

AUSCULTATION list all steps?

Answer 7

listen all 4 valves - diaphragm AND THEN BELL
while palpate carotid pulse

left sided systolic murmurs
AORTIC STENOSIS - over aortic valve and then over carotid arteries with diaphragm

MITRAL REGURGITATION - apex/left axilla with diaphragm while listen to carotid arteries

left sided diastolic murmurs
MITRAL STENOSIS - roll over to left and listen to apex with bell and hold at expiration while holding carotid

AORTIC REGURGITATION - sit up - lean forward and hold at expiration - at lower left sternal edge with diaphragm

Question 8

peripheral pulses list all?

Answer 8

radial - both hands same time

brachial - whole hand under elbow and palpate

carotid- both at different times

femoral - groin area

then palpate both radial and femoral at same time

popliteal - flex knee and use both hands

posterior tibial - below medial malleolus

dorsal pedis - on top of foot - between big toe

bruits = over carotid with diaphragm