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Yr3 Clinical Skills > CVS Examination Qs > Flashcards

CVS Examination Qs Flashcards

1
Q

What signs are we looking out for at first glance?

A
  1. SoB (Pericarditis/Pneumonia/PE)
  2. Cyanosis (R-L Shunting)
  3. Pallor (Haemorrhaging)
  4. Malar Flush (Cheeks due to MS)
  5. Oedema (CHF)
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2
Q

What are we looking for in the hands?

A
  1. Colour
    - Cyanosis: Hypoxemia
    - Pallor: Poor Peripheral Perfusion
  2. Clubbing
    - Infective Endocarditis
    - Congenital Cyanotic Heart Disease
  3. Hands
    - Yes
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3
Q

What are we looking for in the Hands?

A
  1. Splinter Haemorrhaging
    - Psoriatic Nail Disease
    - Infective Endocarditis
    - Sepsis
  2. Janeway Lesions
    - Non-tender Haemorrhagic Lesions
    - Infective Endocarditis
  3. Osler’s Nodes
    - Red-purple tender lumps
    - Infective Endocarditis
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4
Q

What else do we do for the hands?

A
  1. Check Temperature
    - Cold: ACS, Congestive Cardiac Failure
  2. Capillary Refill
    - 2+: Poor Peripheral Perfusion
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5
Q

What causes Poor Peripheral Perfusion?

A
  1. Hypovolemia

2. Congestive Heart Failure

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6
Q

What is the Radio-Radial Delay?

A

Feel both wrists at the same time

  • Coarctation of the Aorta
  • Subclavian Artery Stenosis (Cervical Rib)
  • Aortic Dissection
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7
Q

What is Collapsing Pulse?

A
  1. Aortic Regurgitation (Diastolic)
  2. Ask if there is pain in the shoulder
  3. Place a hand on the wrist and raise Right Arm Briskly
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8
Q

What can be seen in Brachial Pulse?

A
  1. Bounding: CO2 Retention
  2. Thready: Sepsis
  3. Slow: Aortic Stenosis
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9
Q

When auscultating Carotid Pulse, what are we looking for?

A

Bruits: Carotid Stenosis

Also to check for Cardiac Murmurs (Aortic Stenosis)

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10
Q

How do we check for JVP?

A

Turn their head to the left

Measure the IJV

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11
Q

Why do we not check EJV?

A

It branches at a right angle and less reliable for Central Venous Pressure

3cm between Sternal Angle and Top of IJV pulsation point with a ruler

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12
Q

What does Raised JVP mean?

A
  1. Venous Hypertension

2. Right Heart Failiure (Caused by Left)

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13
Q

What is the Hepatojugular Reflex?

A
  1. Putting pressure on the liver and looking for a rise in the JVP
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14
Q

When do we need to use HJR?

A
  1. RVF
  2. LVF
  3. Constrictive Pericarditis
  4. Restrictive Cardiomyopathy
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15
Q

What are we looking for in the face?

A
  1. Hyperlipidemia
  2. Conjunctival Pallor
  3. Corneal Arcus
  4. Xanthelasma
  5. Kayser-Fleischer Rings
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16
Q

What are we looking for in the mouth?

A
  1. Central Cyanosis
  2. Angular stomatitis (Iron deficiency)
  3. High arched Plate (Marfan Syndrome)
  4. Dental Hygiene (Infective Endocarditis)
17
Q

What are we looking for in the chest?

A

Central: (Sternotomy/Thoracotomy)

Clavicular: Pacemaker

Left Mid-Axillary Line: SC ICD

Lateral Thoracotomy: Lift both arms

18
Q

Where do we feel the apex beat?

A

5th Intercostla Space at Mid-clavicular Line

19
Q

What is a Heave and why do we get it?

A

Palpated Precordial Impulse
Palm to Check

Right Ventricular Hypertrophy

20
Q

What is a Thrill?

A

Palpable Vibration by Turbulent Blood Flow

Check all Four Valves

21
Q

Where do we check the Mitral valve?

A

5th Intercostal Space in Midclavicular line

22
Q

Where do we check the Tricuspid valve?

A

5th Intercostal Space on Left Sternal Edge

23
Q

Where do we check the Pulmonary valve?

A

2nd IC space on the Left Sternal Edge

24
Q

Where do we check the Aortic valve?

A

2nd IC space on the Right Sternal Edge

25
Q

When Auscultating, what side of the Stethoscope do we use?

A

Both Bell and Diaphragm

26
Q

For Aortic and Mitral Murmurs, they get ___ with expiration

A

Louder

27
Q

How do we check Aortic Murmurs?

A

Sit them forwards and they take a deep breath

Check at Left 2nd IC space

28
Q

How do we check Mitral Murmurs?

A

Roll them on the Left and they take a deep breath

Auscultate at Axilla

29
Q

What condition can we see a Pansystolic Murmur upon rolling on the left?

A

Mitral Regurgitation

30
Q

What are the final things to check?

A

Inspect Back for scarring

Auscultate the back

  • Coarse crackles: Pulmonary Oedema
  • Absent Air/Stony Dullness: Pleural Effusion and LVF
  • Sacral Oedema (Pitting)
  • Ankles (Oedema for RVF)

Yr3 Clinical Skills (6 decks)

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