Examination of the Cardiovascular System Flashcards
What are the 7 stages to a cardiovascular examination?
- intro and explanation
- inspection
- palpation
- percussion
- auscultation
- other areas
- conclusion and summary
What 2 key things should be done during the intro?
- ask if patient is in discomfort
- position patient 45 degrees with exposed chest
What are the two types of inspection performed?
- general
- close
What should be done for general inspection?
- looking at and around the patient
- looking for obvious signs of: discomfort, breathlessness, pain
Which 2 areas are inspected during close inspection?
- hands
- face, eyes and mouth
What do you look for when inspecting hands?
- warmth
- capillary refill time
- pathology
When performing close inspection of the face what are you looking for?
- pallor
- sweating
- clear pathology
Give 7 examples of pathology seen on the hands.
- peripheral cyanosis
- tar staining
- nail clubbing
- splinter haemorrhage
- kolinichyia
- osler nodes
- janeway lesions
Give 5 examples of pathology of the face as a result of cardiovascular related complications.
- central cyanosis
- malar flush
- conjunctivae
- xanthelasma
- corneal arcus
What can a fast and regular pulse indicate?
- exrecise, anxiety, medication
- pain, fever, hyperthyroidism
What is the pulse felt due to an ectopic beat?
regularly irregular
What does a irregularly irregular beat indicate?
atrial fibrillation
What 3 things could a slow and irregular beat be the result of?
- sick sinus syndrome
- 2nd degree heart block
- complete heart block
what could a low volume pulse mean?
- hypovolaemia
- left ventricular failure
What can an increased volume pulse indicate?
- anaemia
- fever
- thyrotoxicosis
What are 2 examples of pulse character and what are they indicative of?
- slow and rising= aortic stenosis
- collapsing = aortic regurgitation
When can the Jugular venous pulse be seen? What does it indicate?
- when a person is lying at 45 degrees
- reflects changes in pressure of the right atrium
How is the JVP measured? How does it differ from arterial pulsation?
- highest point of pulsation above sternal angle
- double wave form of venous pulsation, JVP can be obliterated by gentle occlusion of the vein
When inspecting the Praecordium what are you looking for?
- scars,
- shape,
- pacemaker
- visible apex beat
How do you inspect the apex beat?
- find it first
- check that its in the normal position
What are the 4 parts to assessing the Praecordium?
- look
- apex beat
- heaves
- thrills
What are heaves? Where do you look for them?
- right ventricular enlargement
- left sternal edge
What is a thrill?
palpable murmur
What are you listening for during auscultation?
- 1st and 2nd heart sounds
- ,added sounds
- murmurs
What manoeuvre is performed to accentuate Mitral stenosis?
- bell at apex, left lateral position
- during expiration
What is the manoeuvre: diaphragm at left axilla for?
radiation of systolic murmur of mitral regurgitation
What manoeuvre is performed to accentuate atrial regurgitation?
- with diaphragm at lower left sternal edge, patient sat forwards
- in expiration
Wat do you do to listen for aortic radiation/cardiac Bruits?
listen over the carotids wit diaphragm during held inspiration
What are murmurs graded out of?
6
Which grade of murmur do thrills become associated with the murmur?
4
What other areas can you examine?
- auscultate base of lungs
- check for sacral oedema
- offer abdominal examination
- peripheral vascular exam
- ankle oedema
- BP
- fundoscopy - examining the fundus of the eye
- urinanalysis
