Normal Cardiovascular Exam Flashcards
What is the correct order for a cardiac exam?
inspect –> palpate –> percuss –> auscultate
What does a lateral PMI suggest?
enlarged left ventricle
How do you grade a heart murmur?
1 to 6
1 = very faint
2 = quiet, heard easily w stethoscope
3 = moderately loud, no thrill
4 = loud w/ palpable thrill ***
5 = very loud w/ stethoscope partially off chest
6 = heard w/ stethoscope entirely off chest
What do you palpate on the carotid arteries?
rate/ rhythm/ amplitude
What does a large V wave indicate?
tricuspid regurgitation
What is the most common cause of elevated JVP?
other causes?
elevated RV diastolic pressure
others: SVC obstruction, severe heart failure
What do you palpate for on CV exam?
thrill
point of maximal impulse (PMI)
What heart sound can you hear in athletes and what is it due to?
S4
due to high pressure atrial contraction forcing blood into a stiff ventricle
What is normal JVP?
0-9
What does jugular venous pulse/distention indicate?
CVP and RAP (activity of right side of heart)
internal jugular better than external
What is an allen’s test?
have pt make a fist and open and close it while occluding radial and ulnar arteries –> let go of ulnar artery –> pale hand should become colored again
repeat with radial artery
indication: lack of dual blood supply to hand (negative indication for radial catheterization)
What are the waves of jugular pressure?
a = atrial contraction c = no clinical significance x = descent when atria are filling v = AV closed, atria filling y = descent, tricuspid opens
How do you grade edema?
0 absent 1+ barely detectable, nonpitting (2mm) 2+ 4 mm, 10-15 sec 3+ 6mm; can be > 1 min 4+ 8 mm; 2-5 min
What is a hepato-jugular reflex?
Pt at 30-45 degrees –> push on liver –> neck vein engorges
Where do you palpate for the PMI?
4th-5th ICS on left side
midclavicular line
