Normal Heart and CV Exam (Johnston) Flashcards
What are the steps to CV exam?
Inspection: General appearance
Palpation : point of maximal intensity
Percussion : estimating cardiac size
Auscultation : listening posts, heart sounds, murmus
Inspection includes looking for:
Shape (Barrel chest-COPD, Pectus carinatum, Pectus excavatum)
Landmarks
Scars/Signs of Trauma
Examples of abnormal chest shapes?
Where are the inspection landmarks?
When palpating in a CV exam, what are you looking for?
Palpating for thrill
Point of maximal impulse (PMI) or Apical Impulse
*4th to 5th intercostal space
Why do we percuss during a CV exam?
Estimate cardiac size when point of maximal impulse (PMI) not detectable
Where specifically are the listening posts for heart auscultation?
Aortic - Right 2nd intercostal space at sternal border
Pulmonary - Left 2nd intercostal space at sternal border
Erb’s - Left 3rd intercostal space at sternal border
Tricuspid - Left 4th intercostal space at sternal border
Mitral - Left 5th intercostal space at mid-clavicular line
What causes the S1 heart sound?
Closing of mitral and tricuspid valves
What causes S2 heart sound?
Closing of aortic and pulmonary valves
How are auscultations graded?
Graded on a scale of 1 to 6
T/F
Assess both carotids at the same time
FALSE!!!!
DO NOT ASSESS BOTH CAROTIDS AT THE SAME TIME
What is this?
What does this show?
Jugular Venous Distention (JVD)
Shows activity of the right side of the heart
How do you measure JVD?
Place pt. in supine position to allow veins to engorge, then raise to 45 degrees
Normal JVD = 0-9
How would you grade an edema with 4 (mm) indendation?
2+
What are causes of increased JVD/JVP?
- SVC obstruction
- Severe heart failure
