Normal Heart and CV Exam (Johnston) Flashcards

1
Q

What are the steps to CV exam?

A

Inspection: General appearance

Palpation : point of maximal intensity

Percussion : estimating cardiac size

Auscultation : listening posts, heart sounds, murmus

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2
Q

Inspection includes looking for:

A

Shape (Barrel chest-COPD, Pectus carinatum, Pectus excavatum)

Landmarks

Scars/Signs of Trauma

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3
Q

Examples of abnormal chest shapes?

A
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4
Q

Where are the inspection landmarks?

A
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5
Q

When palpating in a CV exam, what are you looking for?

A

Palpating for thrill

Point of maximal impulse (PMI) or Apical Impulse

*4th to 5th intercostal space

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6
Q

Why do we percuss during a CV exam?

A

Estimate cardiac size when point of maximal impulse (PMI) not detectable

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7
Q

Where specifically are the listening posts for heart auscultation?

A

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

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8
Q

What causes the S1 heart sound?

A

Closing of mitral and tricuspid valves

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9
Q

What causes S2 heart sound?

A

Closing of aortic and pulmonary valves

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10
Q

How are auscultations graded?

A

Graded on a scale of 1 to 6

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11
Q

T/F

Assess both carotids at the same time

A

FALSE!!!!

DO NOT ASSESS BOTH CAROTIDS AT THE SAME TIME

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12
Q

What is this?

What does this show?

A

Jugular Venous Distention (JVD)

Shows activity of the right side of the heart

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13
Q

How do you measure JVD?

A

Place pt. in supine position to allow veins to engorge, then raise to 45 degrees

Normal JVD = 0-9

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14
Q

How would you grade an edema with 4 (mm) indendation?

A

2+

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15
Q

What are causes of increased JVD/JVP?

A
  • SVC obstruction
  • Severe heart failure
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16
Q
A