Phys Exam Special Tests

Question 1

JVP Measurement

Answer 1

• ruler straight up from angle of Louis
• straight edge across from apex of internal jugular vein
• less than 9 cm is normal
• test for volume overload
• should be routine test on CHF pts

Question 2

Hepatojugular Reflux Test

Answer 2

• push down hard on liver and watch for JVD

- test for volume overload

Question 3

Left Lateral Decubitus for Heart Sound Auscultation

Answer 3

• tricuspid and mitral murmurs
• palpation may help find PMI
• may be easier to hear S3 and S4

Question 4

Leaning Forward Heart Sound Auscultation

Answer 4

-assess aortic and pulmonic murmurs

Question 5

Standing Heart Sound Auscultation

Answer 5

• accentuate mitral valve prolapse murmurs or hypertrophic cardiomyopathy
• will make aortic stenosis murmur softer

Question 6

Squatting/Valsalva Auscultation

Answer 6

• accentuate aortic stenosis murmur

- decrease intensity of mitral valve prolapse murmur or hypertrophic cardiomyopathy

Question 7

Allen’s Test

Answer 7

• determine patency of radial and ulnar arteries
• squeeze both arteries shut and have patient make fist
• pt opens fist, release one artery and watch reperfusion
• repeat with other artery

Question 8

Homan’s Test

Answer 8

• passive dorsiflexion of ankle/calf

- assess for DVT

Question 9

Ankle Brachial Index Test

Answer 9

• take BP at ankle and at brachial artery
• want it to be around 0.9
• lower = peripheral arterial dz
• indicated for diminished pulses in feet or claudication