Physical Assessment- Cardiovascular & Neurovascular

Question 1

What is the health history in cardiovascular assessment?

Answer 1

– Common chief complaints:
Chest pain, shortness of breath, fatigue, orthopnoea, oedema, cyanosis, cough
PQRST

Question 2

What is the past history in cardiovascular assessment?

Answer 2

– Medical: angina, hypertension, obesity, diabetes, congenital heart defects,
stroke, rheumatic fever, aneurysm.
– Surgical: Angioplasty, valvuloplasty, repair of congenital defects,
pacemaker.
– Medications: antianginals, antihypertensives, betablockers, ace inhibitors

Question 3

What is the family history in cardiovascular assessment?

Answer 3

Stroke, MI, hypertension, sudden cardiac death

Question 4

What is the social history in cardiovascular assessment?

Answer 4

– Diet
– Environment
– Home
– Smoking

Question 5

What equipment do you need for cardiovascular examination?

Answer 5

– Stethoscope 
– Sphygmomanometer 
– Watch with second hand 
– Tape measure 
– Flat table/surface

Question 6

What to inspect for in cardiovascular examination?

Answer 6

• Locate anatomical structures 
with tangential lighting 
– Angle of Louis 
– The aortic arch 
– Pulmonic area 
– Erb’s Point 
– Tricuspid area 
– Mitral area, apical impulse is sometimes visible

Question 7

What to palpate for in cardio examination?

Answer 7

Palpate (finger pads) each
area for pulsations, thrills
and heaves.
– If not palpable at Mitral area lie patient to left side

Question 8

How do you Assesses adequacy of blood flow to extremities?

Answer 8

Systematic approach: 
Temporal and carotid arteries 
Upper extremities 
 Brachial 
 Radial 
Lower extremities 
 Femoral 
 Popliteal 
 Posterior tibial 
 Dorsalis pedis

Question 9

When do you auscultate the carotid arteries?

Answer 9

 Patient is middle aged or older 
 Suspect cardiocerebral or 
cardiovascular disease 
 Place bell over carotid artery 
and instruct to hold breath 
 Note bruit

Question 10

What do you inspect for in upper extremities?

Answer 10

Inspect fingers, nails, hands & arms: 
 Colour 
 Clubbing 
 Venous pattern 
 Oedema 
 Ulceration 
 Hair distribution 
 Size

Question 11

What do you palpate for in the upper extremities?

Answer 11

Palpate: 
 Temperature and texture 
 Capillary refill 
 Oedema 
 Radial artery 
 Brachial arteries

Question 12

What do you inspect for in lower extremities?

Answer 12

Inspect legs, ankles, 
feet, toes, nails: 
 Colour 
 Venous pattern 
 Oedema 
 Ulceration 
 Hair distribution 
 Size

Question 13

What do you palpate for in lower extremities?

Answer 13

Palpate: 
 Temperature and texture 
 Capillary refill 
 Oedema 
 Femoral artery 
 Popliteal artery 
 Posterior tibial 
 Dorsalis pedis

Question 14

Neurovascular observations are a combination of peripheral?

Answer 14

1. vascular assessment 
 skin colour 
 skin temperature 
 capillary refill 
 distal pulses 
2. neurological assessment 
 sensation 
 movement

Question 15

Indications for a neurovascular assessment are?

Answer 15

 Fractures/dislocations 
 Soft tissue injuries 
 Limb immobilisation 
 Initiation and change of plaster cast 
 Spinal injuries 
 Vascular injuries 
 Pre and post surgical 
interventions 
 On report of altered sensation 
 Underlying co-morbidities i.e. tumours