Physical Exam (1) - Cardio Flashcards

1
Q

parts of a physical examination

A

observation and inspection

palpation

auscultation

capillary refill time

edema

blood pressure

self care eval

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2
Q

what does the observation and inspection include

A

analysis of the MS and NM systems

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3
Q

analysis of MS and NM system –> O&I

A

posture

gait

muscle strength and tone

skin color and tone

facial expression

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4
Q

what is observed about the chest wall

A

shape and symmetry

observed from the front, back and sides

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5
Q

A-P diameter of the chest wall

A

should be less than the transverse diameter (medial to lateral)

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6
Q

what should we inspect –> O&I

A

skin

nails

lips

noting whether cyanosis or pallor is present

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7
Q

what are thoracic landmarks

A

imaginary lines on the surface

will help localize findings on physical exam

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8
Q

thoracic landmarks

A

midsternal line

right and left midclavicular lines

right and left anterior axillary lines

right and left midaxillary lines

right and left posterior axillary lines

vertebral line

right and left scapular lines

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9
Q

midsternal line

A

vertically down the middle of the sternum

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10
Q

midclavicular lines

A

parallel to the midsternal line

beginning at mid clavicle

R&L

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11
Q

anterior axillary lines

A

parallel to the midsternal line

beginning at the anterior axillary folds

R&L

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12
Q

midaxillary lines

A

parallel to the midsternal line

beginning at the mid axilla

R&L

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13
Q

posterior axillary lines

A

parallel to the midsternal line

beginning at the posterior axillary folds

R&L

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14
Q

posterior axillary lines

A

parallel to the midsternal line

beginning at the posterior axillary folds

R&L

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15
Q

vertebral line

A

vertically down the spinous process

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16
Q

scapular lines

A

parallel to the vertebral line

through the inferior angle of the scap when the pt is standing erect

R&L

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17
Q

what do thoracic landmarks do

A

help document our findings

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18
Q

what do we palpate

A

thorax and chest wall

pulses

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19
Q

what does palpation of the thorax and chest wall include

A

trachea

suprasternal notch

clavicles

manubrium

angle of loius

sternum

ribs

intercostal spaces

xiphoid processes of thoracic spine

20
Q

how do we palpate

A

systematic way

21
Q

what do we have to do prior to palpation

A

let the pt know what you are doing

22
Q

pulses

A

carotid

brachial

radial

femoral

popliteal

dorsalis pedis

posterior tibialis

23
Q

what do we want to know about pulses

A

rate

rhythm

24
Q

what do we use for auscultation

A

stethoscope

to listen to the pt’s chest

25
Q

where do we do ausculation

A

quiet setting

pt must be disrobed

any clothing will impede exam

26
Q

technique of auscultation

A

do not rush

avoid lifting the stethoscope

27
Q

what do we do instead of lifting the stethescope

A

“inch” it

from one site to another

28
Q

where should auscultation be done on the body

A

5 areas of auscultation

not limited to these areas

29
Q

5 areas of auscultation

A

aortic valve area

pulmonic valve area

second pulmonic area

tricuspid area

mitral area

30
Q

aortic valve area

A

2nd intercostal space on the right of the sternal border

31
Q

landmark for aortic valve area

A

angle of louie

32
Q

angle of louie

A

go to the jugular notch then the manubrium then the angle of louie

move over to the right to the aortic valve area

33
Q

pulmonic valve area

A

2nd left intercostal space at the left sternal border

34
Q

second pulmonic area

A

third intercostal space on the left of the sternal border

35
Q

tricuspid area

A

4th intercostal space on the left at the sternal border

36
Q

what is the mitral area also called

A

apical

37
Q

mitral area

A

at apex of the heart

5th intercostal space at the midclavicular line

38
Q

cardiac cycle

A

heart contracts and relaxes rhythmically to ensure proper circulation

39
Q

basic heart sounds

A

S1 and S2

40
Q

S1 and S2

A

most distinct heart sounds

41
Q

S1

A

result of the closure of the AV valves

mitral and tricuspid valves

42
Q

what does S1 indicate

A

beginning of systole

43
Q

where is S1 best heard

A

toward the apex of the heart

44
Q

S1 sounds like

A

lubb

45
Q

S2

A

result of closure of the semilunar valves

aortic and pulmonary

46
Q

what does S2 indicate

A

end of systole

47
Q

where is S2 best heard

A

aortic and pulmonic areas