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
where do we do ausculation
quiet setting pt must be disrobed any clothing will impede exam
26
technique of auscultation
do not rush avoid lifting the stethoscope
27
what do we do instead of lifting the stethescope
"inch" it from one site to another
28
where should auscultation be done on the body
5 areas of auscultation not limited to these areas
29
5 areas of auscultation
aortic valve area pulmonic valve area second pulmonic area tricuspid area mitral area
30
aortic valve area
2nd intercostal space on the right of the sternal border
31
landmark for aortic valve area
angle of louie
32
angle of louie
go to the jugular notch then the manubrium then the angle of louie move over to the right to the aortic valve area
33
pulmonic valve area
2nd left intercostal space at the left sternal border
34
second pulmonic area
third intercostal space on the left of the sternal border
35
tricuspid area
4th intercostal space on the left at the sternal border
36
what is the mitral area also called
apical
37
mitral area
at apex of the heart 5th intercostal space at the midclavicular line
38
cardiac cycle
heart contracts and relaxes rhythmically to ensure proper circulation
39
basic heart sounds
S1 and S2
40
S1 and S2
most distinct heart sounds
41
S1
result of the closure of the AV valves mitral and tricuspid valves
42
what does S1 indicate
beginning of systole
43
where is S1 best heard
toward the apex of the heart
44
S1 sounds like
lubb
45
S2
result of closure of the semilunar valves aortic and pulmonary
46
what does S2 indicate
end of systole
47
where is S2 best heard
aortic and pulmonic areas