Physical Exam of CV System Flashcards
What are the 4 components of a heart exam?
Inspection
Palpation
Percussion (omitted)
Auscultation
Inspection of the heart includes what?
Precordium - apical impulse
Skin - cyanosis, venous distension
Nails - cyanosis, cap refill
What does the palpation of the heart exam consist of?
Palpate precordium at:
- Base
- LT sternal border
- RT sternal border
- Apex
- Epigastric
- Axillae
Point of maximal impulse (estimate diameter)
What are the 5 locations of auscultation of the heart? Where are they located?
Aortic area (2nd ICS RT Sternal) Pulmonic area (2nd ICS LT Sternal) Second pulmonic area (3rd ICS LT Sternal) Tricuspid area (4th ICS LT Sternal) Mitral area (5th ICS midclavicular)
What are you listening for during the auscultation of the heart?
S1, S2 Rate and rhythm Murmur Gallop Click Rub
What consist of the arterial vessel inspection?
Skin- pallor, cyanosis, mottling Hair loss Skin or muscular atrophy Changes in skin texture Edema or swelling
What consist of the venous vessel inspection?
Edema or swelling
Varicose veins
Changes in skin texture
Skin ulcerations
What is the areas of palpation for vessels?
Carotid Brachial Radial Femoral Popliteal Posterior Tibia Dorsalis Pedis
What are the areas you auscultation of peripheral arteries?
Temporal Carotid Renal Abdominal Aorta Femoral
What are the special test used for venous obstruction and insufficiency?
Thrombosis
Homan’s sign
Pitting edema
What are you listen for in the vessel auscultation?
Bruits
What are the pitting edema scores? What are their depths and times?
+1 slight pit (2-3mm, rapidly)
+2 somewhat deep (4-5mm, 10-15 secs)
+3 Noticeable deep (6-7mm, >1min)
+4 Very deep (8-9mm, 2-5mins)
What is the amplitude scale for arteries?
0 - Absent 1 - Diminished 2 - Expected 3 - Full 4 - Bounding
What is the sound indicating systolic and diastolic BP?
First and last Korotkoff
