step 3

Question 1

What are we doing at step 3?

Answer 1

inspect neck and face

Question 2

running order when inspecting the neck and face?

Answer 2

Carotid arteries
JVP
Xantholasma and corneal arcus
conjunctiva pallor
angular stomatis
tongue

Question 3

What are we doing to the carotid arteries ?

Answer 3

Ascultating and palpating it separately

Question 4

Whan auscultating the carotid arteries what are we asking the patient to do? what area of the stethoscope do we use?
what are we assessing for?

Answer 4

ask the patient to take a deep breath and hold it).
use the bell
assessing for bruits which can suggest partial occlusion of the vessels (can sound as a turbulence

Question 5

when palpating the carotid what are we feeling for?

Answer 5

rate
character
volume

Question 6

what is JVP and how do we assess for it ?

Answer 6

pressure in the venous system

ask the patient to turn their neck to look over their left shoulder
create triangle - clavicle to ear
look for flutter/pulse
if flutter/pulse is seen palpate it, if its palpable its arterial if non palpable measure jvp.

can measure with rulers
place rulers on the sternum then at the highest point of flutter keeping horizontal above 4 is indicative of JVP below is pathological.

if no rulers press on the liver should see a rise in pressure then settle however if there is jvp WILL STAY RISSEN.

Question 7

What about the eyes are we assassing for ? and what can they indicate?

Answer 7

xantholasma and corneal arcus which is a sign of hyperlipidemia

conjunctiva pallor for anaemia

Question 8

what in the mouth are we assessing for and what can it indicate?

Answer 8

angular stomatis for anemia/ fungal infection

looking at the tongue for central cyanosis or anemia