Thorax : cardiovascular

Question 1

Demonstrate the surface marking of upper/right/inferior/left borders of the heart?

Answer 1

remember that the left side of the heart is larger than the right side so it is further from the sternum

• also remember 3256 clockwise

Question 2

Demonstrate where you would auscultate for aortic/pulmonary/mitral/tricuspid valves using a stethoscope.?

Answer 2

• remember clockwise 2255
• aortic and pulmonary at the top
• both mitral and tricuspid are on the left but the mitral is more to the edge

Question 3

Examine the radial/ulnar/brachial (2 sites)/carotid pulse and describe them (rate and rhythm).

Answer 3

( for brachial find the tendon and push your fingers underneath )

measure the rate by counting for 15 seconds and the multiply by 4

Rhythm: Normal/Bounding/Slow-Rising (should be normal)

Question 4

Describe the surface marking of the apex beat of the heart and demonstrate palpation.

Answer 4

Description it is at the 5th intercostal space at the midclavicular line

• to demonstrate palpate for manubrium (2nd ICS)
• Palpate down to sternal edge of 5th ICS
• Move to LEFT MCL along the 5th rib

(If patient is female) Palpate inferior to the bra. Attempt to allow only back of hand to make contact with the breast.

Question 5

Demonstrate the sites of routine venepuncture (antebrachial vein in the cubital fossa):

Answer 5

answer with : the antebrachial vein in the cubital fossa

show the vein in the arm

Question 6

Describe and demonstrate the surface marking of the arch of the aorta:

Answer 6

Description: Starts and Ends at the level of the sternal angle (2nd ICS)

Demonstration:

• Palpate for manubrium (2nd ICS)
• The arch of the aorta is arises into, and descends from this level

Question 7

Describe and demonstrate the surface markings of the internal jugular vein

Answer 7

description:

The internal jugular vein follows the line between the ear lobule and the median end of the clavicle

It is posterior to the sternocleidomastoid (SCM) muscle and lateral to the common carotid artery

demonstration:

Patient to look over the shoulder opposite to the side being examined

The internal jugular vein follows the line between the ear lobule and the median end of the clavicle

Question 8

Describe and demonstrate the surface markings of the common carotid artery.

Answer 8

description:

• The common carotid artery supplies the external and internal tissues of the head and face
• It is posterior to (behind) the sternocleidomastoid (SCM) muscle, and medial to the internal jugular vein

demonstration :

To identify: Patient to look over the shoulder opposite to the side being examined

Patient facing forward. Palpate behind the SCM, and pressing the artery posteriorly (onto the transverse process of the cervical vertebrae*)

Question 9

show a chest cT scan :

Answer 9