thorax cas

Question 1

where is the jugular notch

Answer 1

visible dip in between the neck in humans, between the clavicles, and above the manubrium of the sternum.

Question 2

where is the sternal angle

Answer 2

walk your fingers down the manubrium a few centimeters until you feel a distinct bony ridge. This is the sternal angle.

Question 3

where is the manubriosternal joint

Answer 3

same place as the sternal angle

Question 4

where is the xiphisternal joint

Answer 4

bottom of the sternum

Question 5

what is the costal margin

Answer 5

The costal margin (costal arch) is an arch formed by the medial margin of the cartilages of false ribs and one true rib
the bottom curve of the ribs

Question 6

what are the midclavicular line

Answer 6

from the middle of the sternum is middle

one ni is right ect

Question 7

where is the apex beat located

Answer 7

5th intercostal space§

Question 8

Examination of Apex Beat of the Heart

Answer 8

1) Your colleague (or patient) should lie on a couch with head and back raised at 45 degrees.
2) You should approach and stand facing your colleague from their right side.
3) You should use your palm and 4 fingers of your right hand to palpate. You should align your fingers along the left 4th, 5th and 6th intercostal spaces.
4) You should start palpation from the left lateral chest wall (near the mid-axillary line), and move to the anterior chest wall (towards the midclavicular line).
5) If you find the apex beat difficult to palpate in your colleague, a brisk “jogging on the spot” by your colleague (for 1 minute) may increase the heart rate and strength of the heart beat that enables easier palpation.
6) In females, the examiner’s hand should be laid beneath the breast along its lower border (a mitral valvotomy scar could be missed if the apex beat is not visualised).

Question 9

A hyperkinetic and more sustained apex beat called a

Answer 9

thrill

Question 10

what does it signify

Answer 10

is more characteristic of volume overload, and may occur in heart failure, and mitral and aortic regurgitation.§

Question 11

dextrocardia

Answer 11

the apex beat will be palpable on the right side of the sternum.

Question 12

the abnormality bronchial breathing sounds like what

Answer 12

tardis

Question 13

Auscultation of the Heart Valves

4 steps

Answer 13

Inspection

2. Palpation
3. Percussion
4. Auscultation

Question 14

Mitral

Answer 14

left 5th intercostal space at the midclavicular line (= apex beat area).

Question 15

Tricuspid

Answer 15

left 5th intercostal space near the sternum.

Question 16

Pulmonary

Answer 16

left 2nd (or 3rd) intercostal space near the sternum.

Question 17

Aortic

Answer 17

right 2nd intercostal space near the sternum.

Question 18

lub

Answer 18

1st heart sound (S1) due to closure of atrioventricular valves (low pitched)

Question 19

dub

Answer 19

2nd heart sound (S2) due to closure of aortic and pulmonary valves (high pitched).

Question 20

Pulse rate

Answer 20

usually assessed by palpating right radial pulse and expressed in beats per minute

Question 21

Rhythm

Answer 21

usually assessed by palpating right radial pulse. The rhythm can be regular or irregular. Irregular rhythm is usually due to cardiac problems such as atrial fibrillation or ectopic beats.

Question 22

Character and volume

Answer 22

usually assessed by palpating the right carotid artery pulse which is closest to the heart than the radial pulse.

Question 23

Symmetry

Answer 23

of radial, brachial, femoral, popliteal, and pedal pulses can be assessed by comparing pulses on both sides.

Question 24

Radio-femoral delays

Answer 24

between major arteries might observed and are abnormal.

Question 25

where is radial pulse

Answer 25

near thumb

Question 26

where is ulnar pulse

Answer 26

opposite side near pinkie

Question 27

where are the brachialis pulses

Answer 27

elbow and low bicep

Question 28

carotid pulse

Answer 28

neck

Question 29

superficial temparol

Answer 29

in front of ear