Thorax exam Flashcards
Normal adult respirations
12-20 / min
Normal newborn respirations
30-40 / min
4 components of the cardiovascular exam
Percussion, inspection, palpation, auscultation
Normal JVP measurement
< 8-9 cm
In patients with this condition, jugular venous pressure may elevate on expiration and the veins may collapse on inspiration
COPD
Is NOT indicative of heart failure
The point of maximal impulse is between these ribs
5 and 6
Palpation in the cardiac exam with movement of the sternum
Abnormal right ventricular lift
Palpation in the cardiac exam with left sternal border motion
Abnormal left ventricular lift
Lateral displacement of the apical impulse toward the axillary line from ventricular dilation is seen in these 3 conditions
Heart failure
Cardiomyopathy
Ischemic heart disease
2nd right intercostal space contains this
Aorta
2nd left intercostal space contains this
Pulmonary trunk
Lower left sternal border contains this
Tricuspid valve
S2 is heard in this area
2nd right and left intercostal spaces at the upper sternal border
S2 is heard with this part of the stethoscope
Diaphragm
Characteristic S2 split is usually best heard here
Left 2nd intercostal space close to the sternum
The S2 split is heard with this part of the stethoscope
Diaphragm
The S2 split is heard during inhalation or exhalation?
Inhalation
The S1 sound is loudest here
4th left intercostal space at the left sternal border
S4 is heard in these patients
Diastolic heart failure
S4 is heard in the same location as this sound
S1
(at 4th left ICS)
S1 sound is due to these structures
Tricuspid and mitral valves
S2 sound is due to these structures
Aortic and pulmonary valves
Sound heard in diastolic heart failure patients
S4
Sound heard in systolic heart failure patients
S3
Part of the stethoscope that can be used to hear heart sounds when the lungs are too loud
Bell
Mitral stenosis and S3 may be heard here
Mitral area
Apex of heart / PMI
Rolling the patient to the left lateral position allows these to be heard over the PMI with the bell
Mitral stenosis and S3