Thorax Examination [Cardiovascular Station] (Complete) Flashcards
Please auscultate for the pulmonary valve
“Im just going to listen to your heart which will involve me placing a stethoscope on your chest”.
Left upersternal border at the 2nd ICS
N.B. Palpate the right carotid artery during this to identify the first heart sound
Please auscultate for the aortic valve
“Im just going to listen to your heart which will involve me placing a stethoscope on your chest”.
Right upersternal border at the 2nd ICS
Please auscultate for the tricuspid valve
Left 5th costosternal border
Please auscultate for the mitral valve
Left fifth intercostal space at apex beat
Please palpate for the apex beat of the heart
"”Im just going to feel your chest for the apex beat of the heart. Could you please lie down for me?”
Locate the midclavicular line and then the 5th intercostal space at the line visually for your examiner to see.
Feel for the apex beat alonge the 5th intercostal space
You will use your palm and middle three 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 your palpation starting from the left lateral chest wall near the mid-axillary line and move to the anterior chest wall towards the mid-clavicular line.
Please assess for the temperature and capillary refill
“Could you please put your arms out in front of you like this im just going to assess the temperature”
Feel the arm extremities
For CRT use thumb and press on their middle finger
Please measure the heart rate of the patient.
Middle three fingers palpating the radial pulse
Please palpate the carotid artery pulse
“Im now going to feel for the pulse in your neck”
Remember to use your middle hree fingers
Please auscultate the carotid artery
“Im just going to have a listen and feel for the pulse in your neck. Id like you to take a deep breath for me and hold it whilst im doing this”
Remember to use the small bell for this
Please palpate the superficial temporal artery
“Im just going to feel for the pulse on your temple”
Please assess the jugular venous pressure
“Could you lay down for me and turn your head to the left?”
A raised jugular venous pressure can be visibly seen between the two heads of the sternocleomastoid muscle
Please assess for the hepatojugular reflex
“Could you please lay down for me and turn your head to the left?”
“Im just going to press gently on your abdomen”
Please assess for a parasternal heave
“Im just going to have a feel of your chest”
Place the heel of your hand parallel to the left sternal edge (fingers vertical) to palpate for heaves.
(If heaves are present you should feel the heel of your hand being lifted with each systole. Parasternal heaves are typically associated with right ventricular hypertrophy).
Please assess for thrills
“Im just going to have a feel around your chest”
You should assess for a thrill across each of the heart valves in turn (see valve locations below).
To do this place your hand horizontally across the chest wall, with the flats of your fingers and palmover the valve to be assessed.
(Start from most bottom left to upper right)
Please palpate for the ulnar pulse
Pulse on the pinky side
Please palpate the brachial pulse
Find tendon in antecubital fossa and palpate medially
Please palpate for the superficial temporal artery pulse
In front of the tragus of the ear
Please assess for radio-femoral delay
Femoral artery is palpated at the midpoint between the ASIS and pubic symphysis under the inguinal ligament
Please palpate for the popliteal artery pulse
Please palpate for the dorsalis pedis artery
Please palpate for the posterior tibial artery pulse
