Week 10 Percussion_BP_PFI Flashcards
Physical examination
Inspection
Palpation
Percussion
Ausculation
Percussion sounds
Resinant: air-filled organ eg.Lung
Tympanic: air in the organ, no pressure ,drum like eg.stomach and guts
Dull: no air organ eg. Heart liver
Relative dullness of the heart
Size and location of the heart
Upper: 3. Intercostal space
Lower: diaphragm
Left: medioclavicular line, 5 th intercostal space
Right: no exceed sternum
Absolute dullness of the heart
The part is not covered by lungs
Exam: weak percussion-> no sound
Normal border of the lung
- Parasternal line 5 ICS
- Medioclavicular line 6 ics
- Anterior axillary line 7 ics
- Medial axillary line 8 ics
- Scapular line 10 ics
- Paravertebral line 11 ics
Auscultation of the heart
1st heart sound
-closure of av valves
-isovolumetric contraction of the ventricle
-after R wave of ECG
- longer
Auscultation of the heart
2nd heart sound
Closure of semilunar valves
After T wave of ECG
Shorter
Auscultation of the heart
3rd heart sound
Extremely fast ventricular filling
Auscultation of the heart
4th heart sound
Always Pathological
Atrial systole
Punctum maximum
- Tricuspid valve: 4th ICS right parasternal
- Pulmonary valve: 2nd ICS, left parasternal
3.Bicuspid valve: 5th ICS left mid clavicola
4.Aortic valve: 2nd ics right parasternal
Valves disorder
Insufficiency and stenosis
Normal breath sounds
Vesicular sounds- normal, only in inspiration
Bronchovesicular sounds
Bronchial sounds- normal above trachea, spinal cord, and right scapula
Abnormal breathing sounds
Intrapumonal- wheeze: asthma, crackle: mucus, crepitation: pneumonia
Extrapumonal:-pleural friction rub, pleuritis
Pulse mean:
A change in pressure and volume at given point in vasculature
60-100/ min
Pulse wave:
Pressure and volumn fluctuations through the arterial system that dilate the walls of the arteries
