Cardiovascular Clinical Bedside Examination Quiz 4

Clinical Bedside Examination

• Systolic blood pressure response follows four phases: transient increase, sharp decrease, acute drop, and "overshoot" increased blood pressure
• Method to evaluate jugular venous pressure (JVP) involves measuring the vertical distance in centimeters above the sternal angle where the horizontal object crosses the ruler and adding 5 cm
• Breast development typically begins by age 12, and males can also get breast cancer
• Carotid artery palpation should be done cautiously to prevent dislodgment of atherosclerotic plaque, which could lead to stroke
• Jugular venous pulsations (JVP) are usually evident in euvolemic patients and an elevated JVP is correlated with acute and chronic heart failure, tricuspid stenosis, chronic pulmonary hypertension, and other conditions
• Comprehensive cardiovascular exam includes assessment for breast changes, abnormal lymph nodes, and conditions like impaired cardiac output, pericarditis, infective endocarditis, myocarditis, valvular disorders, and cardiomyopathy
• Different types of pulses such as a left-sided S4, bisferiens pulse, and paradoxical pulse indicate specific cardiac conditions
• Electrical alterations like dysrhythmias (bradycardia, tachycardia, atrial fibrillation, atrial flutter) and irregular ventricular rhythm should be assessed
• Heart sounds should be evaluated for variations in intensity
• Spleen located in the left upper quadrant (LUQ) can cause LUQ pain and swelling if inflamed
• Abnormal lymph nodes should be assessed for characteristics like fixed, hard, asymmetric, and swelling, while normal lymph nodes are soft, movable, and symmetric
• Lymphadenopathy should be distinguished between local and generalized, with cervical lymph node swelling being the most common. Supraclavicular swelling requires further investigation.

Clinical Examination of Cardiovascular System

• Blood pressure in the arterial system varies during the cardiac cycle, peaking in systole and falling to its lowest trough in diastole.
• Jugular venous pressure (JVP) reflects right atrial pressure, which equals central venous pressure and right ventricular end-diastolic pressure.
• JVP is best assessed from pulsations in the right internal jugular vein, directly in line with the superior vena cava and right atrium.
• Factors affecting JVP include loss of blood, decreased venous vascular tone, right or left heart failure, pulmonary hypertension, tricuspid stenosis, AV dissociation, increased venous vascular tone, and pericardial compression or tamponade.
• To estimate JVP, find the highest point of oscillation in the internal jugular vein or the point above which the external jugular vein appears collapsed.
• Blood pressure levels fluctuate throughout the day due to physical activity, emotional state, pain, noise, environmental temperature, and substance use.
• Left ventricular stroke volume, aorta and large artery distensibility, peripheral vascular resistance, and arterial blood volume affect blood pressure.
• Blood pressure is usually measured at the fourth intercostal space at the sternum with the cuff centered over the brachial artery.
• Inflating the cuff approximately 30 mm Hg above the pressure at which the pulse disappears helps in measuring blood pressure.
• Heart rate can be assessed by palpating the radial pulse or auscultating the apical pulse.
• EKG waveform P QRS T and health history, including past medical history, medications, holistic aspects, chief complaints, and review of systems are important in clinical examination.
• Physical exam techniques include client positioning and assessment of the precordial examination, PMI, and extra heart sounds.

Test your knowledge of clinical bedside examination and cardiovascular system assessment with this quiz. Explore topics such as jugular venous pressure assessment, blood pressure fluctuation, cardiac exam techniques, and identification of abnormal findings like lymphadenopathy and abnormal heart sounds.