Cardiovascular System Examination PDF

+-----------------------------------+-----------------------------------+ | WIPE | - Wash hands | | | | | | - Introduce yourself and gain | |...

+-----------------------------------+-----------------------------------+ | WIPE | - Wash hands | | | | | | - Introduce yourself and gain | | | consent | | | | | | - Position patient | | | | | | - Expose and explain | | | examination | +===================================+===================================+ | General Impression | - Bedside medications = GTN's | | | | | | - Surgical scars | | | | | | - Shortness of breath or | | | increased WOB | | | | | | - Colour = cyanosis, pallor, | | | malar flush (mitral stenosis) | +-----------------------------------+-----------------------------------+ | Hands | - Finger clubbing = nails & | | | knuckles together = cyanotic | | | congenital heart disease & | | | ineffective endocarditis | | | | | | - Janeway lesions = purple/red | | | lesions = bacterial | | | ineffective endocarditis | | | | | | - Splinter haemorrhages = | | | bruising under nails = | | | ineffective endocarditis | +-----------------------------------+-----------------------------------+ | Face | - Scleral jaundice = check for | | | yellow eyes by lifting eyelid | | | = CVD | | | | | | - Conjunctival pallor = pale | | | skin in eye = underlying | | | anaemia | | | | | | - Xantholasma = yellow bumps = | | | high cholesterol = increased | | | risk of heart attack | | | | | | - Central cyanosis = bluish | | | colouration of lips/tongue = | | | inadequate oxygenation | | | | | | - Dental hygiene = poor = | | | ineffective endocarditis | | | | | | - High-arched palate = high and | | | narrow = Marfan's syndrome = | | | congenital heart disease | +-----------------------------------+-----------------------------------+ | Neck | - Jugular venous pressure = | | | right internal jugular vein | | | should flicker 2x per beat at | | | less than 4cm | | | | | | - Carotid bruits = listening to | | | carotid pulse for beats only | | | = abnormal sounds = arterial | | | occlusive pathology that can | | | lead to a stroke | +-----------------------------------+-----------------------------------+ | Arms | - Radial pulses = rate and | | | rhythm | | | | | | - Radio-radial delay = both | | | radial pulses at the same | | | time = narrowing of aorta | | | (atherosclerosis) | | | | | | - Brachial pulse = rate, rhythm | | | and character | | | | | | - Sitting vs standing blood | | | pressure = difference of more | | | than 15 = orthostatic | | | hypotension | +-----------------------------------+-----------------------------------+ | Chest | - Scars = indicators of | | | previous surgeries | | | | | | - Apex beat = 5^th^ intercostal | | | space = displacement = | | | ventricular hypertrophy | | | | | | - Auscultation = all four | | | points for dual sounds | +-----------------------------------+-----------------------------------+ | Abdomen | - Palpation of liver = firm, | | | spongey feeling = right heart | | | failure or tricuspid | | | regurgitation | | | | | | - Ascites = fluid within the | | | abdomen = right heart failure | | | | | | - Percussion = hollow until you | | | reach the ribs | +-----------------------------------+-----------------------------------+ | Back | - Inspect for scars = previous | | | surgeries | | | | | | - Auscultate 6 lung fields | | | (around the scapula) | | | | | | - Percuss lower lobes = dull | | | sound = pleural effusion = | | | cardiac failure | | | | | | - Palpation = sacral oedema = | | | severe right heart failure | +-----------------------------------+-----------------------------------+ | Legs | - Peripheral cyanosis = bluish | | | discolouration of extremities | | | = peripheral vascular disease | | | | | | - Pitting oedema = swelling in | | | ankles = congestive heart | | | failure | | | | | | - Calf tenderness = sign of CVD | | | | | | - Saphenous vein harvesting = | | | small incision above the knee | | | = removal of a blood vessel | | | in coronary artery bypass | | | graft = coronary heart | | | disease | | | | | | - Pedal pulse | +-----------------------------------+-----------------------------------+