Cardiovascular System Examination PDF
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This document provides a comprehensive overview of cardiovascular system examination procedures. Methods are outlined for assessing various aspects of the system, from general impression and hand evaluation to specific features of the face, neck, arms and chest. It includes important details on key observations crucial in diagnosis.
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+-----------------------------------+-----------------------------------+ | 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 | +-----------------------------------+-----------------------------------+
