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A1 cardiovascular examination (ausculation (MS MS (extra heart sounds (S3,…
A1 cardiovascular examination
head
eye
face
mouth
hands
radial pulse
radial pulse
rate, rhythm
radial-radial
radial-femoral
collapsing pulse
flapping tremor
flapping tremor, sweaty palm, bounding pulse
appearance
lesion, stain
nail, capillary refill
clubbing
temperature
neck
carotid pulse
volume, character
AS: slow upstroke
AR: collapsing pulse
JVP (hepatojugular)
height
normal: 3 + 5 = 8cm
0 point: sternal angle
5 cm: centre of R atrium
character
canon a wave
complete heart block
giant a wave
TS, MS (pHT)
absent a wave
AF
giant v wave
TR
position, respiration
v visible, x palpable
hepatojugular reflex
v obliterated
a wave: atrial systole, v wave: atrial filling
palpation
apex beat (L lateral)
displace laterally/inferiorly
cardiomegaly
double
hypertrophic cardiomyopathy
tapping
MS
volume overload
MR, AR
pressure overload
AS, HT
parasternal heave
right ventricle/left atrium enlargement
thill/palpable murmur
ausculation
MS MS
extra heart sounds
S3
mid diastolic: kentucky
MR
volume overload
S4
atrial systole on poorly compliant ventricle
hypertrophic cardiomyopathy
late diastolic: 007
MR MR
TR TR
hold your breath
A0 AS
AR CHF
sacral edema
inspection
scar
pacemaker
valve replacement
coronary artery bypass grafting
deformity
funnel chest: pectus excavatum
pigeon chest: pectus carinatum
general
respiratory distress (accessory muscles)
obese, cachetic
conscious and alert
bedside
ankle edema
temp, BP
peripheral vascular examination
ECG
