Flashcards in Clinical Skills Deck (74)
Cardiovascular examination of the hands
capillary refill, peripheral cyanosis, xanthomaa, Janeway lesions (not-painful), oeslers nodes (painful), splinter haemorrhages, clubbing
Which lesions are painful?
What are splinter haemorrhages the result of?
Which pulses should be examined in the cardiovascular system?
carotid, brachial, radial
Why would you take blood pressure and pulses on each arm?
to compare any significant differences - these might indicate an aortic dissection or valvuler disorder if difference > 20mmHg
Procedure for checking BP
Wash hands, confirm patient details, inform that it may need to be done more than once, gain consent, inform that this may be withdrawn at any time, do BP, wash hands, thank patient, explain findings
Other pulse issues to be checked in arm?
collapsing pulse - CHECK FOR SHOULDER PAIN
Angle patient should be at during cardiovascular examination
The JVP should be measured from where?
the sternal angle
Where will the JVP be found?
above the supra-clavicular fossa
How might the JVP be accentuated?
asking the patient to take a deep breath or pressing in an upward motion on the liver
A raised JVP may be indicative of?
RHF, Right valvuler disease
What else should be checked at the carotids?
carotid bruits - ask patient to hold breath if necessary
A collapsing pulse is felt as...
a waterhammer pulsation
Things to report about a pulse (4)
rate, rhythm, character and volume
An irregularly irregular pulse is indicative of?
A bounding pulse may indicate?
CO2 retention, liver failure, sepsis
A visible carotid pulse may indicate?
Corneal arcus is a sign of...
Xanthelasma is a sign of...
Grey conjunctiva may indicate...
Anemia may cause which respiratory symptom?
malar flush can be described as...
butterfly pattern redness on cheek
Malar flush is a result of...
What is it important to palpate on the precordium?
the apex beat, heaves and thrills
Where should the apex beat be found?
mid-clavicular line, 5th intercostal space
A displaced apex beat may indicate?
A heave is indicative of...
right ventricular enlargement
A heave is likely to be felt at...
the left sternal edge