HEART

Question 1

CHECK THE 5 CARDIAC AREAS FOR PULSATIONS

Answer 1

POSITIVE: Impulse that rhythmically lifts your fingers INDICATES: Possible cardiac hypertrophy

Question 2

CHECK FOR APICAL IMPULSE

Answer 2

NORMAL: Normal size is approximately 1 cm ABNORMAL: Displacement of the apical impulse right or left

Question 3

CHECK FOR EPIGASTRIC PULSATIONS

Answer 3

POSITIVE: 1. Pulsations coming from superior to inferior 2. Pulsations coming from inferior to superior INDICATES: 1. May indicate right ventricular enlargement 2. May indicate abdominal aortic aneurysm

Question 4

CHECK THE 5 CARDIAC AREAS FOR THRILLS

Answer 4

POSITIVE: A fine, palpable, rushing vibration INDICATES: Grade IV murmur or higher

Question 5

PAIRING OF S1 AND CAROTID PULSE

Answer 5

NORMAL: S1 and the carotid pulse should be synchronous

Question 6

IDENTIFY THE LOCATION AND SIZE OF HEART (PERCUSS)

Answer 6

Percuss down the right sternal border beginning at Aortic Area. Dullness is heard at the 6th intercostal space indicating the superior border of liver (make 1 horizontal mark male and female)

Question 7

AUSCULTATE FOR HIGH PITCHED GENERAL CARDIAC SOUNDS

Answer 7

NORMAL: Listen for rate and rhythm

Question 8

AUSCULTATE FOR LOW PITCHED GENERAL CARDIAC SOUNDS

Answer 8

NORMAL: Listen for rate and rhythm

Question 9

LISTEN IN THE MITRAL AREA FOR S1 AND PALPATE THE CAROTID PULSE - CHECK FOR PAIRING OF THE TWO

Answer 9

NORMAL: S1 and the carotid pulse should be synchronous

Question 10

LISTEN AT THE PULMONIC AREA TO S2 DURING DIASTOLE

Answer 10

VERBALIZE: S2 is heard loudest at base during diastole. I am listening for accentuated, diminished, and splitting, and splitting of S2, abnormal heart sounds and pulmonic murmurs

Question 11

SPECIAL MANEUVER FOR MITRAL MURMUR

Answer 11

BELL (DEEP BREATH IN BEFORE left lateral decubitus position)

Question 12

SPECIAL MANEUVER FOR AORTIC MURMUR

Answer 12

DIAPHRAGM