Precordial Examination

Question 1

What is a Precordial Examination?

Answer 1

This is an examination of the heart which is located in the precordium.

Question 2

Name the Steps involved in the Precordial Examination?

Answer 2

• Inspect
• Palpate
• Auscultation

Question 3

Inspection:

Answer 3

-Scars, deformities, dilated vessels, evidence of surgery or pacemaker

Question 4

Palpation

Answer 4

Locate apex beat- 5th left intercostal space (hands horizontal)

• Sternal heave- left side of sternum (heel of hands upwards)
• Palpate the X4 valves (Aortic, Pulmonary, Tricuspid and mitral)

Question 5

Where is the apex beat located?

Answer 5

Left 5th intercostal space

Question 6

Where is the sternal heave located?

Answer 6

Left sternal angle (heel of hands upwards)

Question 7

Auscultation

Answer 7

Valve Areas:

Listen for the X4 valve areas- Aortic, pulmonary, tricuspid and mitral)

-Image of valve areas- on notes

Tips: Accentuates Sounds

• Turn patient to left side and listen for apex beat- identifies mitral stenosis
• Sit patient forwards and ausculate over left lower parasternal edge > Aortic Regurgitation !!!!!!

Carotids:
-Left and right carotid arteries neck

Question 8

How is the aortic and mitral regurg tested?

Answer 8

Mitral Regurg- turn patient on to their left side and listen over the mitral valve area

Aortic Regurg- listen over the aortic valve and get patient to sit foward and gold their breath in (makes the sound more clear)