Cardiac and Peripheral Vascular Examination Techniques

Cardiac Auscultation

Listening to heart sounds using a stethoscope.

Point of Maximum Impulse

Location where heart's contraction is felt strongest.

Peripheral Vascular Exam

Assessment of blood circulation in extremities.

Capillary Refill

Time taken for color to return after pressure.

Peripheral Edema

Swelling due to fluid accumulation in tissues.

Deoxygenated Blood

Blood lacking oxygen, flows to right atrium.

Oxygenated Blood

Blood rich in oxygen, flows from left ventricle.

S1 Heart Sound

First heart sound; indicates ventricular contraction.

S2 Heart Sound

Second heart sound; indicates ventricular filling.

S3 Heart Sound

Rapid filling sound in a not empty ventricle.

S4 Heart Sound

Sound from a stiff ventricle being overfilled.

SA Node

Primary pacemaker initiating heart's electrical impulse.

AV Node

Delays impulse before it reaches ventricles.

Bundle of His

Conducts impulses from AV node to ventricles.

Purkinje Fibers

Distributes electrical impulses throughout ventricles.

History of Present Illness (HPI)

Detailed account of patient's current health issue.

Myocardial Infarction

Heart attack caused by blocked blood flow.

Syncope

Temporary loss of consciousness; fainting.

Dyspnea

Shortness of breath; difficulty breathing.

Palpitations

Uncomfortable awareness of heart beating irregularly.

Clubbing

Bulbous swelling of nailbed; indicates chronic hypoxemia.

Bruit

Abnormal sound indicating turbulent blood flow.

Carotid Pulse Palpation

Technique to assess blood flow in carotid artery.

Diaphoresis

Excessive sweating, often linked to distress.

Edema Assessment

Evaluation of swelling in extremities for fluid retention.

Turbulent flow

Sound in blood vessels, like a soft whoosh.

Carotid

Major artery in the neck for blood flow.

Femoral

Artery supplying blood to the thigh and leg.

Aorta

Largest artery, carries blood from the heart.

Aortic position

2nd right intercostal space (ICS) for auscultation.

Pulmonic position

2nd left intercostal space (ICS) for auscultation.

Tricuspid position

4th or 5th left intercostal space (ICS) for auscultation.

Mitral position

5th ICS, midclavicular line for auscultation.

S1 sound

Closure of mitral and tricuspid valves; 'lub'.

S2 sound

Closure of aortic and pulmonic valves; 'dub'.

Split S2

Delay in P2 during inspiration; normal variant.

Gallops

Extra heart sounds S3 and S4 indicating issues.

Physiologic murmur

Normal flow murmur due to increased blood velocity.

Pathologic murmur

Turbulence from obstructed or leaky heart valves.

Systolic murmurs

Most common murmurs, occur with pulse.

Diastolic murmurs

Rare murmurs, always pathologic.

Point of Maximal Impulse (PMI)

Location where heart strikes chest wall.

PMI diameter

Normal size is less than 2.5 cm.

Peripheral pulses grading

0 to 4 scale for pulse strength.

Peripheral edema

Fluid imbalance causing swelling, often in legs.

Capillary refill

Time for color to return after blanching.

Normal capillary refill

Less than 3 seconds to return to normal.

Common abnormal findings

Signs of vascular disease in patients.