Heart and Peripheral Vascular System Findings

Carotid Artery Palpation - Normal Finding

Pulse is smooth, moderate strength, and equal bilaterally.

Carotid Artery Palpation - Abnormal Finding

Diminished pulse indicates decreased stroke volume (shock); bounding pulse indicates hyperkinetic states (fever, anxiety).

Carotid Artery Auscultation - Normal Finding

No bruits (turbulent blood flow sounds).

Carotid Artery Auscultation - Abnormal Finding

Bruit (blowing/swishing sound) indicates narrowing or atherosclerosis.

Jugular Venous Pressure (JVP) - Normal Finding

Veins flatten when sitting up; no distension.

Jugular Venous Pressure (JVP) - Abnormal Finding

Jugular Vein Distension (JVD) indicates right-sided heart failure or fluid overload.

Precordium Inspection - Normal Finding

No visible pulsations (except apical impulse in thin individuals).

Precordium Inspection - Abnormal Finding

Heaves/lifts (forceful pulsations) indicate ventricular hypertrophy.

Apical Impulse - Normal Finding

Located at 4th/5th ICS, MCL, light tap.

Apical Impulse - Abnormal Finding

Displaced impulse indicates enlarged heart (cardiomegaly).

Heart Rate & Rhythm - Normal Finding

60-100 bpm, regular rhythm.

Heart Rate & Rhythm - Abnormal Finding

Bradycardia (<60 bpm), Tachycardia (>100 bpm), or irregular rhythm (arrhythmias, atrial fibrillation).

S1 Sound - Normal Finding

Loudest at apex, corresponds with carotid pulse.

S1 Sound - Abnormal Finding

Diminished S1 indicates mitral stenosis or weak contraction.

S2 Sound - Normal Finding

Loudest at base, marks end of systole.

S2 Sound - Abnormal Finding

Fixed splitting of S2 indicates atrial septal defect.

S3 Sound - Normal Finding

Normally absent.

S3 Sound - Abnormal Finding

Present in heart failure (fluid overload).

S4 Sound - Normal Finding

Normally absent.

S4 Sound - Abnormal Finding

S4 heard in hypertension, stiff ventricles (LV hypertrophy).

Murmurs - Normal Finding

No extra sounds.

Murmurs - Abnormal Finding

Systolic murmur indicates aortic stenosis; Diastolic murmur indicates mitral stenosis.

Skin Color & Temperature - Normal Finding

Pink, warm.

Skin Color & Temperature - Abnormal Finding

Pale, cool skin indicates poor circulation (arterial insufficiency); cyanosis indicates hypoxia.

Capillary Refill - Normal Finding

Less than 2 seconds.

Capillary Refill - Abnormal Finding

Greater than 2 seconds indicates poor perfusion (shock, dehydration).

Peripheral Pulses - Normal Finding

2+ (normal), equal bilaterally.

Peripheral Pulses - Abnormal Finding

0 (absent pulse) indicates arterial occlusion; 3+ (bounding pulse) indicates fluid overload.

Edema - Normal Finding

No swelling.

Edema - Abnormal Finding

Pitting edema (1+ to 4+) indicates heart failure, DVT, or lymphedema.

Hair Distribution - Normal Finding

Normal growth.

Hair Distribution - Abnormal Finding

Decreased hair on legs indicates peripheral artery disease.

Varicose Veins - Normal Finding

None present.

Varicose Veins - Abnormal Finding

Bulging, tortuous veins indicate venous insufficiency.

Normal Jugular Venous Pressure (JVP)

Should not exhibit distension when sitting up.

Abnormal Heart Rate in Adults

Irregular heart rates can signal underlying cardiovascular issues.

Function of the Carotid Artery

Supplies blood to the brain, neck, and face.

Impact of Bradycardia

May result from heart block or medication effect.

Impact of Tachycardia

Can result from fever, anxiety, or heart conditions.

Importance of Edema Assessment

Helps in diagnosing heart failure and fluid overload.

Finding S3 Heart Sound

Often associated with fluid overload conditions.

Inspection for Heaves/Lifts

Indicates cardiac enlargement and increased workload.

Underlying Cause of bruit

May indicate arterial narrowing or increased blood flow.

Observing Jugular Veins

Helps assess right heart function and fluid status.

Abnormal S1/S2 Sounds

Signal possible valve dysfunction or heart condition.

Cold, Pale Skin Significance

Often indicates reduced blood flow and potential ischemia.

Capillary Refill as Vital Sign

Quick assessment for peripheral perfusion.

Normal Peripheral Pulse Assessment

Crucial for evaluating arterial health.

Performing Apical Pulse Check

Useful for assessing ventricular health directly.

Hair Distribution Changes Indicating Disease

Can reflect underlying vascular insufficiency.

Pulse Characteristics Evaluation

Assessing quality and regularity can indicate cardiac function.

Significance of Heart Sounds during Assessment

Key for diagnosing specific cardiac conditions.