HA exam 2 - cardiovascular

breast, lymphatic, HEENT, neuro, cardiac, respiratory, GI & GU assessment

five components required for complete cardiovascular history

past medical, surgical, family, social, medications

lift

sustained, upward movement of the chest wall caused by the heart's forceful contraction

heave

forceful, pronounced movement of the chest wall reflecting strong, sustained heart contractions

thrust

localized, vigorous, and abrupt outward movement of the chest wall, often where the apex strikes

thrill

Palpable vibrations caused by loud cardiac murmurs

patient position for cardiovascular inspection and palpation

supine with HOB elevated to 45 degrees

three pulses typically assessed in upper body and neck

brachial, radial, carotid

steps in sequence of cardiovascular auscultation

identify heart sounds, determine HR, determine heart rhythm

S3 heart sound

best auscultated over apex or lower left sternal border; occurs during early diastolic; considered normal in children and young adults

pathologic conditions associated with constant loud S3 sound

volume overload, left ventricular systolic dysfunction; hear S3 gallop sound as KEN-TU-CKY

S4 heart sound

best auscultated over apex; occurs in late diastolic; always considered abnormal

pathologic condition associated with S4 gallop

uncontrolled hypertension; hear as TEN-NES-SEE

when is systolic murmur heard

between S1 and S2w

when is diastolic murmur typically heard

between S2 and S1

aortic regurgitation

early diastolic murmur; often caused by bicuspid aortic valve

pericardial friction rub

inflammation of pericardium; have patient hold breath to differentiate from pleural friction rub

grade 1/6 systolic murmur

barely audible

grade 2/6 systolic murmur

audible but soft

grade 3/6 systolic murmur

easily audible

grade 4/6 systolic murmur

easily audible, associated with thrill

grade 5/6 systolic murmur

easily audible, associated with thrill, still heard with stethoscope lightly on chest

grade 6/6 systolic murmur

easily audible, associated with thrill, still heard with stethoscope off chest

point of maximum impulse (PMI)

where heart apex strikes on chest wall

murmurs

extra heart sounds characterized by turbulent blood flow across valves