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38 Cards in this Set

  • Front
  • Back
S1
-First normal heart sound
-Beginning of systole
-Tricuspid and Mitral valves close
S2
-Signifies end of systole
-Second normal heart sound
-Aortic and Pulmonic valves close
S3
-Sometimes occurs after S2
-Not necessarily pathological for those under 30yo
S4
-Heard before S1
-Signifies ventricular hypertrophy
In order, cardiac auscultation locations
Aortic
Pulmonic
Erb's Pointe
Tricuspid
Mitral
Aortic Auscultation Location
-2nd intercostal space, right sternal border
-Best location to hear aortic valve
-S2 should be louder
Pulmonic Auscultation Location
-2nd intercostal space, left sternal border
-Best location to hear pulmonic valve
-S2 should be louder
Erb's Pointe
-3rd intercostal space, left sternal border
-S1 and S2 typically have same volume at this location
Tricuspid Auscultation Location
-4th intercostal space, left sternal border
-Best location to hear tricuspid valve
-S1 should be louder
Mitral Auscultation Location
-5th intercostal space, midclavicular line
-Best location to hear mitral valve
-Also location to begin searching for apical pulse
-S1 should be louder
How should the heart be auscultated?
-All five cardiac auscultation points, in order (APETM)
-Once with diaphragm and once with bell side of stethoscope
Murmur
-Sound heard due turbulence caused by leaky valve or abnormal blood flow through heart chambers
Bruit
-Sound heard due to turbulence caused by abnormal blood flow due to plaque on artery walls
Tangential Lighting
-Penlight used at 90* angle to skin
-Used to see depth on skins surface
-Used on neck to check for jugular vein distention
-Used on precordial area to check for abnormalities
Precordial
-Body surface directly over the heart
Continuous Murmur
-A murmur that continues through both systole and diastole
-Potentially very serious, notify healthcare provider
Diastolic Murmur
-A murmur present only during diastole
-Potentially very serious, inform healthcare provider
Systolic Murmur
-A murmur present only during systole
-More common and less likely to be a serious issue
Pansystolic or pandiastolic murmur
-A murmur heard throughout the respective phase
-As opposed to early, mid or late murmurs present during the described period of the phase
What arteries may be auscultated?
Temporal (checked for bruit)
Carotid (checked for bruit)
-Checked in three locations
-High
-Middle
-Lower
Brachial (used for BP)
Femoral (checked for bruit)
Heaving
-Palpable feeling of heart solidly hitting chest wall
Commonly Examined Lymph Node Locations
Preauricular
Postauricular
Submandibular
Submental
Anterior Cervical Chain
Posterior Cervical Chain
Deep Cervical Chain
Superficial Cervical Chain
Supraclavicular
Axillary
Epitrochlear
Femoral
Normal Lymph Node Response
-Palpable when 1-2cm
-Rubbery
-Movable
-Swelling typically bilateral
-Well defined edges
Modified Allen's Test
-Used to test quality of blood supply to hand, especially prior to procedures involving the radial artery
-Radial and ulnar arteries are occluded stopping blood flow
-Client clinches hand several times
-One artery is released to evaluate how quickly color and blood supply perfuses the palm
-Repeated for other artery
Pitting
-Depression left when pressure is applied to edema
Pitting
-Depression left when pressure is applied to edema
Brawny
-Edema does not pit
Pitting
-Depression left when pressure is applied to edema
Brawny
-Edema does not pit
Edema Pitting Scale
1+ 2mm
2+ 4mm
3+ 6mm
4+ 8mm
Pitting
-Depression left when pressure is applied to edema
Brawny
-Edema does not pit
Edema Pitting Scale
1+ 2mm
2+ 4mm
3+ 6mm
4+ 8mm
Apical Pulse Width
-1-2 finger widths is normal
-3-4 finger widths is indicative of enlarged heart
Lift
-Feel pulsation of heart over precordial area
-Not term used for apical pulse
-Indicative of enlarged heart
Thrill
-Feeling as though a car is purring when palpating precordial area
-Always related to a murmur
Pulse Locations
Temporal
Carotid
Apical
Brachial
Radial
Ulnar
Femoral
Popliteal
Dorsalis Pedis
Posterior Tibial
What is the normal sound when auscultating a peripheral artery?
-Nothing or faint S1, S2 sounds