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20 Cards in this Set

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  • Back


right atrial pressure/CVP

decreases with blood loss

increases with heart failure, pulmonary HTN,

tricuspid stenosis

Obstructive lung dz-increases on expiration

hypovolumic-lie flat


early diastole

right left sternal border

left apex

left lateral side position

after S2


late diastole

left apex

just before S1

heard with bell held tightly-low freq

sign of ventricular distress

palpate for heaves, lifts, thrills

use palm of finger pads held flat

lifts and heaves

sustained impulses usually produced by an

enlarged right of left ventricle or atrium.

If present you will feel the impulse rhythmically lift your finger.


press the ball of your hand firmly on the chest to chest for buzzing or vibrating sensation from

underlying vascular turbulence.

Presence of a thrill changes the grading

S1 and S2 palpation

S3 and S4 palpation

Using firm pressure, place you right hand on the chest wall. With your left index finger and middle finger, palpate the carotid artery.

**just before carotid upstroke

Apply lighter pressure at the cardiac apex.

**follows carotid upstroke

Apical impulse

Left ventricular area

2.5cm normal

>4 or 5 left ventricular overload

Increase in amplitude with hyperthyroid, left ventricular overload

LVH, aortic stenosis, HTN

Impulse of

Left sternal border 3,4,5

Right ventricular area

Increase in right ventricular overload, right atrial septal defect, pulmonic stenosis, pulmonary HTN.

if obstructive pulmonary dz-the impulse is felt in the epigastrium.

Impulse of

pulmonic area

Left 2nd Interspace

Increased in pulmonary HTN

Impulse of

Aortic Area

Right 2nd interspace

Increased in Systemic HTN

pulsation here suggests dilated or aortic anuresym.


Used to estimate cardiac size except if you cannot feel the apical impulse.


high pitch



Aortic and mitral regurg

pericardial friction rub



low pitch


mitral stenosis


apply lightly with just enough pressure to get a seal. Pressing too firmly makes it function more like a diaphragm.

left lateral position

S3/S4 mitral murmurs

Sit up, lean forward, stop breathing

Aortic murmurs

Extra sounds in systole

ejection sound and systolic click

Extra sounds in diastole

Opening snap, S3 and S4

Standing squatting

identifies mitral valve prolase-shortens murmur

distinquishes Hypertropic Cardiomyopathy (decreases murmur) from aortic stenosis (increases murmur)


Increased in mitral proplase

HC-decreases with squatting, increases with


HC-Only systolic murmur to increase with