Cardiac & Resp Examination Flashcards
What are you looking for in the hands in CV exam?
Temperature Cap refill Endocarditis stigmata: Clubbing Splinter haemorrhages Osler's nodes Janeway lesions
What do you do after hands in CV exam?
Radial pulse (rhythm, rate) Radial radial delay Collapsing pulse Brachial/carotid (volume, character) Blood pressure
What do you look for in the face in CV exam?
Xanthelasma Corneal arcus Conjuntival pallor Central cynaosis Malar flush Would do fundoscopy for roth spots
What do you do for the chest in CV exam?
Inspection (pacemaker/scars/deformities/chest drain)
JVP (+hepatojugular reflex)
Palpate apex beat, heaves and thrills
Auscultate aortic, pulmonary, tricuspid, bicuspid
Radiation to carotids
Mitral murmur? (turn onto left)
Aortic murmur? (sit forwards and hold breathe out)
Name the 2 systolic murmurs
Aortic stenosis (ASS) (ejection systolic) Mitral regurgitation (pansystolic)
Name the 2 diastolic murmurs
Aortic regurgitation (early diastolic) Mitral stenosis (congenital/rheumatic disease) (mid diastolic)
General inspection clues in respiratory exam
O2 mask/nasal cannula Inhalers/nebulisers/spacers Peak flow meter Sputum pot Scars Drains Breathless at rest?
What do you look for in the hands in a resp exam?
Clubbing Peripheral cyanosis Tremor (B2 agonist use) Pulse CO2 retention flap
What do you look for in face in a resp exam?
Conjunctival pallor
Horner’s syndrome
Central cyanosis
Oral thrush (steroid use)
What do you look for in neck in resp exam?
JVP (cor pulmonale, tension pneumothorax, SVC obstruction)
Lymph nodes
Causes of clubbing
Carcinoma of bronchus Cystic fibrosis/empyema/lung abscess Cyanotic heart disease Infective endocarditis Liver cirrhosis IBD Idiopathic/familial
What do you look for in the chest for resp exam?
Inspect both axillae and chest
Scars, chest wall shape, lesions, dilated veins
Movements (accessory muscle breathing, flail segment, pursed lips exhalation)
What do you do after chest inspection in resp exam?
Palpation of abnormalities Tracheal deviation Apex beat Chest expansion Percussion Auscultation (deep breaths, 99)
Causes of inspiratory crackles
Early: bronchiolitis
Mid: pulmonary oedema
Late: COPD, pneumonia, interstitial lung disease
Throughout insp and exp: bronchiectasis
Causes of pleural rub?
Pneumonia, PE
