Cardiovascolar assessment

1. 👀INSPECTION

1.1. *Assess pt v/s{Temp, HR, RR,and spo2} *jugular Venous pulsation "insupine position" *carotid artery at"any position " *suprastiernal notch pulsation" supraclavicular erea "

1.2. Abnormal findings

1.3. *large bounding visible pulsation *Distended neck veins *Distended chest wall *Elevated jugular vein pulsation *pulsation to right sturnum "aortic aneurysm" *Apical pulsation toward axillary line "ventricular hypertrophy

1.4. Normal findings

1.4.1. Caroted artery *carotid pulsation is normally *carotid pulsation is not unaffected by position *un affected by respiration

2. 👐Palpation

2.1. *Palpating the carotid {rate, rhythm, amplitude, contour, symmetry, elasticity, thrills} *Assess capillary rafill"nail beds on the fingers and toes " *palpate for arterial pulses {temporal, caroted, redial, ulner, poplotial, tepial, dorsal spedias}_(volume, symmetry, rhythm, strenghth)

2.1.1. Palpate precordium

2.2. Carotid *each carotid separately *Regular rhythm *smooth less acute descent *soft and pliable *strong amplitude

2.2.1. _Palpate by palm *Apex{5th intercostal space midclavicular line}thrills _palpate by thumps *Base left( pulmonic area) 2th intercostal space left sternal border *Base right(aortic area) 2th intercostal space right sternal border *LLSB(tricuspid area) 4th to5th intercostal space at left sternal border *Epigastric area (below the xphoid process

2.2.2. Normal findings

2.3. Abnormal findings

2.3.1. *Arrhythmia *Abnormal pulses *Unequal pulses *stiff, cordlike arteries *positive abdominojugular reflux *Apical impulse right side "congenital heart disease" *Aortic stenosis

3. ¶carotid *lightly palpate each carotid separately *Regular rhythm *strong amplitude *equal pulses *soft and pliable ¶jugular *flatten *normally distends

3.1. New Topic

4. *Percution middile with middelfinger *percution at the anterior axillary line continue toward the sternum along the "5th" intercostal space *changes sound from resonance to dullness over the left border of the heart

5. 👂Auscultation

5.1. By the{bell, diaphragm} *the bell¦narrwer, smalker circular, low sound *the diaphragm ¦wider, large circular, higt sound

5.2. Neck ¶ have pt hold breath *Auscult the caroted with the bell *Auscult the jugular with the bell

5.2.1. ¶Important

5.2.2. 🔊Normal suonds *S1:lub, systole *S2:dub, diastole

5.2.3. 🔇Abnormal sounds *S3:taa, lub, dub *S4:taa, lub, dub, taa

6. Percution🖐️

7. ¶Abnormal sounds *carotid "bruits" *jugular "hums"

8. ¶Precordium €listen at each site with both the bell and diaphragm. *Auscult at Apex "4th intercostal space midclavicular line" _rate, rhythm, extra sounds or murmurs *{All Patient Take Medication} *A_ (Aortic area) R 2th intercostal space close to the sternum *P_(pulmonic area) L2th intercostal space close to the sternum *T_(Tricuspid area) between 3th,4th, 5th,and 6th intercostal space at left sternal border *M_(Miteal area) 5th,6th intercostal space in midclavicular line

8.1. Jugular veins *jugular Venous pulsation is not *Jugular pulsation affected *affected by respiration