1. Neck Vessels
1.1. Carotid Arteries
1.2. Assess one side at a time
1.3. Smooth with a brisk upstroke and slower downstroke
1.4. Auscultate for bruit
1.4.1. Indicates a turbulence
1.4.2. Use the bell
2. Neck Vessels
2.1. Jugular Vein
2.1.1. Place client sitting at a 30-45 degree angle
2.1.1.1. Should be absent of Jugular Vein Distension(JVD)
3. Abnormal Findings
3.1. Heave or lift
3.1.1. a sustained forceful thrusting of the ventricle during systole
3.2. Thrill
3.2.1. Palpable vibration
3.2.1.1. Feels like a purring cat
3.3. Bruit
3.4. Diminished or weak pulses
3.5. Pulse deficit
3.5.1. Assess radial pulse and apical pulse
3.5.1.1. When different subtract the radial rate from the apical and record it as a pulse deficit
4. Movement of Blood
5. Cardiac Cycle
5.1. Diastole
5.1.1. Ventricles relaxed, blood pours in the ventricles
5.1.2. S2
5.1.2.1. Starts with closure of the semilunar valves
5.1.2.1.1. Loudest at base
5.2. Systole
5.2.1. S1
5.2.1.1. AV valve closure
5.2.1.1.1. Loudest at apex
6. Extra Heart Sounds
6.1. Murmurs
6.1.1. S3
6.1.1.1. Ventricles resistant to fill
6.1.1.1.1. Occurs immediately after S2
6.1.2. S4
6.1.2.1. Occurs at the end of diastole
6.1.2.1.1. Right before S1
6.2. Turbulent blood flow
7. Heart Failure
7.1. Right Side
7.1.1. Causes a back up in the body
7.1.1.1. Edema
7.1.1.2. Hepatomegaly
7.1.1.3. Ascites
7.1.1.4. Enlarged Spleen
7.1.1.5. JVD
7.2. Left Side
7.2.1. Causes respiratory manifestations
7.2.1.1. SOB
7.2.1.2. Low o2 Saturation
7.2.1.3. Crackles
7.2.1.4. Frothy Sputum
7.2.1.5. Dyspnea
7.2.1.6. Cough
7.2.1.7. Confusion
8. Lub and Dub
8.1. S1
8.1.1. Closure of the mitral and tricuspid valves signal systole."Lub". Best heard at the Apex.
8.2. S2
8.2.1. Closure of the aortic and pulmonic valves signals diastole. "Dub". Best heard at the Base.