Cardiovascular examination From Talley and OConnor 6 th Edition Sem 4 GKV Dr Scarpa Schoeman 0823787333 or schoemanfhsufsacza Dept of Internal Medicine UFS Dept of Internal Medicine ID: 359386
Download Presentation The PPT/PDF document "Dept of Internal Medicine" is the property of its rightful owner. Permission is granted to download and print the materials on this web site for personal, non-commercial use only, and to display it on your personal computer provided you do not modify the materials and that you retain all copyright notices contained in the materials. By downloading content from our website, you accept the terms of this agreement.
Slide1
Dept of Internal Medicine
Cardiovascular examinationFrom Talley and O’Connor 6th Edition Sem 4 GKV Dr Scarpa Schoeman0823787333 or schoemanfhs@ufs.ac.zaDept of Internal MedicineUFSSlide2
Dept of Internal Medicine
OverviewPrep for the examination sessions PLEASETalley and O’Connor - ! Yes please ! – DVD and text.MUST understand cardiac cycle.There are variations in practice – (it will confuse you probably)PLEASE ASK QUESTIONS!!!!!!Slide3
Dept of Internal Medicine
OverviewTaken from:Evans, D. E., & Brown, J. (2009). How to succeed at medical school : an essential guide to learning (p. ix, 179 p.). Oxford: Wiley-Blackwell.Evans-Brown Model to learn clinical skillsSlide4
Dept of Internal Medicine
OverviewMichels, M. E. J., Evans, D. E., & Blok, G. A. (2012). What is a clinical skill? Searching for order in chaos through a modified Delphi process.Sem 1-5 Anatomy + Physiologyp102 (TC 6th edition)Sem 5+ = Experience!!Slide5
Dept of Internal Medicine
Cardio examINTRODUCTION (name and role)Informed consentAsk pt to undress & Clean hands (you)InspectionPalpationPercussionAuscultationThank pt and help to get dressedSlide6
Dept of Internal Medicine
Cardio examFrom the bedside (Insp)Level of illness – acute, chronic, acute on chronicAdditional stuff - O2, tubes!Chest wall – scars, deformities, lumps, pulsationsHands & Wrists (Insp) ClubbingCyanosis (peripheral)
Splinter bleeds, Osler nodes,
Janeway
lesions
(IE)
Tar staining (smoking)
Palmar erythema (red palms) Slide7Slide8Slide9Slide10Slide11Slide12Slide13Slide14Slide15Slide16
Dept of Internal Medicine
Cardio examHands & Wrists (Palp) Cap refill (<2sec), temp of hands, PULSESRate (30 sec: REGULAR pulse, 1min IRREGULAR)Rhythm (AF!!)Character and Volume (bigger artery)Hyperdynamic? Weak?Rad/Rad & Rad/Fem delay (coarctation)Arms – BLOOD PRESSURE (p54-55)Slide17
Dept of Internal Medicine
Cardio examFACEEyesAnaemia + JaundiceArctus cornealis/senilisXanthelasmaCheeks redness (?mitral facies) Mouth
Lips – peripheral cyanosis
Tongue – central cyanosis
Bad teeth – site for bacteraemia
High arch palate (
Marfan’s
)Slide18Slide19Slide20Slide21Slide22
Dept of Internal Medicine
Cardio examNECKCarotid arteries palp (and Auscultation)JVP (SUPER NB)Indication of RA pressure45° position is NBDistance from RA to sternal angle(SA) = 5cmThen vertical height above SA to max pulsationPOSITION yourself in top spot!Slide23Slide24Slide25
Dept of Internal Medicine
Cardio examPrecordiumPalpationZ-manoeuvre (thrills and heaves)APEX BEAT!!! Percussion – not very useful at allAuscultateM , T , P, A , Carotid (?stenosis)Diaphragm (+bell for M)ManoeuvresLeft lateral – MSSitting forward - AISlide26Slide27Slide28Slide29Slide30Slide31
Dept of Internal Medicine
Cardio examBACKInspect: scars, deformities, lumpsPalpationSacral oedemaAuscultateBreath sounds (? Different L vs R)Fine basal creps = Pulm oedema (LHF)
Absent – percuss for pleural effusion
ABDOMEN
Hepatomegaly? (Pulsatile liver – TI)
Splenomegaly?
Ascites?
Aorta aneurism
Fem arteries (palp and
Ausc
)Slide32
Dept of Internal Medicine
Cardio examLEGSPulses present?Toes (same as hand – not tar staining!)DVT?Ankle oedema (pitting 1-3+)OtherFundoscopyUrine dipstixTemp (fever)Slide33Slide34
Dept of Internal Medicine
OverviewMichels, M. E. J., Evans, D. E., & Blok, G. A. (2012). What is a clinical skill? Searching for order in chaos through a modified Delphi process.p102 (TC 6th edition)Slide35
Dept of Internal Medicine
OverviewTaken from:Evans, D. E., & Brown, J. (2009). How to succeed at medical school : an essential guide to learning (p. ix, 179 p.). Oxford: Wiley-Blackwell.Evans-Brown Model to learn clinical skillsSlide36
Dept of Internal Medicine
Cardio examMany thanks!!!