OPETA: Cardiovascular Exam

Cardiovascular Exam	Online PETA Home
View Entire Video Primary exam Preparation Pulse and Blood Pressure Inspection Carotid Pulsations The Precordium Stethoscope Tutorial Auscultation with the Diaphragm Auscultation with the Bell Special Considerations Be able to identify the significance of a positive finding of any of these tests Irregular Pulse Auscultation for Bruits Jugular Venous Pressure S3 and Mitral Murmurs Aortic Insufficiency Special Considerations for a Female Patient	Preparation Position and gown patient ALWAYS stand to patient's right side Inspection Inspect ankles for signs of edema Identify carotid and jugular pulse Pulse and Blood Pressure Note vital sign values Measure pulse and blood pressure if no values are reported or if values are abnormal Special Consideration: Irregular Pulse Measure up to a minute Carotid Pulsations Observe pulsations in neck Palpate one side at a time Note amplitude and contour Special Consideration: Auscultation for Bruits Place diaphragm or bell over each carotid artery Ask patient to hold their breath momentarily The Precordium Observe for precordial movement Identify apical pulse visually Palpate apical pulse/PMI Palpate for extra movement Auscultation with the Diaphragm Auscultate aortic area (R 2nd IS) Auscultate pulmonic area (L 2nd IS) Auscultate tricuspid (L sternal border) Auscultate mitral area (PMI) Auscultation with the Bell Auscultate mitral area (PMI) Auscultate other areas as time permits Special Consideration: Jugular Venous Pressure Position on exam table starting with head elevated 30 degrees Use tangential lighting Identify jugular venous pulse (distinct from carotid pulse) Adjust bed angle as needed Measure distance of pulse above sternal angle Special Consideration: S3 and Mitral Murmurs Roll patient on left side Palpate to locate PMI Auscultate in the mitral area (PMI) with the bell Special Consideration: Aortic Insufficiency Position patient sitting and leaning forward Ask patient to exhale Auscultate the L 3rd and 4th IS with the diaphragm
ONLINE PHYSICAL EXAM TEACHING ASSISTANT	The UF College of Medicine Harrell Center