Heart
What is Heart auscultation?
Listen to all valves (APETM)
S1, S2, S3, S4
What is a stye?
reddish lump on the outer edge of your eyelid. It’s filled with pus and inflammatory cells produced when a clogged gland or follicle becomes infected
Is it normal to feel lymph nodes?
Yes, in children
No, in adults
S1 heart sound?
Sound of mitral valve closing, just before tricuspid valve
Heard all over precordium but loudest at the apex
Aortic valve is where?
2nd intercostal space, right sternal border
What is splitting S2?
lub dub dub, listen to see if it happens during inspiration (normal), It is caused when the closure of the aortic valve and the closure of the pulmonary valve are not synchronized during inspiration.
What is the Confrontation Test?
Testing peripheral vision
Cover the one you are not testing
Superior, lateral, inferior
The degrees of peripheral vision are 50, 90, and 70
Arterial Insufficiency?
Arteries are not allowing blood to get to extremities
Will find weak pulses, pale skin (or bright red if infected), skin is thin, and not a lot of hair (losing hair)
Splitting S2?
lub dub dub
First thing you want to do is listen to see if it happens during inspiration (If you only hear it when a patient is taking a deep breath or breathing in, then it is the splitting s2)
Pulmonic valve is where?
2nd intercostal space, left sternal border
What is a bruit?
blowing, swishing sounds indicating blood flow turbulence (listen over coratid arteries normally)
Jaeger Card tests for what?
near vision
Claudication is what?
Arterial cause: not enough blood to extremities
Calf pain/leg pain while walking and pain decreases when sitting down
Murmur?
Turbulent blood flow in the heart
Typically heard at every valve (Valves not closing completely)
Graded 1-6 (soft murmur=2 or ; 6 = don’t even need stethoscope)
Erb’s Point is where?
third intercostal space close to the sternum
Systemic hypertension
heart has to pump harder and everything becomes hypertrophied, easier to feel the apical impulse and make it more lateral
What is Arcus senilis?
Halo of the eye (normal eye change in elderly)
Venous Insufficiency?
Venous blood not getting back to heart and pools in legs
Will notice swelling/edema, brown thick leathery skin, looks like unhealed blisters, does NOT affect hair loss
You are attempting to find the apical impulse. Where would be the place you would place your fingers?
Left side, 4th or 5th intercostal space, midclavicular line
Tricuspid Valve is where?
4th/5th intercostal space, left lower sternal border
Pulmonic hypertension
happens when the pressure in the blood vessels leading from the heart to the lungs is too high (more likely to see edema)
Pupillary light reflex?
Normal constriction of pupils when bright light shines on retina
PERRLA
Modified Allen Test is?
Checking to see if blood flow is occurring
Positive collateral circulation is NORMAL
*please demonstrate how to do it for points!
Your patient has an ingrown toenail, and it has become infected. You would expect to find an enlarged lymph node where?
Inguinal
Mitral Valve is where?
Left side, 5th intercostal space, midclavicular line