Point of maximum impulse, apex of the ventricle, 5th intercostal space, midclavicular, left side. Also know as the apical pulse
What is a thrill?
Continuous palpable sensation like the purring of a cat or vibrations
Where can you hear the aortic valve?
2nd right intercostal space alongside the sternum
Where can you hear the tricuspid valve?
4th left intercostal space alongside the sternum
Where can you hear the pulmonic valve?
2nd left intercostal space alongside the sternum
Where can you hear the mitral area?
5th left midclavicular space midclavicular
What is the epigastric area?
Landmark used to palpate for aortic abnormalties, located at the tip of the sternum
What is Erb's point?
Where S1 & S2 are heard equally, 3rd left intercostal space alongside the sternum
What is the apical area?
Same as mitral area, 5th left intercostal space midclavicular. The apical pulse will be a light tap in the area at the apex
What are palpatations?
Sensation of rapid or irregular beating of the heart
What is a murmur?
Sustained swishing or blowing sounds heart at the beginning, middle or end of the systolic or diastolic phase. Due to increased blood flow through a normal valve or back flow through a valve that fails to close
What is S4?
Atrial gallop occurs just before S1 or ventricular systole. Similar to the sound of Tennessee. Due to atrial contraction pushing against a ventricle that is not accepting blood because of heart failure.
What is S3?
Extra heart sound. A ventricular gallop, occurs just after S2 at the end of ventricular diastole. Due to premature rush of blood into the ventricle thatis is stiff or dilated as a result of heart failure and hypertension. S1, S2, S3 sounds like Kentucky
What is S2?
Follows the short systolic pause and precedes the long diastolic pause, year hear it best at the aortic area
What is S1?
Occurs after long diastolic pause and preceding the short systolic pause. S1 is high pitched, dull in quality, and heard best at the apex
What is a doppler?
Ultrasound stethoscope used to hear the sound of pulse wave that is difficult to palpate
Explain jugular veins?
Most accessible veins for examination. Drain bilaterally from the head and neck into the superior vena cava. EJ lies superficially and is above the clavicle. IJ is lies deeper along the carotid
What is claudication?
side effect of periperal artery disease. Venous stasis in the legs and feet
What is a Dysrhythmia?
Failure of the heart to beat at regular successive intervals
Crackles, most common in dependent lobes. Caused by sudden reinflation of groups of alveoli. Can be fine high-pitched, medium low-pitched, or coarse and loud
High-pitched, continuous musical sounds like a squeak heard continuously during inspiration or expiration. Heard all over lung fields
Loud, low-pitched rumbling course sounds heard during inspiration or expiration. heard over trachea and bronchi.
Describe pleural friction rub
Dry, rubbing, or grating heard during inspiration or expiration. Heard all over lateral lung field
What are adventitious sounds?
Sounds often superimposed over normal sounds. Include rales, wheezes, rhonchi, and pleural rub. Abnormal lung sounds
What is respiratory expansion?
a test that indicates the use of accessory muscles on inspiraton. How far the chest expands during inhalation and exhalation
What is orthopnea?
Shortness of breath while laying flat
What is dyspnea?
Clinical signs of hypoxia, subjective sensation of difficult or uncomfortable breathing. Shortness of breath usually associated with exercise or excitement
What is tactile fremitus?
Sound waves created by the vocal cords that are heard and felt through the chest. Vibrations
What is edema (pitting and non-pitting)?
Accumulation of excess fluid in the interstitial space.
Pitting-Depression in the edematous tissue that disappears slowly
Non-pitting-abnormal excess accumulation of serous fluid in connective tissue or in a serous cavity
What is somnolence?
Quality or state of being drowsy
What is cyanosis?
A bluish or purplish discoloration of skin due to deficient oxygenation of the blood
What is barrel chest?
Anteroposterior diameter equals transverse diameter, characterized aging and chronic lung disease. Rounded bulging chest related to a lung disease, usually occurs because lungs are overinflated with air
What are acessory muscles?
Muscles of respiration. Only used during forces breathing (exercise, asthma attack), Can be used in normal breathing rhythm when a breathing pattern disorder exists
What is vesicular breath sounds?
Soft, breezy and low-pitched. Inspiratory phase is 3x longer than expiratory phase, best heard over lung's periphery (except scapula). Created by air moving through smaller airways. Heard at the periphery
What are bronchovesicular breath sounds?
Blowing sounds that are medium pitched and medium intesity. Inspiratory phase is equal to expiratory phase. Best heard posteriorly between scapulae and anteriorly over bronchioles lateral to sternum at 1st and 2nd intercostal spaces. Created by air moving through lungs. Between scapula, lateral to sternum
What are bronchial breath sounds?
Loud and high-pitched with hollow quality. Expiration lasts longer than inspiration. Heard only over trachea. Caused by air moving through trachea close to chest wall. Treacheal, louder expiration lasts longer
What is the apical-radial pulse?
The pulse over the groove along the radial or thumb side of the client's wrist. Used because it is easy to palpate
What is the carotid pulse?
reflect heart function better than periperal ateries because their pressure correlates with the aorta. Supplies oxygenated blood to the head and neck. Sternocleidomastoid muscle protects it
What is the brachial pulse?
Peripheral pulse found in the groove between biceps and triceps muscles at the antecubital fossa. Used to assess status of circulation to lower arm
What is the radial pulse?
Radial or thumb side of forearm at wrist, common site used to assess character of pulse peripherally and assess status of circulation to hand
What is the ulnar pulse?
Ulnar side of forearm at wrist, site used to assess status of circulation to hand, also used to perform allen's test
What is the temporal pulse
Over temporal bone of head, above and lateral to eye, easily accessible site to assess pulse in children
What is the femoral pulse?
Below inguinal ligament, midway between symphysis pubis and anterior superior iliac spine. Used to assess character of pulse during physiological shock or cardiac arrest when peripheral pulses are not palpable, used to assess status of circulation in legs
What is the popliteal pulse?
Behind knee in popliteal fossa, site used to assess status of circulation in lower leg
What is dorsalis pedis pulse?
Along top of foot between extension tendons of great and first toe, site used to assess status of circulation to foot
What is posterior tibial pulse?
Inner side of ankle, below medial malleolus, used to assess status of circulaton to foot
What are pulsations?
The rhythmic beat of the heart and blood vessels, a throbbing
What is pulse deficit?
Radial pulse is slower than the apical pulse because ineffective contractions fail to send pulse waves to the periphery
What is the peripheral pulse?
Includes radial pulse, brachial pulse, ulnar pulse, femoral pulse, popliteal pulse, dorsalis pedis pulse, and posterior tibial pulse. Measure these pulses for equality and symmetry
What is the pedal pulse?
Pulse in the foot
What is variscosity?
Distended, swollen knotted veins
What is phlebitis?
Inflammation of a vein that occurs commonly after trauma to the vessel wall, immobilization and prolonged insertion of IV catheters. Usually associated with formation of clots
What are lymphatics?
Vessels that carry lymph (extracellular tissue fluid)
What is systole?
Ventricles contract and eject blood from the left ventricle into the pulmonary artery. Period where the heart is contracting specifically the contracting of the left ventricle
What is diastole?
The ventricles relax and the atria contract to move blood into the ventricles and fill the coronary arteries. Minimal arterial pressure on the atria during relaxation and dilation of the ventricles. The time when the ventricles fill with blood
What is bronchophony?
If fluid is compressing the lung, the vibrations from the client's voice are transmitted to the chest wall and the sound becomes clear.
What is whispered pectoriloquy?
When the whispered voice becomes clear and distinct due to lung abnormalties
What are the different lung lobes called?
Right upper, right middle, right lower, left upper and left lower.