CVS (Precordium) Examination Checklist:

Batch 2013 (Academic session 2014/2015)

27/ May / 2014 (Tuesday 2 30 – 4 30 pm)

No.A Activity Done Not Done

1 A. Opening phase:
1. Stands on right side of the patient
Greets patient
Introduces self
Asks patient’s name.
2. Explains the procedure and requests patient’s permission.
B. Positioning / Exposure:
3. Ensures patient lies supine on couch.
Exposes upper trunk up to lower end of sternum.
C. Inspection:
4. 4. Inspects and comments on general appearance of patient i.e.
Gender – male or female
Age group – young, middle aged, elderly
Posture – sitting, standing, lying
Comfort / consciousness level – comfortable, in pain, restless,
unconscious, alert, drowsy.
5. Inspects and comments on precordium,
Apex beat,
Other pulsations,
Scars
Pigmentations
D. Palpation:
6. Palpates apex beat with all fingers.
7. Locates exact position of apex beat with single finger.
8. Counts intercostal spaces (ICS) by identifying sternal angle with other
hand and dragging the finger to left for counting intercostal spaces down
till apex beat level
9. Checks mid-clavicular line by identifying both ends of clavicle on left
side and drawing an imaginary line down from the midpoint.
10. Palpates left parasternal heave by using palmar surface of right hand
at left lower sternum.
11. Palpates precordium in all 4 areas i.e. aortic (2nd right ICS), pulmonic
(2nd left ICS), tricuspid (4th left ICS) and apical (over apex) areas for
thrill with palm.
E. Auscultation:
12. Auscultates with the patient lying down, the aortic, pulmonic, tricuspid,
and mitral (apical) area with the diaphragm for S1, S2 and murmurs.

13. Auscultates with the patient lying down, the aortic, pulmonic, tricuspid,
and mitral (apical) area with the bell for additional heart sounds.
F. Closing phase:
14. Shows good overall professionalism and approach
 confident, well organized,
 polite, respectful,
 communicating with patient during examination
 Thanks patient after finishing the examination