CVS

Relevant GS-
clubbing, pulse, cuanosis, JVP

1. Inspection
i. Shape of Precordium-
bend a bit
- right of patient
- foot end of patient
bulging
ii. Visible impulse- pulm, mitral, aortic, epigastric( with thumb, and fingers over
abd), suprasternal
iii. scar- internal mammary artery- graft, bypass

2. Palpation
i. Apex beat- right palm over precordium
- left hand count, show teacher, sternaal prominence, 2nd space . . . 5th space.
- if abesent, lt lat-- sit up-- walk a bit -- right side.
- left parasternal heave
- base of heart- sit up, lean forward, hold breath at end of exp, 2nd space on
both sides.
- aortic, pulm, tricuspid, neoartic impulse if found, carotid to time.

3, Auscaltate
- Mitral - MS hear with bell
- Aortic - 2nd HS
- Pulm- 2nd HS
- Tricusp
- Neoartic( hold at end of resp)
MR- femoral pulse

4. Pulse
- 3 fingers- arteria dorsalis pedis( make prominnet by back pressure on hand),
brachial, radial
thumb- carotid, femoral