NSG 2317 Lecture Notes - Lecture 7: Pulmonary Valve, Aortic Valve, Rib Cage
8 Jan 2020
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Internal: external, venous pulse and pressure, objective data carotid arteries, objective data jugular venous pressure, jugular veins. Inspect the jugular venous pulse: estimate the jugular venous pressure, objective data precordium, precordium. Inspect the anterior chest: palpate the apical impulse, palpate across the precordium, percussion has been replaced with radiographic image or echocardiogram, objective data auscultation, auscultate the heart sounds. Identify auscultatory areas: note the rate and rhythm, sinus arrythmia, pulse deficit. If you hear a murmur describe it by indicating the following characteristics: timing: systole of diastole. Infants: auscultate using the small (pediatric size) diaphragm and bell, heart rate range 100-180 bpm immediately after birth; then to an average of 120-140bpm, wide fluctuation with activity; 170bpm or more during crying, 70- If thrill occurs in 2nd and third right interspaces: occurs with severe aortic stenosis, occurs with systemic hypertension. Dilatation and hypertrophy of lv are caused by increased stroke volume of lv.
