In a cardiovascular examination, inspection and palpation are crucial for identifying abnormalities.
Abnormal findings observed during an inspection
Abnormal findings observed during palpation
Pulse abnormal findings
Thrill: A palpable vibration indicating turbulent blood flow from conditions like aneurysm or aortic regurgitation at the left sternal edge.
Heaves: Heaves are broad, forceful apical impulses indicating left ventricular heave. Thrills are vibrations felt over areas of turbulent blood flow associated with loud murmurs and valvular heart disease at the left sternal edge.
Point of Maximal Impulse (PMI): Locate the PMI at the fifth intercostal space in the midclavicular line. A laterally displaced or enlarged PMI indicates cardiac enlargement.
Capillary Refill: Assess capillary refill by squeezing the nail bed briefly. A normal refill takes less than 2 seconds; a prolonged refill suggests compromised arterial perfusion.
Pitting Edema: Check for pitting edema by pressing the skin over the tibia or medial malleolus. Pitting edema ranges from 1+ (mild) to 4+ (severe).
From Chapter 13:
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