A comprehensive physical examination of the chest and cardiovascular system involves systematic assessment through inspection, palpation, percussion, and auscultation, including evaluation of respiratory rate, rhythm, and depth; chest configuration with anterior-posterior to transverse diameter ratio of 1:2; thoracic expansion symmetry; percussion for resonance or dullness; auscultation for lung sounds, heart sounds (S1, S2, S3, S4), murmurs, and bruits; carotid artery assessment; peripheral vascular examination including capillary refill, lymph node palpation, and pulse assessment at brachial, radial, femoral, popliteal, posterior tibial, and dorsalis pedis locations; and abdominal assessment for bruits and aortic pulsation.
Deep Dive
Prerequisite Knowledge
- No data available.
Where to go next
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Deep Dive
ASMR Student Nurse | Physical Diagnosis Chest and Cardiovascular ExamAdded:
Hello, my name is Catherine. I'm going to be the physician system student today. Today we're going to be doing a cardiovascular and chest exam. Before we begin, I'm going to wash your hands and be kind of your shirt, your shoes, and your socks.
Okay, I'm making sure I have adequate exposure to the chest. I'm assessing the rate, the rhythm, and depth of respirations. I'ming for any signs of respiratory distress or any use of accessory muscles during respiration.
I'm going to check the chest configuration ensuring that the anterior posterior and transverse diameter is at a ratio of 1 to two. Okay. So now I'm going to ask you to face that wall and move your head back.
Okay. So now I'm going to palpate the posterior lateral chest walls for tenderness and deformities.
Okay. I'm also going to be testing for thoracic expansion for symmetry respirations. So, I just want you to take a deep breath in and out.
Wonderful. Okay, I'm going to now test how fun this is. So, I'm going to point I'm going to put my hands at different points on your back and I just want you to say 99 slowly. Okay.
>> 99 99 99 Okay, wonderful. So now for this I just want you to cross your arms behind you.
Give yourself a hug.
Okay. So now I'm going to percuss the posterior and the lateral chest wall assessing for any resonance or dullness.
And I'm going to compare the sides by Okay. So now I'm going to listen to your posterior and lateral chest wall. I'm going to listen for one full cycle of inspiration and expiration at each point checking for any presence of rails wrong orus. And I'm going to note any lung sounds that I hear. For this I just want you to read out of your mouth.
One more.
All right. I heard the lung sounds by for this part. You can now lay down.
I'm now going to be um palpating the anterior chest wall for any tenderness and deformities.
I'm now going to be assessing the anterior chest walls thoracic expansion for symmetry of respiration. So again, take a deep breath in and out. Wonderful. Okay. Same thing like the back. I'm going to do tac reminis and different points. When you feel my hand on your skin, just say 99 >> 99.
Now, we're going to percuss. So, I'm going to percuss the antior chest wall, noting for any signs of resonance or dullness at each point. And I'm going to compare the sides that are And then just lift up the bottom. Thank you.
Now we're going to be listening to the chest wall. I'm going to listen for a wonderful cycle of inspiration and exploration at each point. Listening for the presence of rails and mises. For this, I just want you to breathe in and out of your mouth.
All right.
So, for now, we're going to move on to the cardiovascular exam. For this, I'm going to raise the head of the bed to about 30°.
All right. So, now I'm going to be observing the veins for any signs of distension and pulsations.
I'm going to use my stethoscope once again, and I'm going to listen for any brewies that I may hear.
So, for this test, I'm going to places that go on your corateed artery. I just want you to face the opposite direction and hold your breath. Okay? And we're going to do both sides.
Okay. Take a deep breath and hold it.
Now, other side. Take a deep breath and hold it.
Okay. So, now I'm going to palpate the corateed arteries. Checking for the rate, the rhythm, and amplitude.
on each side.
Other side.
So now I'm going to use additional lighting to check the cordium for any signs of abnormal wall movement and the apical impulse on either side.
Okay.
So now I'm going to move on to palpating the anterior chest. I'm going to use the ball of my hand and place it around different parts of your chest. I'm going to check for the thrills, keys, and lips.
So, moving it over the aortic area, pulmonic area, point the bottom a little bit, the tricuspid point, and now mitro point. And while I'm here, I'm going to check the maximal apical impulse. I'm going to note the location, the size, and the intensity. I'm going to do I'm going to use three fingers.
Feel like a right path and then I'm going to move down to one finger.
Okay. Wonderful.
All right. Moving on. I'm going to again listen to your chest. I'm going to listen for the intensity of S1 and S2.
I'm also going to see if I hear any S3, S4 sounds for any murmurs, gallops or rups. So for this I'm also going to pop artery while I move my subs.
I'm going to use my diaphragm first.
Okay.
Moving on to deep bell. Same thing.
Okay.
So now we're going to move on to the peripheral vascular exam. So for this part, I'm going to observe the upper and the lower extremities for any signs of symmetry, edema, paler, or cyanosis.
While I'm here, I'm going to test capillary refill of the upper and the lower extremities, ensuring that capill refills in less than two seconds.
And I'll make sure to test without lower now. Beautiful.
Now I'm going to pate your lymph nodes.
I'm seeing if there's any enlargement or tenders and do it bilaterally as well.
Now I'm also going to test the same thing for the inguinal lymph nodes. So for this I'm testing for the enlargement and the tenderness. I'm checking the horizontal chain first and now the vertical chain.
Okay, moving on. I'm going to palpate a few different pulses on the body checking the weight, the rhythm, the amplitude and for symmetry. I'm going to start on the brachio artery and I'm going to move bilaterally. The brachio artery, brachio artery on the other arm, radial artery. Moving down to again I would check underneath clothing.
Now popial just have your knee bent and I'm going to push deep inside of your knees and so other legal rest. Now I'm going to check the posterior tibialis.
to the outside other side and then pis.
Okay. So now I'm going to do the abdominal area. So I'm going to use my stethoscope and listen for any signs of release on the abdominal area. I'm going to move it on different points and as I go Okay. So, my art renal arteries on either side.
Can you just pull down your shorts a little bit for me? Thank you. All right.
IC artery.
And now for moral artery. I'll check underneath clothing. All right.
Last thing is I'm going to palpate your abdominal order. So for this exam, I'm going to squeeze onto your stomach and I'm popping the abdominal order, checking to see if it's less than 3 cm.
Okay, all done.
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