Thursday, May 8, 2008

Precardium: Inspection

9:24 AM Fundamentals of Nursing, Nursing Procedure No comments

Method Of Exam

Inspect the precordium tangentially while the patient is laying flat in bed from either the patient's head or foot for symmetry and pulsations.

Normal:

* The precordium is symmetrical.
* In thin individuals, the apical impulse is recognizable.
* Apical impulse is located in 5th interspace just internal to midclavicular line.
* The left precordium will dip slightly during systole.

Abnormal Finding

* Bulge
> Precordial: Implies onset during childhood ( RV hypertrophy.)
> Aortic area bulge:( Aortic aneurysm)

* Pulsations
> Precordial : RV hyperactivity
> Displaced apical impulse: (Cardiac hypertrophy or dilatation, Mediastinal shift, Deformities of thorax, Raised intra-abdominal pressure)
> Apical impulse on right: (Dextrocardia)
> Aortic:( Aneurysm or dilatation)
> Pulmonary: (Pulmonary artery dilatation)
> Epigastric: (RV hypertrophy)

Knowledge Base

Anatomy of heart chambers and its relationship to precardium

Apical impulse

Pathology of chamber enlargement

* Dilated cardiomyopathy (Whole heart, section)
* RV hypertrophy (Whole heart, section)
* Biventricular hypertrophy (Whole heart, section)

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* Stress can help protect you from danger.
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Thursday, May 8, 2008

Precardium: Inspection

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