Post sims 5 - Ati PDF

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1. During your physical exam what are you listening for at each different location of the heart exam? The locations of auscultation center around the heart valves. The aortic, pulmonic, tricuspid, and mitral valves are four of the five points of auscultation. The fifth is Erb’s point, located left of the sternal border in the third intercostal space. The aortic point is located right of the sternal border in the second intercostal space. The pulmonic point is to the left of the sternal border in the second intercostal space. The sound that emits from the aortic and pulmonic points is the S2 “dub” of the typical “lub-dub” heartbeat. The S1 and S2 sounds are present in normal heartbeat patterns. The tricuspid point is found left of the sternal border in the fourth intercostal space, and the mitral point is located midclavicular on the left side of the chest in the fifth intercostal space. Both the tricuspid and the mitral points are where the S1 “lub” can be heard. The base of the heart is where the aortic and pulmonic S2 sound will be loudest. The apex is where the tricuspid and mitral S1 sound is loudest upon auscultation. The apex region will also be where S3 and S4 sounds(extra heart sounds not usually noted in normal assessments) and mitral stenosis murmurs may be auscultated, if present.

2. Discuss all locations making sure to also include the definition of point of maximal intensity. A mnemonic that aids in recalling the points of auscultation is APE To Man: Aortic- Right of sternal boarder in second intercostal space (Base) S2 “dub” Pulmonic- Left of sternal boarder in second intercostal space (Base) S2 ‘dub” Erb’s Point- Left sternal border in third intercostal space S1 and S2 (Line of separation between base and apex) Tricuspid-Left of sternal border in fourth intercostal space (apex) S1 “Lub” Mitral- Midclavicular on left side of chest in fifth intercostal space (Apex) S1 “lub” 3. Where would you listen for and how do you assess for most accurate heart rate? The best places to find your pulse are on your wrists, the insides of your elbows, the tops of your feet and the side of your neck, just under your jaw. Place two fingers on the pulse location, and count the number of beats you feel in 60 seconds....