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Precardium: Inspection

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To identify apex of the heart. To detect enlargement of RV, aorta and pulmonary artery.

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Precardium: Inspection

  1. 1. Precardium: Inspection To identify apex of the heart. To detect enlargement of RV, aorta and pulmonary artery.
  2. 2. Method Of Exam <ul><li>Inspect the precordium tangentially while the patient is laying flat in bed from either the patient's head or foot for symmetry and pulsations . </li></ul>
  3. 3. Normal: <ul><li>The precordium is symmetrical. </li></ul><ul><li>In thin individuals, the apical impulse is recognizable. </li></ul><ul><li>Apical impulse is located in 5th interspace just internal to midclavicular line. </li></ul><ul><li>The left precordium will dip slightly during systole. </li></ul>
  4. 4. Abnormal Finding <ul><li>Bulge </li></ul><ul><li>Precordial : Implies onset during childhood ( RV hypertrophy.) </li></ul><ul><li>Aortic area bulge :( Aortic aneurysm) </li></ul>
  5. 5. Abnormal Finding <ul><li>Pulsations </li></ul><ul><li>Precordial : RV hyperactivity </li></ul><ul><li>Displaced apical impulse : (Cardiac hypertrophy or dilatation, Mediastinal shift, Deformities of thorax, Raised intra-abdominal pressure) </li></ul><ul><li>Apical impulse on right : (Dextrocardia) </li></ul><ul><li>Aortic :( Aneurysm or dilatation) </li></ul><ul><li>Pulmonary: (Pulmonary artery dilatation) </li></ul><ul><li>Epigastric : (RV hypertrophy) </li></ul>
  6. 6. Knowledge Base <ul><li>Anatomy of heart chambers and its relationship to precardium </li></ul><ul><li>Apical impulse </li></ul>
  7. 7. Knowledge Base <ul><li>Pathology of chamber enlargement </li></ul><ul><li>Dilated cardiomyopathy </li></ul><ul><li>( Whole heart , section ) </li></ul>
  8. 8. Knowledge Base <ul><li>Pathology of chamber enlargement </li></ul><ul><li>RV hypertrophy </li></ul><ul><li>( Whole heart , section ) </li></ul>
  9. 9. Knowledge Base <ul><li>Pathology of chamber enlargement </li></ul><ul><li>Biventricular hypertrophy </li></ul><ul><li> ( Whole heart , section ) </li></ul>
  10. 10. <ul><li>Resources: Bates, A Guide to Physical Exam . </li></ul><ul><li>“ Nurses Information” </li></ul><ul><li>http://nursesinformations.blogspot.com </li></ul>

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