MedSim – Cardiovascular System Percussion

MedSim – Cardiovascular System Percussion


Cardiovascular System Percussion The evaluation of the cardiovascular system includes a thorough medical history, a detailed examination of the heart and the peripheral arterial and venous circulations, and appropriate laboratory studies. A careful assessment will enable the examiner to identify the etiologic, anatomic, and physiologic components of a specific cardiovascular disorder, as well as to determine overall cardiac function. The examination involves inspection, palpation, percussion and auscultation of the heart and vessels. Procedure Introduce yourself and confirm the patient’s identity. Explain what is going to take place and ask for consent. Make sure your palm is warm before percussing any patient. Ask the patient to lie supine. Place the left middle finger (pleximeter finger) on the area to be percussed. The back of its middle phalanx is then struck with the tip of the right middle finger (percussing finger). Make sure that the percussing movement originates at the wrist and not the elbow. The percussing finger should be bent so that when the blow is delivered, its terminal phalanx is at right angles to the metacarpal bone and it strikes the pleximeter finger perpendicularly. As soon as the blow is delivered, the percussing finger should be raised. Ensure that the delivered blow is no heavier than necessary to elicit the resonance of the area being examined and the wrist joint must move freely. Exercise caution while percussing as repeated blows can cause discomfort to your patient and even cause rib fracture. To identify for the left border of the heart, begin percussing the 5th intercostal space from the mid-axillary line and move medially towards the sternum till the note changes from resonant to dull. The left border should normally be at or medial to the mid-clavicular line. Since the sternum hides the right cardiac border, it cannot be percussed in most cases. Physical findings must be interpreted in light of all previously collected data. The general scheme is to develop a postulate and test it with further history, additional observations or maneuvers on physical examinations, and laboratory tests.

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