Inspection and Palpation of Precordium
- Palpate for PMI, if cannot find it, have patient exhale fully, if still cannot find it, have patient lie in left decubital position.
- look visually for precordial heaves
Auscultation Supine
Supine. All Physicians Take Money with Diaphragm. Listen for murmurs, rubs, or gallops. Then flip to bell and listen to tricuspid and mitral.
Core Pulses
compare side-to-side radial, posterior tibial, dorsalis pedis
Inspection for Edema
press skin firmly for 5 seconds and look for indentations. compare side-to-side. Dorsum of foot, behind medial malleolus, and over shins
Palpate precordium
- palpate for thrills (vibrations) at L/R 2nd intercostal space
- palpate costo-sternal junction along sternum and ribs looking for tenderness
Auscultate sitting forward
have patient sit and lean slightly forward and exhale fully. Use diaphragm and listen to tricuspid and mitral areas
Auscultate left lateral decubitus
Have patient lie on left side. Listen to mitral area using BELL
Additional Pulses
compare side-to-side brachial, femoral, and popliteal pulses. Use two hands and grasp behind knee for popliteal pulse.
Carotid Pulses
- Auscultate carotid arteries looking for bruits using bell.
- palpate carotid pulse and go one at a time
Additional inspection and palpation
- check cap refill of nail beds (should be
