what does a left parasternal heave indicate
right ventricular hypertrophy
where should thrills be palpated
apex, upper part of praecordium and the sternal notch
what is the commonest cause of thrill
aortic stenosis
how do you palpate for heaves
place outstretched right hand just to the left of the sternum with fingers pointing towards the neck
how are heart murmurs graded
1/6 to 6/6
leg vascular exam
inspect palpate radiofemoral delay 3 x pulses ankle oedema
abdomen
inspect
palpate superficial and deep for liver
percuss liver
bruits
extras
ophthalmoscopy
obs chart
urine
ECG
BP
Abdo
causes of clubbing
lung cancer celiac disease interstitial lung disease heart valve disorder lung infection (chronic suppurative disease)- CF, bronchiectasis infective endocarditis grave's disease liver cirrhosis
CO2 retention
warm hands, flapping tremor, bounding pulse