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CARDIOLOGY MODULE-2 ND YEAR. JOHN N. HAMATY D.O. PROGRAM DIRECTOR. INTRODUCTION. COURSE OUTLINE OBJECTIVES LECTURE MATERIAL FINAL EXAM. INTRODUCTION. John Hamaty , D.O. FACC, FACOI CONTACT INFORMATION: 3001 Chapel Ave, Suite 101 Cherry Hill NJ 08002 TEL: (856) 755-1173 - PowerPoint PPT Presentation
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CARDIOLOGY CARDIOLOGY MODULE-2MODULE-2NDND YEARYEAR
JOHN N. HAMATY D.O.JOHN N. HAMATY D.O.
PROGRAM DIRECTORPROGRAM DIRECTOR
INTRODUCTIONINTRODUCTION
COURSE OUTLINECOURSE OUTLINE OBJECTIVESOBJECTIVES LECTURE MATERIALLECTURE MATERIAL FINAL EXAMFINAL EXAM
INTRODUCTIONINTRODUCTION
John Hamaty, D.O. FACC, FACOIJohn Hamaty, D.O. FACC, FACOI
CONTACT INFORMATION:CONTACT INFORMATION:
3001 Chapel Ave,3001 Chapel Ave,Suite 101Suite 101
Cherry Hill NJ 08002Cherry Hill NJ 08002
TEL: (856) 755-1173TEL: (856) 755-1173
EMAIL: EMAIL: [email protected]@sjhg.org
CARDIAC EXAMCARDIAC EXAM
INSPECTION OF THE INSPECTION OF THE CHESTCHEST
FIRST PART OF ANY PHYSICALFIRST PART OF ANY PHYSICAL STANDING, SITTING AND LYINGSTANDING, SITTING AND LYING CHEST MORPHOLOGYCHEST MORPHOLOGY CARDIOVASCULAR PULSATIONS-CARDIOVASCULAR PULSATIONS-
APEXAPEX
PALPATIONPALPATION
RIGHT SIDE OF SUPINE PATIENTRIGHT SIDE OF SUPINE PATIENT USE FINGERTIPSUSE FINGERTIPS TIME USING SIMULTANEOUS TIME USING SIMULTANEOUS
PALPATION OF THE CAROTID PULSEPALPATION OF THE CAROTID PULSE CHEST EXPOSED AND 30 DEGREES CHEST EXPOSED AND 30 DEGREES
WITH PATIENT LATERAL DECUB.WITH PATIENT LATERAL DECUB.
CARDIAC CARDIAC AUSCULTATIONAUSCULTATION
GENERAL PRINCIPLESGENERAL PRINCIPLES
VIBRATIONS ON THE SURFACE OF VIBRATIONS ON THE SURFACE OF CHEST SET INTO MOTION A CHEST SET INTO MOTION A COLUMN OF AIR THAT IS COLUMN OF AIR THAT IS COLLECTED AND CONDUCTED TO COLLECTED AND CONDUCTED TO THE EAR BY THE STETHOSCOPETHE EAR BY THE STETHOSCOPE
STETHOSCOPESTETHOSCOPE
THE MOST EFFECTIVE THE MOST EFFECTIVE STETHOSCOPES ARE MADE OF STETHOSCOPES ARE MADE OF PLASTIC TUBING 10-12 INCHES PLASTIC TUBING 10-12 INCHES LONG WITH INTERNAL DIAMETER LONG WITH INTERNAL DIAMETER OF 1/8 IN.OF 1/8 IN.
BELL AND DIAPHRAGM TO BELL AND DIAPHRAGM TO COLLECT SOUND.COLLECT SOUND.
STETHOSCOPESTETHOSCOPE
HIGH-FREQUENCY SOUNDS-S1 AND HIGH-FREQUENCY SOUNDS-S1 AND S2, SYSTOLIC CLICKS AND HIGH-S2, SYSTOLIC CLICKS AND HIGH-PITCHED MURMURS ARE HEARD PITCHED MURMURS ARE HEARD BEST WITH THE DIAPHRAGM.BEST WITH THE DIAPHRAGM.
THE BELL IS APPLIED LIGHTLY TO THE BELL IS APPLIED LIGHTLY TO CHEST TO PREVENT AMBIENT NOISECHEST TO PREVENT AMBIENT NOISE
BELL IS FOR LOW FREQUENCY-3BELL IS FOR LOW FREQUENCY-3RDRD AND 4AND 4THTH SOUNDS, DIASTOLIC SOUNDS, DIASTOLIC MURMURS.MURMURS.
HEART SOUNDSHEART SOUNDS
FIRST HEART SOUND:FIRST HEART SOUND: Occurs Occurs before before palpable arterial palpable arterial
upstroke of the carotid and can be upstroke of the carotid and can be distinguished from S2, which occurs distinguished from S2, which occurs immediately immediately after after peak of carotid peak of carotid pulsepulse
Heard best medial to apex at lower Heard best medial to apex at lower left sternal border. left sternal border.
FIRST HEART SOUNDFIRST HEART SOUND
TWO COMPONENTSTWO COMPONENTS INITIAL COMPONENT IS THE MOST INITIAL COMPONENT IS THE MOST
PROMINENT AT THE APEX. THIS PROMINENT AT THE APEX. THIS REPRESENTS MITRAL VALVE REPRESENTS MITRAL VALVE CLOSURE.CLOSURE.
SECOND PORTION OF S1 IS SECOND PORTION OF S1 IS CLOSURE OF TRICUSPID VALVE CLOSURE OF TRICUSPID VALVE AND HEARD BEST AT 4AND HEARD BEST AT 4THTH LEFT LEFT INTERCOSTAL SPACE.INTERCOSTAL SPACE.
FIRST HEART SOUNDFIRST HEART SOUND
OPENING OF THE AORTIC AND OPENING OF THE AORTIC AND PULMONIC VALVES ALSO OCCURS PULMONIC VALVES ALSO OCCURS DURING S1 BUT IS USUALLY DURING S1 BUT IS USUALLY SILENT.SILENT.
USUALLY A SINGLE SOUND. IT CAN USUALLY A SINGLE SOUND. IT CAN BE SPLIT, ACCUNTUATED OR BE SPLIT, ACCUNTUATED OR PARADOXICALLY SPLIT IN CERTAIN PARADOXICALLY SPLIT IN CERTAIN DISEASE STATES.DISEASE STATES.
THE SECOND HEART THE SECOND HEART SOUNDSOUND
THE FIRST COMPONENT AORTIC THE FIRST COMPONENT AORTIC VALVE CLOSUREVALVE CLOSURE
THE SECOND COMPONENT IS THE SECOND COMPONENT IS PULMONIC VALVE CLOSUREPULMONIC VALVE CLOSURE
INSPIRATORY SPLITTING OF S2 IS INSPIRATORY SPLITTING OF S2 IS DUE TO DELAY IN PULMONIC DUE TO DELAY IN PULMONIC COMPONENTCOMPONENT