SCMC Physical Exam e Cardiovascular exam(cont'd Auscultation e Optimal conditions include supine, quiet and breathing normally Develop a routine of Second right interspace Pulmonic valve listening systematically Third ten antegan to all components of the cardiac cycle and all auscultatory areas with bell and diaphragm Listen in the 4 principal areas of the precordium (i.e, tricuspid, pulmonary mitral and aortic valves)
Physical Exam ⚫ Cardiovascular exam (cont’d) – Auscultation ⚫ Optimal conditions include supine, quiet and breathing normally ⚫ Develop a routine of listening systematically to all components of the cardiac cycle and all auscultatory areas with bell and diaphragm ⚫ Listen in the 4 principal areas of the precordium ( i.e., tricuspid, pulmonary, mitral and aortic valves)
SCMC Our role as pediatricians o Attempt to provide a definitive diagnosis of an innocent cardiac murmur on the basis of specific clinical features, not just as a diagnosis of exclusion Provide patients and family with an explanation and reassurance Cost effective use of medical resources
Our role as pediatricians ⚫ Attempt to provide a definitive diagnosis of an innocent cardiac murmur on the basis of specific clinical features, not just as a diagnosis of exclusion ⚫ Provide patients and family with an explanation and reassurance ⚫ Cost effective use of medical resources
SCMC Physical Exam e Ausculatation- The Sounds S1 e Closure of the a-v valves e Single sound in early isovolumic ventricular contraction Best heard in tricuspid and mitral areas
Physical Exam ⚫ Ausculatation- The Sounds – S1 ⚫ Closure of the A-V valves ⚫ Single sound in early isovolumic ventricular contraction ⚫ Best heard in tricuspid and mitral areas
SCMC Physical Exam ● Auscultation S2 Closure of the semilunar valves Physiologic splitting results from increased right heart filling and decreased left heart filling during inspiration ● Pathologic splitting
Physical Exam ⚫ Auscultation – S2 ⚫ Closure of the semilunar valves ⚫ Physiologic splitting results from increased right heart filling and decreased left heart filling during inspiration ⚫ Pathologic splitting
SCMC Physical Exam e Auscultation of murmurs Murmurs are audible sound waves resulting from turbulent blood flow Classification of murmurs Timing IntensIty ● Location on chest wal Duration Configuration Quality ● Pitch
Physical Exam ⚫ Auscultation of Murmurs – Murmurs are audible sound waves resulting from turbulent blood flow – Classification of murmurs ⚫ Timing ⚫ Intensity ⚫ Location on chest wall ⚫ Duration ⚫ Configuration ⚫ Quality ⚫ Pitch