#enlargement of the heart right ventricular dilatation -left or slightly upper left ventricular dilatation-left inferior LV &RV dilatation -left inferior (both side dilatation)
11 #enlargement of the heart • right ventricular dilatation –left or slightly upper • left ventricular dilatation—left inferior • LV &RV dilatation –left inferior (both side dilatation)
12
#Posture: ·recumbent position-—upper ·left lateral position—-to the left2- 3cm right lateral position-to the right 1.0-2.5cm Dextrocardia:5-ICS-RS
13 #Posture: • recumbent position—upper • left lateral position—to the left 2- 3cm • right lateral position—to the right 1.0-2.5cm • Dextrocardia: 5-ICS—RS
Inspeeno apical impulse abnormal 2)Intensity and extent changes Decrease Increase Physiological Chest wall pachynsis Thin chest wall Narrow intercostol space Broaden intercostol space exercise,euphoric mood Pathological myopathy(AMI,DCM) .LV hypertrophy pericardial effusion hyperthyroidism emphysema fever constrictive pericarditis anemia left side massive pleural effusion or pneumothroax
14 Decrease Increase Physiological Chest wall pachynsis Narrow intercostol space Thin chest wall Broaden intercostol space exercise,euphoric mood Pathological . myopathy(AMI,DCM) . pericardial effusion . emphysema .constrictive pericarditis . left side massive pleural effusion or pneumothroax .LV hypertrophy .hyperthyroidism . fever .anemia 2)Intensity and extent changes Inspectionapical impulse - abnormal
Inspection -apical impulse abnormal 3)Inward impulse: apex excavation in the systole seen:adhensive pericarditis prominent RV hypertrophy
15 3)Inward impulse: • apex excavation in the systole • seen: adhensive pericarditis prominent RV hypertrophy Inspection -apical impulse - abnormal