Inspection 3 Abnomal pulsations of percardium 1)left third-forth intercostal space lateral to the sternum(3,4ICS-LS) seen:RV hypertrophy 6
16 Inspection 1)left third-forth intercostal space lateral to the sternum(3,4ICS-LS) • seen: RV hypertrophy 3 Abnomal pulsations of percardium
2)hypoxiphoid process seen: difference deep inspiration RV hypertrophy abdominal aorta (aneurysm) 17
17 2)hypoxiphoid process seen: difference deep inspiration RV hypertrophy ↑ abdominal aorta (aneurysm) ↓
3)basal part of the heart 2 ICS-LS:dilatation of the pulmonary artery or pulmonary hypertensin,occasionally healthy young man 2 ICS-RS:aneurysm of aortic arch or dilatation of ascending aorta
18 3)basal part of the heart • 2 ICS-LS: dilatation of the pulmonary artery or pulmonary hypertensin, occasionally healthy young man • 2 ICS-RS: aneurysm of aortic arch or dilatation of ascending aorta
Palpation 1 Apical impulse and pulsation of precardium 2 Thrill 3 Pericardial friction rub
19 Palpation 1 Apical impulse and pulsation of precardium 2 Thrill 3 Pericardial friction rub
Palpation 1 Apical impulse and pulsation of precardium Exact position of apex The beginning of systole of ventricle first sound Heaving apex impulse:reliable of LV hypertrophy
20 1 Apical impulse and pulsation of precardium • Exact position of apex • The beginning of systole of ventricle first sound • Heaving apex impulse: reliable of LV hypertrophy Palpation