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It emphasizes pulmonary exam as forthcoming and outlines four basic approaches: observation, palpation, percussion (omitted in cardiac exam), and auscultation. Guidance includes respectful gown management and patient-touch technique to preserve modesty while enabling accurate heart and lung assessment, including surface anatomy and palpation methods such as identifying the PMI and key valve locations.",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/examination-of-the-cardiovascular-system-keys-to-performing-a-respectful-effective-exam-observation-palpation-percussion-auscultation/317066/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/examination-of-the-cardiovascular-system-keys-to-performing-a-respectful-effective-exam-observation-palpation-percussion-auscultation/317066.png","ImageObject",300,407,{"name":92,"@type":93},"Kurz","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-25","2026-09-20",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",13,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"What vital signs and history elements are included in the cardiovascular exam?","Question",{"text":113,"@type":114},"The exam includes an appropriate history and review of systems, plus vital signs: blood pressure and pulse (rate, rhythm, and volume).","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"Which physical exam components are used for cardiac evaluation?",{"text":118,"@type":114},"Four basic components are listed: observation, palpation, percussion (omitted in the cardiac exam), and auscultation.",{"name":120,"@type":111,"acceptedAnswer":121},"How should clinicians perform a respectful and effective exam while using gowns and touching patients?",{"text":122,"@type":114},"Explain what you’re doing and why before starting, expose only the minimum necessary skin using artful gown and drapes, ask for patient assistance with positioning when needed, don’t rush or cause pain, and avoid examining through the gown because poor technique leads to missed findings.","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},317066,1790282920,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":36,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":145},2336478945635,"https://ap-avatar.wpscdn.com/davatar_6f874abed73319feea01a86fa6f0fab8","Examination Of The Cardiovascular System  \nPOM-October 9, 2019 Charlie Goldberg, M.D.  \n[cggoldberg@health.ucsd.edu](cggoldberg@health.ucsd.edu)  \nCardiovascular Exam  \n•  Includes  \n• appropriate history and ROS  \n• Vital Signs: Blood pressure; Pulse: rate, rhythm, volume  \n• Assessment distal vasculature (legs, feet, carotids) → vascular disease (atherosclerosis) is a systemic illness !  \n• Pulmonary Exam (coming soon)  \n• 4 basic PE components:  \n• Observation, Palpation, Percussion (omitted in cardiac exam)& Auscultation  \nThoughts On Gown Management &  \nAppropriately/Respectfully Touching Your Patients  \n• Several Sources of Tension:  \n• Area examined reasonably exposed – yet patient modesty preserved  \n• Palpate sensitive areas to perform accurate exam-requires touching people w/whom you’ve little acquaintance – awkward, particularly if opposite gender  \n• Exam not natural/normal part of interpersonal interactions-as newcomers to medicine, you’re particularly aware & hence sensitive → a good thing!  \nKeys To Performing a Respectful & Effective Exam  \n• Explain what you’re doing (& why) before doing it→ acknowledge “elephant in the room”!  \n• Expose minimum amount of skin necessary- “artful” use of gown & drapes (males & females)  \n• Examining heart & lungs of female patients:  \n• Ask patient to remove bra prior and/or learn to work around bra  \n• Expose side of chest to extent needed  \n• Enlist patient’s assistance→ positioning breasts to enable cardiac exam  \n• Don’t rush, act in a callous fashion, or cause pain  \n• PLEASE… don’t examine body parts thru gown:  \n• Poor technique  \n• You’ll miss things  \n• You’ll lose points on scored exams (OSCE, CPX, USMLE)!  \nObservation  \n• Pay attention to:  \n• Chest shape  \n• Shortness of breath (@ rest or walking)?  \n• Sitting upright? Able to speak?  \n• ? Visible impulse on chest wall from vigorously contracting ventricle (rare)  \nSurface Anatomy  \nFinding The Sternal Manubrium Junction (aka Angle of Louis)– Key To Identifying Valve Areas  \nClavicle Clavicle  \nManubrium  \nSternum  \n~~ ~~ Sternal  \nManubrium Junction  \n (Angle of  \nLouis)  \n1st Rib  \n2nd Rib    \n2nd ICS    \nManubrium  \nSternal Manubrium  Junction  \nSternum  \nManubrium slopes in one direction while Sternum angles in different direction. Highlighted by q-tips → intersection defines Sternal Manubrium Junction  \nValves And Surface Anatomy  \n• Areas of auscultation correlate w/rough location of each valve  \n• Where you listen will determine what you hear! More Anatomy @:  \n[http://www.blaufuss.org/tutorial/indexTut.html](http://www.blaufuss.org/tutorial/indexTut.html)  \nPIE Group: [http://pie.med.utoronto.ca/PIE/PIE_whatWeDo_valves.html](http://pie.med.utoronto.ca/PIE/PIE_whatWeDo_valves.html)  \nPalpation-Technique  \nLeft ventricle  \n- Fingers across chest, under breast (explain 1st)  \n• Point of Maximal Impulse  \n(PMI) → apex ventricle that pin-points w/finger tip; ~70% of patients-if not palpable, repeat w/patient on L side  \n- Size of LV – increased dimension if PMI shifted to L of mid-clavicular line  \n• Vigor of contraction  \n• Palpable thrill (rare) -associated  \nw/regurgitant or stenotic murmurs (feels like sensation when kink garden hose)  \nFor Male Patients  \nFor Female Patients  \nPalpation – Technique (cont)  \n• Right ventricle:  \n• Vigor of contractility  \n→ heel of R hand along sternum  \n• Rarely abnormal with RV (pulmonary hypertension)","cbCaisJ4FcncRCCy","https://ap.wps.com/l/cbCaisJ4FcncRCCy","pdf",3547098,"English","# Examination Of The Cardiovascular System\n## Vital Signs and Distal Vascular Assessment\n## Core Physical Exam Components\n## Gown Management and Respectful Patient Touch\n## Keys To Performing a Respectful & Effective Exam\n## Observation and Surface Anatomy\n## Valves and Areas of Auscultation\n## Palpation Technique (PMI, Left and Right Ventricles)","[{\"question\":\"What vital signs and history elements are included in the cardiovascular exam?\",\"answer\":\"The exam includes an appropriate history and review of systems, plus vital signs: blood pressure and pulse (rate, rhythm, and volume).\"},{\"question\":\"Which physical exam components are used for cardiac evaluation?\",\"answer\":\"Four basic components are listed: observation, palpation, percussion (omitted in the cardiac exam), and auscultation.\"},{\"question\":\"How should clinicians perform a respectful and effective exam while using gowns and touching patients?\",\"answer\":\"Explain what you’re doing and why before starting, expose only the minimum necessary skin using artful gown and drapes, ask for patient assistance with positioning when needed, don’t rush or cause pain, and avoid examining through the gown because poor technique leads to missed findings.\"}]","Examination Of The Cardiovascular System - Keys To Performing a Respectful & Effective Exam - Observation, Palpation, Percussion & Auscultation | PDF",1789928415,101]