Create an account
Distended neck veins
distention greater than 3cm with pt sitting at a 30-45 degree angle.- Possible etiology is elevated right atrial pressure; right sided heart failure.
Bluish or purplish tinge to areas such as tongue, conjunctivae, inner surface of lips.- Inadequate O2 saturation of arterial blood due to pulmonary or cardiac disorders.
Bluish or purplish tinge in extremities, or in nose and ears.- Reduced blood flow because of heart failure, vasoconstriction, cold environment.
Clubbing of nail beds
obliteration of normal angle between base of nail and skin.-Endocarditis, congenital defects, prolonged O2 deficiency.
Color changes in extremities with postural change
Pallor, cyanosis, mottling of skin after limb elevation; dependent rubor (reddish-blue discoloration), glossy skin.- Chronic decreased arterial perfusion.
Venous- necrotic crater-like lesion usually found on lower leg. Characterized by slow wound healing. Arterial- pale ischemic base, well defined edges, usually found on toes, heels, lateral malleoli.
Visable dilated, discolored, tortuous vessels in lower extremities. - Incompetent valves in vein.
Weak, slowly rising pulse; easily obliterated by pressure. - Blood loss, decreased CO, aortic valve disease, peripheral arterial disease.
Regular rhythm but strength of pulse varies with each beat.- Heart failure, cardiac tamponade.
tachycardia.- Exercise, anxiety, shock, need for increased cardiac output, hyperthyroidism.
bradycardia. - Rest/sleeping, SA or AV node damage, athletic conditioning, side effect of drugs, hypothyroidism.
Displaced point of maximal impulse
palpated below the 5th intercostal space and left of the midline. -Left ventricluar dilation.
Hands/feet cold to touch. -Intermittent claudication, peripheral arterial obstruction, low CO, severe anemia.
Pitting edema of lower extremities or sacral area
visable indentation after application of firm pressure; weight gain; tightening of clothing. - Interruption of venous return to heart, fluid in tissues.
Abnormal capillary refill
blanching of nail bed for >2sec after application of firm pressure is released.- Possible reduced arterial capillary perfusion, anemia.
Asymmetry in limb circumference
Measureable swelling in limb. -Venous thromboembolism, varicose veins, lymphedema.
Abnormal Cardiac Borders
left border of cardiac dullness extends past MCL in 5th ICS; border of cardiac dullness extends past sternal border. - Cardiac enlargement due to coronary heart disease, heart failure, cardiomyopathy.
apical HR exceeds the peripheral pulse rate.- Cardiac dysrhythmias; most commonly atrial fibrillation.
Third Heart Sound
Extra heart sound, low pitched, heard in early diastole, similar to the sound of a gallop. -Left ventricular failure; volume overload; mitral, tricuspid or aortic regurgitation; HTN.
Fourth Heart Sound
Extra heart sound, low pitched, heard in late diastole, similar to the sound of a gallop. -Forceful artrial contraction from resistance to ventricular filling.
Turbulent sounds occuring between normal heart sounds; characterized by loudness, pitch, shape, quality, duration and timing.- Cardiac valve disorder, abnormal blood flow patterens.
Please allow access to your computer’s microphone to use Voice Recording.
Having trouble? Click here for help.
We can’t access your microphone!
Click the icon above to update your browser permissions and try again
Reload the page to try again!Reload
Press Cmd-0 to reset your zoom
Press Ctrl-0 to reset your zoom
It looks like your browser might be zoomed in or out. Your browser needs to be zoomed to a normal size to record audio.
Please upgrade Flash or install Chrome
to use Voice Recording.
For more help, see our troubleshooting page.
Your microphone is muted
For help fixing this issue, see this FAQ.
Star this term
You can study starred terms together