Cardiovascular system, blood

The cardiovascular exam includes assessmen of the extremities, neck, andprecordium. Examination of the upper and lower extremities is discussed in different sections of this shapter, as each occurs in the screeningexam sequence. Examination of the neck vessels and the precordium is detailed in this section. The pulse and blood pressure, wich are significant parameters of cardiovascular function, are measured at the biginning of the physical exam. Review apropirate literature for correct procedure, normal parameters, and significance of abnormal findings. Refer also to Unit XII of this text.
The heart and great vessels lie in the mediastinum (the middle part) of the thoracic cage. The heart sits like an ivertedtriangle in the thorax: the ''top'' is the base and the ''bottom'' is apex. Cardiac borders extend vertically from the second to the fifth intercostal space and horizontally from the right strenl border to the left midclavicular line.The heart is two pumping systems separated by a wall, or septum. There are four chambers - anatrium and a ventricle on each side - separated by valves. These heart valves are uniderectional, so that blood can flow only one way. They open and close passively, depending on the pressure gradients in the chambers. The atrioventricular (AV) valves separate the atria and the ventricles; the left AV valve is the bicuspid or mitral and the right AV valve is the tribicuspid. The semilunar valves are located between the ventricles and the great arteries. The aortic valve separates the left ventricle and the aorta. The pulmonary artery.
pulmonary congestion and increasing right atrial presure is reflected in the neck veins and the abdomen. Theprecordium is the anterior surface of the chest wall overlying the heart and great vessels. The four ''valve areas'' are located here, although these are not the actual anatomical locations of the valves themselves. Rather,...

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