Avaliação Semiológica e Diagnóstico em Pequenos Animais - Aula 5.2

Summary

This lecture covers the physical examination techniques for assessing the circulatory system in animals, particularly those with cardiopathies. It discusses how to identify key signs like exercise intolerance, lethargy, and changes in posture upon arrival at the clinic. The script details various examination steps, including evaluating the head, neck, thorax, and abdomen for abnormalities such as edema, heart murmurs, or arrhythmias. Techniques like palpation, percussion, and auscultation are explained in depth, emphasizing how to detect heart conditions and guide further diagnostics. The lecture provides vital insights into recognizing and managing cardiovascular health in animals.

Takeaways

• 😀 The examination of the circulatory system involves evaluating physical signs such as reduced physical activity, exercise intolerance, and lethargy in patients with cardiopathies.
• 😀 Observation of signs like edema, ascites, and abnormal respiratory patterns (tachypnea, dyspnea, orthopnea) helps identify circulatory system issues in patients.
• 😀 The physical examination follows a structured sequence: head, neck, chest, and abdomen. Each area provides crucial insights into the circulatory system.
• 😀 The initial evaluation of the head involves checking for symmetry, mucosal color (paleness or congestion), and dental health, as periodontal diseases can affect cardiovascular health.
• 😀 Capillary refill time (CRT) is assessed by pressing on the mucosa and checking how quickly the color returns, which should happen within 1 to 2 seconds.
• 😀 Palpation of the neck, including checking the jugular pulse, is essential for understanding circulatory function. Alcohol-moistened cotton can help highlight the jugular vein for better assessment.
• 😀 During chest palpation, attention is given to detecting precordial shock, structural abnormalities like fractures, and signs of subcutaneous emphysema.
• 😀 Thoracic percussion helps identify abnormal masses, effusions, or changes in thoracic structure, which are key indicators of circulatory issues.
• 😀 Cardiac auscultation is vital for identifying heart murmurs, determining heart rate, and evaluating the severity and location of any murmurs in specific valvular regions.
• 😀 Heart sounds (S1, S2, S3, and S4) are assessed during auscultation, with S1 and S2 corresponding to valve closures, while S3 and S4 are linked to abnormal heart conditions like congestive heart failure.
• 😀 Heart murmurs are classified by intensity, from grade 1 (very faint) to grade 6 (loud with palpable thrill), providing a detailed evaluation of the heart’s condition.
• 😀 Arrhythmias and friction sounds can be detected during auscultation, with the pulse at the femoral artery providing additional insight into irregularities in heart rhythm.

Q & A

What are some early signs of circulatory system issues in animals with cardiopathy?

Early signs of circulatory system issues in animals with cardiopathy include decreased physical activity, lethargy, exercise intolerance, and sleepiness.

Why is observing the posture of a patient important during the physical examination?

Observing the posture is crucial because it helps identify signs such as edema, ascites, or abnormal breathing patterns, which may indicate a serious condition in patients with circulatory issues.

What is the significance of examining the mucous membranes in a circulatory system examination?

The examination of mucous membranes helps assess their color and the presence of any secretions or inflammation, which can provide important clues about the cardiovascular health of the animal.

How is the capillary refill time (CRT) assessed, and what is the normal range?

CRT is assessed by applying digital pressure to the mucosa and observing how quickly the color returns after release. A normal CRT is between 1 to 2 seconds. A CRT longer than 2 seconds indicates a potential circulatory problem.

What does a positive cough reflex during a trachea palpation indicate?

A positive cough reflex during trachea palpation indicates the presence of a cough, which can be a symptom of respiratory or circulatory issues in the patient.

What is the purpose of palpating the thorax during a physical examination?

Palpating the thorax helps detect abnormal findings such as increased volume, fractures, or subcutaneous emphysema, which are important signs of circulatory or cardiac conditions.

How are heart murmurs classified during auscultation, and what does each grade indicate?

Heart murmurs are classified from grade 1 to grade 6. Grade 1 is a very soft murmur heard only after prolonged auscultation, while grade 6 is a very loud murmur with a palpable thrill that can still be heard even with the stethoscope away from the chest.

What is the significance of the heart's S3 and S4 sounds during auscultation?

The S3 and S4 sounds are typically associated with pathological heart conditions. S3 is linked to rapid ventricular filling, often seen in congestive heart failure, while S4 is associated with atrial contraction, which can be observed in conditions like atrial fibrillation.

Why is the location of the precordial impulse important during a cardiovascular exam?

The location of the precordial impulse helps determine the area where the heart's abnormal beats, such as a murmur or irregular rhythm, are most prominent, aiding in diagnosing specific cardiac conditions.

What other aspects should be considered during the cardiovascular examination, aside from auscultation and palpation?

Aside from auscultation and palpation, it is important to assess for signs like arrhythmias by feeling the femoral pulse, checking for friction rubs, and evaluating abdominal organs to detect potential complications such as ascites or hepatomegaly, which can relate to circulatory health.