Pemeriksaan Fisik System Kardiovaskuler

Summary

This video provides an in-depth guide on heart examination techniques, starting with chest inspection to identify abnormalities. It covers palpation to locate the heart’s apex, percussion to determine heart boundaries, and auscultation to detect murmurs in heart valves like the aortic, pulmonary, tricuspid, and mitral valves. The examination also includes assessing jugular vein pressure to detect increased right ventricle pressure. Throughout the process, practical tips are given for positioning the patient and using a stethoscope for accurate auscultation. The session concludes with a focus on interpreting physical signs to assess heart health.

Takeaways

• 😀 Inspect the chest shape to identify abnormalities such as scars, trauma, or an abnormal chest shape (e.g., excavator).
• 😀 During palpation, locate the heart's apex using the palm of your hand, and ask the patient to raise their left hand to assist in finding the correct spot.
• 😀 Percussion helps determine the boundaries of the heart, including the left boundary at the anterior axillary line and the right boundary between the liver and diaphragm.
• 😀 Percussion on the left parasternal line helps identify the left heart border and confirms if there are any abnormal changes.
• 😀 Auscultation of heart valves (pulmonary, aortic, tricuspid, mitral) is critical for detecting murmurs, both systolic and diastolic.
• 😀 Specific auscultation areas are vital: SC2 on the right for pulmonary valve and SC4 on the left for tricuspid valve.
• 😀 The mitral valve is assessed at the apex or the fifth axillary line for systolic or diastolic murmurs.
• 😀 The jugular vein examination involves checking for distension, which may indicate increased pressure in the right ventricle.
• 😀 A flashlight can be used to assist in visualizing the jugular vein when it's not visible under normal light conditions.
• 😀 The angle between the clavicle and sternum helps measure jugular vein distension, providing insights into the pressure in the right atrium and right ventricle.
• 😀 Ensure the patient is relaxed and in an appropriate position (e.g., turning left) when conducting these examinations to yield accurate results.

Q & A

What is the first stage in the heart examination process?

The first stage in the heart examination process is inspection, where the examiner observes the shape of the chest and identifies any abnormalities such as scars or trauma.

What should the examiner check during palpation of the chest?

During palpation, the examiner determines the location of the apex of the heart, checks for any vibrations or abnormal sounds, and confirms whether the apex is felt in the correct position.

How can the examiner locate the apex of the heart during palpation?

The examiner can ask the patient to raise and tilt their left hand to the left, which helps the examiner feel the apex of the heart more clearly.

Why is percussion performed during the heart examination?

Percussion is performed to determine the boundaries of the heart, specifically to differentiate between the lung, stomach, and liver boundaries, and to identify changes in tympany or dullness that indicate heart size or condition.

What is the purpose of the auscultation stage in the heart examination?

Auscultation is performed to listen for murmurs or abnormal heart sounds that may indicate issues with heart valves, such as aortic, pulmonary, mitral, or tricuspid valve problems.

How is the jugular vein examination conducted in the heart assessment?

The examiner observes the jugular vein for signs of increased pressure by asking the patient to turn their head to the left and using a flashlight to assess the vein's visibility. A ruler is used to measure the height of the jugular vein to estimate pressure levels.

What does a visible jugular vein indicate during the examination?

A visible jugular vein typically indicates elevated pressure in the right atrium, which can be a sign of increased pressure in the right ventricle.

What is the significance of the sound changes detected during percussion?

Changes in sound during percussion, such as a shift from tympany to dullness, indicate the boundaries of the heart and help the examiner identify potential heart enlargement or abnormalities.

How is a murmur detected during auscultation of the heart?

A murmur is detected by placing the stethoscope on the heart valves and listening for abnormal sounds. The murmur can be systolic or diastolic, depending on the timing of the abnormality in the cardiac cycle.

What does the presence of a systolic murmur in the tricuspid valve suggest?

A systolic murmur at the tricuspid valve suggests that there may be a problem with the valve, potentially indicating a condition such as tricuspid regurgitation.