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LATEST VERSION 2025/2026.
Order of cardiac assessment - ANS IPAP: Inspect, Palpate, Auscultate, Percuss
Objective data in a cardiac assessment - ANS BP (both arms), neck vessels (JVD), pulse
(apical, radial, extremities both sides), precordium (heart sounds)
Where are the points to listen during auscultation in a cardiac assessment - ANS Pulmonic
valve (2 intercostal, pt left), Aortic valce (2 intercostal, pt right), mitral valve (5 intercostal
nipple line), tricuspid valve (5 intercostal pt slight left of sternum), erbs point
When to use the bell during cardiac auscultation - ANS Only to hear low pitched sounds not
heard with diaphragm. Minimal pressure
Where and when is S1 heard - ANS Heard with closure of tricuspid and mitral valves.
Beginning of systole.
Where and when is S2 heard - ANS Heard with closure of pulmonic and aortic valves.
Beginning of diastole.
What is S2 split - ANS When aortic valve closes significantly earlier than pulmonic valve. Two
separate sounds.
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, What is S3 - sound, cause, when - ANS Low intense vibrations caused by ventricular filling.
Ventricles resistant to filling usually due to high fluid state, associated with left ventricular
failure. Immediately after S2.
What is S4 - sound, cause, when - ANS Low frequency vibrations caused by atrial contraction.
Associated with coronary artery disease and systolic overload, outflow obstruction to ventricle.
Just before S1
How are murmurs assessed (3) - ANS Loudness (six grades), timing (diastole or systole), pitch
(low, medium, high)
What is Cardiac Output - ANS CO = HR x SV
The amount of blood pumped by each ventricle per minute
4 things influencing CO within one person (not demographic differences) - ANS Heart rate,
preload, afterload, contractility
What is chronotropy - ANS The body's ability to control the HR
HR - normal, tachycardia, bradycardia - ANS Normal - 60-100bpm
Tachycardic - >100 bpm
Bradycardic - <60 bpm
What do baroreceptors do - ANS Respond to changes in BP (short term).
What is stroke volume - ANS Volume of blood ejected per beat during systole
What is preload - ANS The amount of stretch (pressure) on myocardial fibers at end diastole.
End diastolic volume.
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