Investigation of the heart and great vessels. Inspection, palpation, and percussion of the heart. Apical impulse. Dr. Szathmári Miklós Semmelweis University First Department of Medicine 17. Oct. 2011. Surface projection of the heart and great vessels.
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Dr. Szathmári Miklós
First Department of Medicine
17. Oct. 2011.
During the diastole, pressure in left atrium slightly exceeds that in the relaxed left ventricle, and blood flows from left atrium to left ventricle across the open mitral valve
During the systole, the left ventricle starts to contract and ventricular pressure exceeds left atrial pressure, thus shutting the mitral valve. Closure of the mitral valve produces thefirst heart sound (S1).
Az ejekció után csökken a bal kamrai nyomás, becsapódig az aorta billentyű S2
As the left ventricular pressure continues to rise, it exceeds the pressure in the aorta and forces the aortic valve open.Normally is not audible.
After mitral valve opens there is a period rapid ventricular filling. In young adults it can produces the third heart sound (S3).
of the left ventricle
ask the patient to roll partly onto the left side
Your thumb should press just inside the medial border of the relaxed sternomastoid muscle, at the level of cricoid cartilage
Markedly distended right external jugular vein (EJV). This is the result of elevated central venous pressure (CVP). In practice the EJV is not as reliable in determining CVP as the internal jugular vein due to the fact that it sometimes has valves and is not in a direct line with the right atrium. Pressure on the liver, however, will have similar impact on the appearance of the IJV as for the EJV. This is referred to as hepatojugular reflux.