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Blood Pressure Measurement Best Positions Cardinal Techniques Landmarks ECG
100
The elbow is slightly flexed with the brachial artery at the level of the heart.
The correct position of the arm when taking the blood pressure
100
sitting
thorax & lungs
100
palpation
joint crepitus
100
sternal angle/ angle of Louis
best guide for counting the ribs & interspaces
100
4th ICS to the right of the sternum
lead placement of V1
200
~ 2.5 cm above the antecubital fossa
The proper placement of the cuff
200
supine with head of bed raised 30 degrees
cardiovascular system (JVP, PMI, murmurs)
100
auscultation
valvular pathology
200
5th ICS just medial to the left mid clavicular line or 7-9 cm from the sternal line
location of the point of maximal impulse (PMI)
200
midaxillary line same level as V4 & V5
lead placement of V6
300
Pevent discomfort from unnecessarily high cuff pressure
Rationale for estimating the systolic BP by palpation method before actual BP measurement
300
left lateral decubitus
rectal exam & prostate
100
inspection
respiratory distress
300
at or near the lower left sternal border
murmurs originating from the tricuspid valves
300
1 mv (10 mm) & 25mm/sec
standard voltage and speed
400
auscultatory gap
a silent interval that may be present between systolic and diastolic pressures
400
dorsal lithotomy
pelvic & rectal exam
100
percussion
dullness, resonance, or tympany
400
2nd interspace left
surface marker for the pulmonary artery
400
smooth like a hill
normal configuration of the p wave
500
"white coat" hypertension
a condition wherein the office BP is high but the ambulatory pressures are normal
500
sitting, leaning forward
murmur of aortic insufficiency
200
auscultation
distinguish pleural fluid from mass in lungs
500
The inferior angle of the scapula lies at the level of the 7th rib. The interspace T7-T8 is a landmark for thoracentesis.
a useful bony landmark in the posterior thorax
500
normal, but if prominent assoociated with T wave changes it may indicate hypokalemia
significance of the presence of p wave




The Physical Exam

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