Lungs, Abdomen and Legs
·
Percuss and ausciltate lung bases
on the back for pulmonary oedema, then check for sacral oedema
·
Abdomen:
o Tender or enlarged liver Þ ?heart failure
o Pulsitile liver Þ ?tricuspid regurgitation
o Ascites Þ ?heart failure
o Splenomegaly Þ ?infective endocarditis
·
Legs:
o Femoral artery pulses: palpate and ausciltate for bruits
o Popliteal pulse
o Feel leg pulses both sides at once, standing at end of bed (gives you
two chances to find them!):
§ Posterior tibial pulse: posterior to medial malleolus
§ Dorsalis pedis pulse: just lateral to the extensor hallucis longus
tendon (seen when big toe dorsiflexed)
o Palpate the distal shaft of the tibia for oedema – press for 15 seconds. If present, note upper level
o Cyanosis and clubbing of the toes, pallor, cool, ¯capillary
refill of toes
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