Reference no: EM133793770

Question

Normal jugular venous pressure (JVP) is 4 cm or less above the sternal notch when the head of the bed or examining table is elevated to 45 degrees. JVP is a surrogate for right atrial pressure. Elevated JVP is most commonly seen in certain cardiac conditions. The normal PMI is usually palpable medial to the midclavicular line in the fifth intercostal space; it may be observed as a single thrust corresponding with left-ventricular systole. Lateral displacement of the PMI is usually associated with cardiomegaly. The presence of an irregular heartbeat should prompt evaluation for signs of fluid overload like peripheral edema, pulmonary edema, and hepatomegaly. Be sure to investigate peripheral circulation when cardiac dysfunction is suspected. Auscultate for carotid bruits (brain oxygenation). Palpate the most distal pulses (lower extremities). Gait is part of a good neurological exam, which is essential for a patient with palpitations who is at risk of embolization. It acts as a gross screening for cerebellar dysfunction. Given that this test is investigating causes or complications of diagnoses on the differential list and is less centrally related to the diagnosis, more specific cerebellar examination techniques.