Cardiovascular, Peripheral vascular, and Respiratory Advanced Physical Assessment
Physical assessment of the cardiovascular, peripheral vascular, and respiratory systems are crucial for identifying life-threatening conditions in clients. They form part of the quick evaluation in emergencies. Regarding the respiratory system assessment, I have come across additional resources involved in auscultation.
Generally, auscultating the respiratory system enables assessment of the air rushing through the respiratory tract during the process of inspiration and expiration. Bronchial, bronchovesicular, and vesicular are the three distinct breath sounds that are assessed through auscultation. The bronchial sound gets auscultated along the trachea with a high pitch, a hollow quality, and more heard during expiration than during inspiration. On the other hand, bronchial-vesicular presents with a moderate pitch, and the duration of the breath sound is equal during expiration and inspiration. Vesicular breath sound heard in the peripheral lung fields has a low pitch, which is breezy in quality and takes longer during inspiration than in expiration following auscultation.
However, concerning the cardiovascular assessment, the five auscultation points for the heart valve sounds remain a challenging concept. Nonetheless, I can identify the aortic area (located on the second intercostal space, right sternal border). Thus, the identification of the S1 and S2 heart sounds patterns remains a formidable challenge. Gavrovska, Zajić, Bogdanović, Reljin & Reljin (2017) acknowledge that one of the significant problems in heart sound analysis is the identification of the S1 and S2 sounds. The hard part comes when locating the pulmonic area, Erb’s point, the tricuspid area, and the apex because of the differentiation of the intercostal spaces.
Reference
Gavrovska, A., Zajić, G., Bogdanović, V., Reljin, I., & Reljin, B. (2017). Identification of S1 and S2 heart sound patterns based on fractal theory and shape context. Complexity, 2017.