Examination Of Precordium Introduction Consent 1.Inspection Visible Scar marks Deformity Pectus Excavatum Carinatum Any bulge in the thorax Any visible pulsation Anything Abnormal 2. Palpation Must rub your hands if cold weather (i) First palpate Apex beat feel it with your fingers after feeling count it from Manubrium Sterni which is in the 2nd intercostal space Locate intercostal space & weather it is in mid clavicular line or displaced Check weather Apex beat is normal or Tapping or Heaving with your finger If Tapping your finger will be tapped/touched slightly. If Heaving your finger will be lifted upwards (not just touched) Ill heave finger lifted up for short time Well sustained heave finger lifted up for long time (ii) Right Ventricular Heave/ Left Parasternal Heave (iii) Palpate both Aortic & Pulmonary Areas with fingers & palms of your hand to see if a thrill is present or not. (iv) Palpate trachea (v) Feel Epigastric Pulsation 3. Auscultation Starts from MITRAL AREA after locating AB i. Place the steth at mitral area ii. Synchronize it with carotid iii. Give command Of Respiration to patient Murmur of right heart exaggerate during inspiration & left heart exaggerate during expiration سانس اندر لیں باہر نکالیں اور روک لیں iv. Ask patient to go to left lateral position see if there is an exaggeration of a murmur Murmur of Aortic regurgitation exaggerates in this position v. Check radiation of murmur in axillary area Now TRICUSPID AREA same 3 steps Place the steth at exact area Synchronize it with carotid Give command of respiration سانس اندر لیں باہر نکالیں اور روک لیں Next PULMONARY AREA Place the steth at exact point Synchronize it with carotid artery pulsation Give command of respiration سانس اندر لیں اور روک لیں NEXT AORTIC AREA i. Place the steth at exact area ii. Synchronize it with carotid iii. Give command of respiration سانس اندر لیں باہر نکالیں اور روک لیں iv. Ask the patient to sit up & lean forward to check gor murmur of aortic as it exaggerates in this position بیٹھیں اور تھوڑا سا جھک جائیں v. Check the radiation in the neck 4. Do the relevant examination Look for the basal crepts Do The Hepatojugular reflex Look for hepatomegaly Look for Pedal Edema Examine Hands for signs of Infective endocarditis like Splinter Hemorrhages Janeway Lesions Osler Nodes Petechiae Bruises & other things. Say thank you & cover the patient

Description of Findings I've an 8 years old boy lying comfortably on bed with no obvious distress or dysmorphic features. (environment of pt Cannulated or not O2 administered or not) On Inspection there are no visible Scar marks or visible pulsations, no deformity Pectus Excavatum Carinatum or any other. On palpation AB is in 5th intercostal space in mid clavicular line tapping in character. There were no Parasternal Heave or thrill present. The Trachea was central & there are no epigastric pulsations Both the first & second heart sounds are audible with grade 3 pan systolic murmur maximum heard at the lower left para sternal border radiating to the whole of precardium with no exaggeration on respiration & change of posture. The pitch of the murmur is high & the character of murmur was harsh/blowing This child is not in heart failure & there are no signs of Infective endocarditis.

Have an ospe tomorrow. These videos saved my life 💯

Your videos are very informative and well done and your little patient is just precious and so cooperative.

Behind the Respected Sir There's picture of respected worthy vice chancellor Dr M. Umar Sitara e imtyaz ❤😊

JazakAllah o khairan kasiraa....may Allah bless you sir always. So helpful videos

Awesome information, this just makes it easier, to test the patient in question,👌🏽👌🏽👌🏽👌🏽👍🏼👍🏼👍🏼👍🏼👍🏼

Very brave little boy laying real still while the doctor is squeezing and pressing on his stomach. Maybe he’s the doctor’s kid!

Great videos.really like them.thank you dr junaid for making examination so much easy for us

Best way to teach clinicals ❣️

Jazak Allah Sir... Very informative especially the variation with respiration point

Very helpful . JazakALLAH

Amazing sir❤️ Keep doing 🙌

Found something worthy ❤

JazakAllah! Really Helpfull☺️ Thank You Sir♥️

Thank you, great video!

Very useful video ...Jazaka Allah sir ... But one step u forget I think sir ,u have not check pulse 🤔

you didnt tell about where to examine which area from where, for example at which intercostal space is the mitral, pulmonary etc. also the findings you told were of a normal patient ???? please confirm

Amazing 🎉❤

😊

Very welldone doc 👌

perfect,awesome,crossed limits

excellent video

Amazing sir g💓

Allah Apka bohat bhala kary

Love from india kolkata

JazakAllah Great sir

sir can you pls explain the commands you gave while auscultating pulmonary and aortic area

JazakAllah khair sir

Nice one sir

Excellent 👍

Thank you sir.

So its a case of VSD then (inferred from the description of murmur)?

Dont we put bell for mitral murmurs?

🙌🏽

Sir kindly make vedio on Albinism examination

Thanku dr 👍👍👍

عاشت ايدك والله

Excellent

7:05 9:05

5:10 best

Saviour,,👏

Aleikum salam. 🇹🇷

Thanku so much sir

وعليكم السلام

Awesome

Sir g vedio banatay huway plz ye camra work tek karay

Explaination given at the end was of normal child???

Why do we syncronise with carotids?

29 march

Jvp please