Figure 7.7. Examination of the apex impulse in the supine position.

Figure 7.7Examination of the apex impulse in the supine position

Place the patient in the supine position elevating the trunk approximately 30–45 degrees. Position yourself on the patient's right side and place the flat part of your right hand over the left precordium in the fourth, fifth, and sixth intercostal spaces near the mid clavicular line. First locate the apex impulse with the distal half of the palm of your hand and its adjacent proximal phalanges. The full extent of a broad apex impulse is best appreciated with the palm. Use the tips of the first and second fingers placed directly on the impulse to make detailed observations of the impulse. Assess the location, diameter and duration of the impulse.

From: Chapter 7, An Overview of the Cardiovascular System

Cover of Clinical Methods
Clinical Methods: The History, Physical, and Laboratory Examinations. 3rd edition.
Walker HK, Hall WD, Hurst JW, editors.
Boston: Butterworths; 1990.
Copyright © 1990, Butterworth Publishers, a division of Reed Publishing.

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