Physical Exam

Cardiology

Jugular Venous Pressure: distance between angle of Louis and the mid right atrium (8.0, 9.7, & 9.8) is highly variable depending on body angles of 30, 45, and 60 degrees respectively. The variability is highest at 45 degrees. (1.36 cm H20/blood = 1.0 mm Hg)

Seth R. How Far Is the Sternal Angle from the Mid-right Atrium? J Gen Intern Med 2002; 17: 852.

 

S3: evidence of congestive heart failure.

 

Marcus G. Relationships Between Accurate Auscultation of a Clinically Useful Third Heart Sound and Level of Experience. Arch Intern Med 2006; 166: 617. 

Gregory M. Association Between Phonocardiographic Third and Fourth Heart Sounds and Objective Measures of Left Ventricular Function. JAMA 2005; 293: 2238.

Pulmonary

Whispered Pectoriloquy: whispered words sound louder over consolidated lung

Bronchophony: "99" sounds clearer over consolidated lung

Egophany: the letter "e" sounds like "a" over consolidated lung