Stupid CS question about female pts

[BleedCubbieBlue]

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Hey everyone,
This is a really stupid question, sorry, but I appreciate any help I can get. I take CS soon.

So when listening to heart sound on a female, in order to listen to the tricuspid and mitral areas, how do you maneuver around breast tissue and the pts bra? Can you kind of fudge it and just do it near the area, on the nearest area of skin not covered by the bra?

Thanks

 

[ohboy]

Hey everyone,
This is a really stupid question, sorry, but I appreciate any help I can get. I take CS soon.

So when listening to heart sound on a female, in order to listen to the tricuspid and mitral areas, how do you maneuver around breast tissue and the pts bra? Can you kind of fudge it and just do it near the area, on the nearest area of skin not covered by the bra?

Thanks

When I took CS I fudged it. I don't have my scores back yet so I can't recommend that to you. The way I was actually taught to do it was to drape the legs of the patient, have her lift the gown to the base of her left breast and ask her to raise her breast. Auscultate the areas needed and have her put her gown back down.

 

[ucsfstudents]

Details are not crucial here. These are actors. Tell them what you are doing, listen on the skin in the "heart area" and move on. You can have them lift up their breast. Just remember to keep them in the loop on what you're doing. They likely will not note whether you listened to the correct area -- they will note whether you did a heart exam, and maybe listened in 4 places on the left chest.

 

[DartosDO]

Details are not crucial here. These are actors. Tell them what you are doing, listen on the skin in the "heart area" and move on. You can have them lift up their breast. Just remember to keep them in the loop on what you're doing. They likely will not note whether you listened to the correct area -- they will note whether you did a heart exam, and maybe listened in 4 places on the left chest.

Correct. The graders can't tell if you're in the right place. Just be sure to keep the pts informed. Safest bet is to have the pt hold themselves out of the way - everyone is happy that way.

 

[kaboodle]

The above responses are wrong. These are trained standardized patients for a national board exam, so they do know where you should be listening. All you have to do is tell them to hold their breast, or move their bra so you can auscultate properly. After all, you are the doctor so you need to tell your patient what to do in order for you to perform a good physical exam.

 

[DartosDO]

The above responses are wrong. These are trained standardized patients for a national board exam, so they do know where you should be listening. All you have to do is tell them to hold their breast, or move their bra so you can auscultate properly. After all, you are the doctor so you need to tell your patient what to do in order for you to perform a good physical exam.

I don't think we meant just throw your scope on some random intercostal space - put the scope where it needs to go! But just don't worry if ur nervous and think u might hear a 1/6 murmur on a 20 y/o with a cough.