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  #1  
Old 07-12-2013
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Stethoscope Auscultation of Female Heart in the CS Exam?

FA has some brief description in two sentences. In reality, how will you do it?

If you untie the gown and ask if it is OK to loose the gown from the back, you may have to expose the patient's back too. How far will you lower the gown?

If you ask the patient to lift up the gown from below, don't you think it is a little awkward to listen to the heart?

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Old 07-12-2013
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For aortic and pulmonary areas no need to untie or remove anything just listen to those areas from the front with the gown on. For tricuspid and apex ask patient to lift the gown up and listen to them.
thats it
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Old 07-12-2013
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Do not lift up the gown, ask the patient to untie it and then just open it in the front.
For the mitral area, you may ask the patient to lift up her bra.

If you lift up the gown, you will expose a lot more!
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this was on mdofola
youtube
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I think they might to it in that weird way because the patient is not wearing a bra. On the exam, they will be wearing a bra and it would be weird doing auscultation this way. Just do it the way you normally do it, not everything is different on CS! I did it the way I described and passed with high performance in ICE.
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Old 07-12-2013
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Found this on youtube

Heart Auscultation


"avoid inappropiate eye-contact with the breasts"
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  #7  
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Question

Quote:
Originally Posted by val7 View Post
Do not lift up the gown, ask the patient to untie it and then just open it in the front.
For the mitral area, you may ask the patient to lift up her bra.

If you lift up the gown, you will expose a lot more!
For aortic, pulmonary and tricuspid valves, it seems to be OK to pull down the gown.

How about mitral valve and PMI? It does not seem to be right to further pull down the gown. So have to lift up the gown and ask her to lift up the bra too?
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Old 07-12-2013
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Untie her bra , and listen to her heart.
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Old 07-13-2013
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Quote:
Originally Posted by Sadde View Post
Untie her bra , and listen to her heart.
Do not make the standardized patient take off her bra.
Although this is the best way to really auscultate, they are standardized patients and cannot be asked to take off their bra. This is in the ECFMG orientation video.
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Old 07-13-2013
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so , whats final ? are we going to untie or lift up ???
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guys its really simple
if the patient is lying at a 45 degree
angle (which should be the case
in cardio examination)
u can listen to aortic and pul
through the gown(i mean directly
under it) without removing
it
and then listen to the tricuspid
and mitral by asking her to
lift her gown up and pull the drape
up to cover her abdomen and lower body.
just common sense.
So better to have them at a 45 degree angle
on the examination table.

Last edited by add1; 07-13-2013 at 03:42 PM.
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Quote:
Originally Posted by Sadde View Post
Untie her bra , and listen to her heart.
Dude i know you are joking but their will be some retards who read this and actually do it....come on man
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Old 07-13-2013
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Take it from someone who just cleared the exam, DO NOT go up the gown....ask her if you can untie it and tell her to pull it down......listen to aortic and pulmonary....thank her then tell her to pull it down a little bit further....they will do it without hesitation because everyone asks them to to do this....listen to tricuspid.....and then ask her to lift up her breast to listen to mitral valve and for PMI

DO NOT GO UP THE GOWN.
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Old 07-14-2013
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Quote:
Originally Posted by Medicine23 View Post
Take it from someone who just cleared the exam, DO NOT go up the gown....ask her if you can untie it and tell her to pull it down......listen to aortic and pulmonary....thank her then tell her to pull it down a little bit further....they will do it without hesitation because everyone asks them to to do this....listen to tricuspid.....and then ask her to lift up her breast to listen to mitral valve and for PMI

DO NOT GO UP THE GOWN.
I totally agree. This is what I did in my exam and I got a high pass in ICE.
Going up to gown is just weird!
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Old 07-15-2013
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Hypothetically speaking, What happens if you accidentally get an erection or a semi-erection during this examination? Is this an irregular behavior or it's just fine? I know it's kinda weird, but let's face it seriously. Thanks.
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Old 07-16-2013
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well no offense, but do you really think anyone would get an erection while doing a physical examination on a female??? So how did you manage in the med school buddy???
Though in actual test, your anxiety levels will high enough to not let it happen....remember, it's all in our mind.
Quote:
Originally Posted by DocCT View Post
Hypothetically speaking, What happens if you accidentally get an erection or a semi-erection during this examination? Is this an irregular behavior or it's just fine? I know it's kinda weird, but let's face it seriously. Thanks.
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