Three things happen before you ever put the stethoscope down: you run the exam in the correct order, you find the apical impulse with your fingertips, and you read the neck. Build the four-step sequence for any body system — the abdomen will punish you if you get it wrong — then describe a point of maximal impulse and a jugular pulsation and see what each one is telling you about a failing heart.
Choose the system, then click the four techniques in the order you would perform them. One system does not follow the rule.
Your sequence appears here
Which position brings out which finding?
Position matters more in the cardiac exam than anywhere else. Match the maneuver.
Palpate with the finger pads for pulsations and the ball of the hand for the buzzing of a thrill. Then describe what you felt, and the bench will tell you what it means.
Also palpated
Two windows onto the heart sit outside the chest. First tell them apart, then measure the one that counts.