- Position the patient supine
with the head of the table slightly elevated
- Inspect for precordial movement.
Tangential lighting will make movements more visible
- Palpate for precordial
activity in general. You may feel "extras" such
as thrills or exaggerated ventricular impulses
- Palpate for the point of maximal
impulse (PMI or apical pulse).
It is normally located in the 4th
or 5th intercostal space just medial
to the midclavicular line
- Note the location, size, and quality
of the impulse
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