Article: Also known as palpation, place your right hand over the patient's left pectoral. The heel of your hand should be against the sternal border and your fingers should lie just below the nipple. You hand should lay flat against the chest, fingers extended. Make sure you tell the patient what you are going to do before you begin, and explain the purpose. While palpating, be aware of the following: Can you feel a point of maximum impulse (PMI), which indicates the location of the left ventricle? Try to pinpoint its exact location, which is usually near the mid-clavicular line. If the ventricle is normal-sized and functioning, it should be about the size of a penny. If it is enlarged, it may be located closer to the armpit. What is the duration of the impulse? If the patient suffers from hypertension, the impulse will last longer. This is subtle and largely a subjective assessment, however. How strong is the impulse? Do you feel a vibration (or thrill)? If a valve is partially obstructed, you may detect this. If you notice a murmur during auscultation, then check again for a thrill. After auscultating the apex, it is important to listen to the following areas with your stethoscope:  The left side of the patient's sternum, at the bottom (in the 5th intercostal space). This is the best place to auscultate the tricuspid valve.  The left side of the patient's sternum, near the top (in the 2nd intercostal space). This is the best place to auscultate the pulmonic valve.  The right side of the patient's sternum, near the top (in the 2nd intercostal space). This is the best place to auscultate the aortic valve.  Note that listening to the heart's apex is the best spot to assess the mitral valve. The bell is the auscultatory part of the stethoscope with the smaller circumference and concave surface. It is sensitive to abnormal heart sounds called murmurs.  The bell should be applied lightly over the skin to increase sensitivity to murmurs. Pinch the sides of the bell with your thumb and index finger. Rest the heel of your hand against the patient’s chest to ensure that the bell is placed lightly. The bell should create an air-tight seal with the skin to easily hear abnormal heart sounds. This position amplifies the apex’s heart sounds. Place the bell lightly on the apex and listen for murmurs.  Ask the patient to sit up, lean forward, exhale completely and suspend breathing. This maneuver accentuates murmurs.  Both of these maneuvers are "specialty techniques" used to better assess for any heart pathology or murmurs. Do not discuss your physical examination findings with the patient still undressed.
Question: What is a summary of what this article is about?
Feel the patient's heart. Listen in the other 3 auscultation spots. Repeat steps 2 and 3, this time using the bell of your stethoscope. Ask the patient to lie on his/her left side and ensure proper draping. Leave the examination room and allow the patient to get dressed.

If you are buying bettas to breed, make sure to get them only from one specific, reputable breeder. This can help ensure the quality and success rate of your betta spawn.  Be aware that getting quality bettas to breed can be expensive. More expensive fish generally mean that a breeder has also used selective breeding techniques. Although this isn't a guarantee of successful breeding, it can ensure the health and quality of your fish and possible their spawn. Some elements to look for in a breeder include: accomplishments, longevity, experience, knowledge, professionalism, affiliation with betta organizations, availability, reputation, track record, cleanliness, reference.  Ask the breeder to let you know about the parentage of the bettas. If he can't answer the question, you may want to consider using another breeder that keeps tabs of his bettas' parentage. Find quality betta breeders through organizations such as the International Betta Congress. If you have friends or family that breed bettas or are familiar with them, you might ask them for suggestions, too. Figure out which bettas to get depending on what qualities you're hoping to highlight or breed out. You want to get the best quality stock you can afford and finding the right pair can help ensure health, beauty, and even your enjoyment.  Make sure that you and your breeder both have knowledge of your fish's genetics. Knowing which traits can be inherited is important for responsible breeding to prevent  generations of fish that follow from being unhealthy. Be aware that selective breeding is meant to bring out certain characteristics in a betta fish. For example, you may want to bring out black lace patterns in your betta. By choosing another betta with more distinctive lace patterns and mating it with your betta, you can bring out this particularly quality. You can apply this principle to color and fin size, too. Remember that if you're hoping to achieve a certain goal through your selective breeding, either with fin size or color, it can take a few years and cycles for these traits to fully appear.  You can either use hybridization or inbreeding for desired traits. Hybridization will bring out the best traits in two genetically different parents, and inbreeding crosses two similar parents for offspring that also have the similar traits. Betta breeding can be rough no matter what, but it's important to get fish that are approximately the same size. This helps prevent injury to one of the fish. Looking at the size of each betta can ensure healthy spawn and a healthy breeding process for each fish.  Be aware that a fish that is too small may be too young to breed. Aim to breed bettas that are four to twelve months old, which can help ensure that the sizes are proportionate as well as help prevent bad quality spawn. Detect sexual maturity in your betta by looking for males that build bubble nests and females that have a whitish egg spot on their underside. Females are also able to build bubble nests - don't let that fool you. Many people want to selectively breed their bettas for fin size and finnage. Looking at the fins for characteristics you want to bring out as well as for potential injury can help ensure that you get the qualities you hope to breed.  Check the caudal, or tail, fin for straightness and curvature. Good breeding stock bettas with have straighter caudal fins that are curved in opposite directions. Avoid bettas with caudal fins curved in the same direction. Look for ray branching or splitting on all of the bettas fins. The more branches or splits you have, the more supportive, larger, and beautiful finnage you will get. Make sure the betta has no traces of fin rot, which looks like ripped or fuzzy fins with red tips or near the tears. Bettas come in and exhibit a wide range of colors on their bodies. Find the color bettas you like as mates or for your betta as a mate and try to choose colors that work well together.  Be aware that bettas come in colors such as red, orange, yellow, turquoise, steel blue or royal blue. They can also have black or iridescent features. For example, you might find that breeding the blues with black lace features give your fish beautiful colors.  Ask the breeder if you are unsure of what can work best for your betta.
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Buy bettas from one breeder. Choose your optimal betta pair. Check the size. Examine the fins. Combine complementary colors.