Which abnormal conditions may affect the location of the apical impulse?

Answer;

Cardiac enlargement:

- Left ventricular dilation (volume overload) displaces impulse down and to the left ans increases size more that one space.

-A sustained impulse with increased force and duration but no change in location occurs with left ventricular Hypertrophy and no dilation (pressure overload)

- Pulmonary emphysema which makes it non-palpable from the lung sound overriding heart sound.

Explanation;Apical impulse is a point of maximal impulse; pulsation created as the left ventricle rotates against the chest wall during systole. When visible, it occupies the fourth or fifth intercostal space, at or inside the midclavicular line. It occurs during systole (short, normally first 1/2 of systole).It is normally 1 ×2 cm in size.

Letter a, because when there are unlike charges they will always attract to each other.

The force is push or pull