Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Cardio Exam 1 > 15 - Heart Sounds > Flashcards

15 - Heart Sounds Flashcards

1
Q

When listening to the heart, where would you listen to the aortic area?

A

upper right sternal edge (AS)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

When listening to the heart, where would you listen to the pulmonary area?

A

upper left sternal edge (PS,PR, ASD, OS of MS)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

When listening to the heart, where would you listen to the tricuspid area?

A

lower left sternal edge (AR, PR, TS, VSD)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

When listening to the heart, where would you listen to the mitral area?

A

apex (1st, 3rd, 4th heart sounds, MS, AR)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

When listening to the heart, where would you listen to mitral radiation?

A

posterolateral to apex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

When listening to the heart, where would you listen to aortic or pulmonary radiation?

A

upper chest

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Where else is a a place where we listen to the heart?

A

Carotids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Describe the sequence of S1, S2, S3 and S4… What do they mean?

A

S1 ________ S2 __*_____**_ S1

S1-->S2 = systole
S2-->S1 = diastole
* = S3 will occur here if present (pathologic)
** = S4 will occur here if present (pathologic)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is physiological splitting?

A

Physiological splitting
This happens when someone takes a deep breath
This is normal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is pathological splitting?

A

Pathological splitting
This happens when there is a atrial septal defect
A fourth heart sound is almost always abnormal
Common to hear S3 in an MI or with some heart failure going on

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the scale for murmur intensity?

A

1 - very faint
2 - quiet, usually not heard immediately
3 - moderately loud (NO THRILL)
4 - loud with a thrill (THRILL)
5 - very loud with a thrill (barely touch chest with stethoscope and hear it)
6 - no stethoscope is need to hear (with a thrill)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How do you describe a murmur?

A
  • Pitch – high or low
  • Quality – blowing, harsh, musical
  • Timing - systolic or diastolic, continuous vs. cresendo-decresendo
  • Where it is best heart (aortic, apex)
  • Radiation (axilla = ventricular hypertrophy)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is S1 related to?

A
  • Mitral and tricuspid valve closure
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

When does S1 occur?

A

S1 occurs just before the upstroke of the carotid pulse

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Can you hear S1 better with the diaphragm or the bell?

A

Diaphragm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Where is S1 usually louder?

A

Usually louder over the apex and along lower left sternal border

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

When will you hear decreased S1 sounds?

A

Decreased conduction of sounds with COPD, pulmonary disease and pericardial effusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

When would a wide split of S1 occur?

A

A widely split occurs in complete right bundle branch block

19
Q

What can an S1 split be confused with?

A

A relatively loud S4 preceding S1 may sometimes be confused with a split S1

20
Q

What does it mean when S1 varies from beat to beat in intensity?

A

Variation in the intensity of S1

  • This means it varies from beat to beat
  • Common feature of atrial fibrillation
  • The first thing you should think of when someone older
  • They will have SOB, they get tired, they feel palpitations
  • They can go in and out of atrial fib and can’t feel it if they’re older
21
Q

What is S2?

A

The sound of aortic and pulmonary valve closure

A2 = aortic valve closing
P2 = pulmonic valve closing
22
Q

Is S2 best heard with the diaphragm or the bell?

A

Diaphragm

23
Q

Where is S2 best heard?

A

Location – left second interspace close to the sternal border

24
Q

Describe S2 splitting

A

Physiologically normal

  • S2 is usually single during expiration
  • Separation of A2 and P2 occurs during inspiration
25
Q

What does it mean when there is an increased intensity in A2?

A

Increased intensity of A2 often occurs in systemic hypertension, coarctation of the aorta, and a ascending aortic aneurysm

26
Q

What does it mean when there is an increased intensity in P2?

A

Increased P2 intensity is pulmonary arterial hypertension

27
Q

What is S3?

A
  • Low frequency diastolic sounds that appear to originate in the ventricles
  • Ventricular filling sounds
28
Q

Is S3 best heard with the diaphragm or the bell?

A

Bell

29
Q

When will we see S3?

A
  • Can be heard in healthy young adults (thyrotoxicosis, pregnancy)
  • Usually abnormal in patients over 40, suggests an enlarged ventricular chamber
  • S3 is the ventricular gallop (chronic mitral regurgitation)
  • Important and common early finding in heart failure(diastolic)
30
Q

What is the pitch of S3?

A

S3 and S4 are lower pitched sounds than S1 and S2

31
Q

When will we hear S4?

A
  • Can be heard in many healthy older adults without any cardiac abnormality due to decreased ventricular compliance
  • With age, the ventricles are tired, worn out and stiff
  • Instead of the ventricle taking in all the blood easily and expanding accordingly, the blood is hitting the ventricular wall and the blood is moving around a bit
  • Common in hypertensive heart disease, Aortic stenosis, hypertrophic cardiomyopathy
  • Heard in the majority of patients during acute case of MI
32
Q

What population is S4 abnormal in?

A

Usually abnormal in children and young adults

33
Q

Is S4 a high or low pitched sound?

A

Lower pitched sound

34
Q

There are two types of aortic pathology to know… What are they?

A
  • Aortic stenosis

- Aortic regurgitation

35
Q

What is aortic stenosis?

A

In Aortic Stenosis blood encounters an obstruction while exiting the left ventricle

Classic case is the little old lady who stands up too quickly and falls over

36
Q

What is aortic regurgitation?

A

In Aortic Regurgitation a diastolic murmur may be heard over the aortic area and you may hear an associated diastolic murmur at the apex

37
Q

Describe a aortic stenosis

A
  • Heard best in the top two regions (Aortic and Pulmonic areas)
  • Pitch is usually medium
  • Described as harsh
  • Graded at a 4-6
  • Heard during systole
  • Ejection sound or S4 sound
  • Apical heave

NARROW pulse pressure

38
Q

Describe aortic regurgitation

A
  • Heard best in the bottom of the heart - tricuspid region
  • Heard in diastole (S2-S1)
  • Indicative of left ventricular hypertrophy so PMI may shift to axilla
  • Bounding carotid pulse is present

WIDE pulse pressure

39
Q

Describe mitral stenosis

A
  • Heard best when laying on the left side
  • Heard best with the bell
  • Low pitched, rumbling sound
  • Graded at 1-4
  • Indicative of right ventricular hypertrophy
  • Seen with weak pulses

NARROW pulse pressure

40
Q

Describe mitral regurgitation

A
  • Heard best in the mitral area ***
  • Heard best with the diaphragm
  • High pitched “blowing” sound
  • Systolic and mid-systolic rumble
  • Radiates to the axilla
  • S3 can be heard
  • S4 is seen in acute, but not usually in chronic mitral valve regurgitation

WIDE pulse pressure

41
Q

If you have a murmur present during systole (S1-S2), what are the two possibilities?

A
  • Mitral regurgitation

- Aortic stenosis

42
Q

If you have a murmur present during diastole (S2-S1) what are the two possibilities?

A
  • Aortic stenosis

- Mitral stenosis

43
Q

If you have a wide pulse pressure, what are the two possibilities?

A
  • Aortic regurgitation

- Mitral regurgitation

Cardio Exam 1 (15 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions