Abnormal Heart Sounds Flashcards

1
Q

AV valves

A

mitral and tricuspid

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

Semilunar Valves

A

Aortic and pulmonic valves

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

S1

A

AV valve closure

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

S2

A

Semilunar valve closure

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

S3

A

abrupt deceleration of inflow across the mitral valve

Happens after S2

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

S4

A

increased LV end diastolic stiffness decreasing compliance

happens before S1

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

S3 systolic or diastolic

A

rapid filling phase of diastole

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

S4 systolic or diastolic

A

after the P wave on EKG in atrial systole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

how narrow is a split S2

A

normally very narrow

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

when does S2 normally happen

A

normally late in inspiration

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

should S2 disappear during exhalation?

A

yes, and if not ask the patient to sit up

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

which is normally louder A2 or P2

A

A2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

if P2 is louder what should you suspect

A

PAH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

why would P2 be decreased or absent?

A

usually due to increased AP diameter associated with aging but also can be due to pulmonic stenosis

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

A2 decreased/absent

A

calcific aortic stenosis

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

A2 increased intensity

A

usually only heard in R 2nd IC

louder due to systemic HTN

17
Q

why would splitting of S2 be louder?

A

delayed closure of the pulmonic valve

18
Q

fixed splitting what is and why?

A

refers to wide splitting that does not vary with respiration

this is often due to prolonged RV systole and in ASD

19
Q

systolic clicks are caused by

A

mitral valve prolapse

20
Q

aortic ejection

A

base and apex not variable with respiration and may accompany a dialted aorta or aortic valve disease from stenosis or bicupsid aortic valve

21
Q

pulmonic ejection

A

2 and 3rd ICS (L)
decreases with inspiration

dilation of pulmonary artery, PAH, and pulmonic stenosiso

22
Q

opening snap

A

early diastolic caused by stenotic mitral valve

heard best with diaphragm

23
Q

what age should you be concerned about s3

24
Q

is S3 normal in third trimester?

25
common causes of S4
HTN heart disease aortic stenosis hypertrophic cardiomyopathy
26
common causes of S3
``` decreased cardiac contractility heart failure ventricular volume overload mitral regurgitation Left to Right shunts ```
27
Grade 1 murmur
very faint only a cardiologist is going to hear this
28
Grade 2 murmur
quiet, but heard immediately after placing stethoscope on chest
29
Grade 3 murmur
moderately loud
30
Grade 4 murmur
Loud, with palpable thrill
31
Grade 5 murmur
Very loud, with thrill. may be heard with stethoscope partly off chest
32
Grade 6 murmur
very loud, with thrill. May be heard with stethoscope entirely off chest
33
holosystolic mumurs
Mitral regurgitation tricuspid regurgitation VSD
34
pathological murmurs
Aortic Stenosis --- carotids heard best leaning forward s1-s2 hypertrophic cardiomyopathy --- decrease with squatting increases with standing S1 pulmonic stenosis ---- harsh E1-A2
35
Aortic Regurgitation
best heard with patient sitting, leaning forward with breath held after exhalation
36
mitral stenosis
use the bell best heard in exhalation use handgrip to make more audible
37
atrial myxoma
may cause obstruction of AV valve and a mid-diastolic murmur sounds like mitral stenosis and is presystolic
38
tricuspid regurgitation in infants
usually correlates with low apgar due to transient papillary muscle dysfunction also occurs in pulmonary atresia and ebstein's anomaly
39
TOF has a murmur caused by
pulmonary stenosis