Batten- Heart Sounds ILA

Question 1

closure of mitral and tricuspid valves

Answer 1

S1 (lub)

Question 2

closure of semilunar valves

Answer 2

S2 (dup)

Question 3

when pulmonic (P2) closes after aortic (A1)

Answer 3

physiologic splitting (S2 splitting) (“lub, sound of scissors cutting paper”; buh, buhroom)

Question 4

when tachycardic, sounds like horse gallop following S2; best heard at LLSB and apex

Answer 4

S3 Gallop (lub, dup-dup)

Question 5

gallop just before S1; always pathologic

Answer 5

S4 gallop (lub-lub, dup)

Question 6

noises b/t S1 and S2

Answer 6

clicks

Question 7

ejection click following S1 at LUSB

Answer 7

Pulmonary click

Question 8

ejection click following S1 at LMSB and maybe RUSB

Answer 8

aortic click

Question 9

midsystolic click at apex

Answer 9

mitral valve prolapse

Question 10

sounds heard at APEX

Answer 10

always mitral valve

Question 11

Barely audible – heard by attending only (I’m kidding!)

Answer 11

1/6

Question 12

Soft, but can be readily heard by medical student

Answer 12

2/6

Question 13

Moderately loud WITHOUT thrill

Answer 13

3/6

Question 14

Loud WITH thrill

Answer 14

4/6

Question 15

Audible with stethoscope tilted about 45 degrees off chest

Answer 15

5/6

Question 16

Audible with stethoscope hovering over but not touching chest

Answer 16

6/6

Question 17

sounds like wind b/t S1 and S2; caused by flow through semilunar valves

Answer 17

Systolic Ejection Murmur (SEM)

Question 18

roaring murmur that obscures S1 and S2

Answer 18

Holosytolic murmur (HSM); pansystolic

Question 19

(Holosystolic) pansystolic murmur heard at apex =

Answer 19

mitral valve regurgitation

Question 20

MAIN (Holocystolic) pansystolic murmur heard at LLSB

Answer 20

Ventricular Septal Defect (VSD)

Question 21

this murmur found at LLSB that mostly obscures S1 and S2 but you can still hear S2

Answer 21

VSD (ventricular septal defect)

Question 22

murmur heard after S2

Answer 22

diastolic murmur

Question 23

aortic insufficiency has what kind of murmur

Answer 23

diastolic murmur

Question 24

heard throughout cardiac cycle due to disturbance of flow patterns

Answer 24

continuous murmur

Question 25

heart murmur heard at RUSB

Answer 25

aortic stenosis

Question 26

heart murmur heard at LLSB

Answer 26

ventricular septal defect

Question 27

heart murmur heard at apex

Answer 27

mitral regurgitation
mitral stenosis

Question 28

location where there are the most amount of pathologic possibilities for heard heart murmur

Answer 28

LUSB

Question 29

this has a heart murmur that is a fixed, widely split S2 due to increased flow through pulmonary valve

Answer 29

Atrial Septal Defect (ASD)

Question 30

harsh murmur at RUSB; whooshing through S1

Answer 30

aortic stenosis

Question 31

harsh murmur at LUSB

Answer 31

pulmonary stenosis

Question 32

murmur heard at left interscapular area of back; patient w/ weak femoral pulses

Answer 32

coarctation of aorta

Question 33

systolic murmur that is blowing and heard at apex

Answer 33

mitral regurgitation

Question 34

diastolic decrescendo murmur; LUSB; best heard w/ patient leaning forward and expiring

Answer 34

Aortic Insufficiency (Regurgitation)

Question 35

late diastolic murmur; rumbling sound heard at apex

Answer 35

mitral stenosis (think late diastolic is just about to be S1)

Question 36

continuous “machine-like” murmur at LUSB and can be heard on the back

Answer 36

patent ductus arteriosus

Question 37

this maneuver causes small heart w/ less volume

Answer 37

standing

Question 38

this maneuver causes large heart w/ more volume

Answer 38

squatting

Question 39

this maneuver deals w/ phase 1 only and small heart

Answer 39

Valsalva

Question 40

this maneuver differentiates b/t Mitral regurgitation and Aortic stenosis

Answer 40

handgrip