Cardiac Cycle & Heart Sounds Flashcards
S1 (lub)
Closure of the bicuspid/mitral and tricuspid valves
S2 (dub)
Closure of the Aortic Valve or Pulmonary valves
S3 (kentucky)
Atrial Depolarization and the resulting flow of blood into the ventricle upon ventricular diastole
S4 (tenessee)
The last bit of blood being pushed in the ventricles of the heart by the chordae tendonae of the atria
Regurgitation
when blood flows backwards from the point that it should be flowing properly through the valve
Stenosis
when blood flows harder than it should because of a hardening of the aortic valve or the pulmonary valves
Aortic Valve (where to listen)
Right side of the 2nd intercostal space
Pulmonary Valve (where to listen)
Left side of the 2nd intercostal space
Tricuspid Valve (where to listen)
Left 4th intercostal space
Mitral valve (where to listen)
Listen at the Left 5th intercostal space on the mid axillary line
Murmur 1 Grading
You can hear it with a stethoscope in quiet place
Murmur 2 Grading
You can hear it with a stethoscope in loud places
Murmur 3 Grading
Prominently heard murmur
Murmur 4 Grading (dangerous)
You can hear it with thrills and you can hear it as you go axillary
Murmur 5 Grading (dangerous)
Loud murmur with thrills and you can hear it with the stethoscope tilted
Murmur 6 Grading (dangerous)
Loud murmur with thrills and you can hear from far away without the stethoscope
RINSPIRATION (just draw the diagram out)
On the right side of the chest you can hear the pulmonary and tricuspid valves are louder
LEXPIRATION (just draw the diagram out)
On the left side of the chest you can here aortic and mitral valves faster
What is the effect of the preload on the heart?
During a larger volume of preload, you can here the heart louder usually.
During less preload (less volume in the ventricles), it is harder to here the murmurs of the heart.
Hypertrophic Cardiomyopathy (HOCM)
Exceptional:
You can actually here the hypertrophic cardiomyopathy better under less preload because the ventricles will try to contract harder to push the blood out of the ventricles.
*** an increase in the preload will cause the cardiomyopathy to be hidden.
Mitral Valve Prolapse (MVP)
HIGH LEVELS of ventricular volume (preload) can help the prolapsed mitral valve fold back into place!
that is why it is better to here a mitral valve prolapse during a lower amount of preload levels
The Effect of Afterload on the Murmurs
Increased levels of Afterload Pressure usually will INCREASE THE NOISE MADE BY THE MURMUR, LOWER AFTERLOAD WILL DECREASE THE NOISE MADE BY THE MURMUR
***Exceptions:
Increased afterload= softer murmurs
Decreased afterloads= louder murmurs
Aortic Stenosis (Systolic Murmur)
Loudest--> Increased Preload, Increased Afterload between s1+ s2 ca2+ deposits in the aortic valve OLD- SAD (synchopy, angina, dyspnea) radiate into the carotid arteries
Mitral Regurgitation (holosystolic murmur)
caused by rheumatic heart disease
radiates to the axilla (giving the “thrill”)
best heard at apex of the heart
