Cardiac Function: Examining The Heart Flashcards

1
Q

Used for high frequency sounds such as valve closures, systolic events, and regurgitation murmurs

A

Diaphragm

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2
Q

Used for low frequency sounds (S3, S4) like a diastolic murmur of mitral stenosis

A

Bell

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3
Q

Can only hear with patient seated and leaning forward

A

Aortic regurgitation

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4
Q

MArks the onset of systole with the closure of the AV valves

A

First heart sound (S1)

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5
Q

Marks the onset of diastole with the closure of the semilunar valves

A

Second Heart sound (S2)

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6
Q

If the HR is slow, the shorter period is

A

Systole

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7
Q

To identify S1 vs S2, we want to check the

-Palpable impulse occurs just after S1

A

Carotid pulse

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8
Q

Found in the right second (or third) intercoastal space

A

S2

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9
Q

Will be louder, shorter, and sharper

-Higher frequency sound

A

S2

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10
Q

Heard well across the entire precordium

-coincides with closure of mitral and tricuspid valves

A

S1

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11
Q

S1 is loudest at the

A

Apex

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12
Q

S1 should be louder than S2 at the

A

Apex

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13
Q

S2 should be louder than S1 at the

A

RICS

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14
Q

The intensity of S1 increases with the strength of

A

Ventricular contraction

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15
Q

The position of the AV leaflets at the onset of systole affects the intensity of S1, the wider they are apart, the

A

Louder S1 (indicator of valve disease)

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16
Q

The position of the AV leaflets at the onset of systole depends on the

A

PR interval

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17
Q

When ventricular systole immediately follows atrial systole, so valve leaflets are wide open and S1 is loud

A

Short PR interval

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18
Q

Gives more time for leaflets to float together so S is not as loud

A

Long PR interval

19
Q

The most important characteristic of S1 is

20
Q

Vigorous ventricular contraction, short PR interval, or delayed closure of valve gives a

21
Q

If pulse is regular and S1 intensity varies beat-to-beat, consider

A

AV dissociation (complete heart block)

22
Q

A loud unexplained S1 can mean

A

Mitral Stenosis

23
Q

A faint or absent S1 can mean

A

Acute aortic regurgitation

24
Q

The S2 sound has 2 components caused by closure of the

A

Semilunar valves

25
We hear a single S2 sound during
Expiration
26
Normally, for our S2 sound, which closes first
AV closes before PV
27
Pulmonary circulation is a low pressure system so there is less back pressure in the pulmonary artery and the
P2 is heard later than A2
28
During inspiration, the interval separating A2 and P2
Increases (A2 first then P2)
29
In greater than 90% of normal people, A2 and P2 are perceived as a single sound during expiration. In those with splitting, it disappears when they
Sit up
30
Wide physiologic splitting of S2 can be caused by a
Conduction problem or hemodynamics problem
31
A Right Bundle Branch Block (RBBB) or left ventricular preexcitation are two types of
Conduction problems leading to physiologic splitting of S2
32
Prolongation of RV systole, pulmonic stenosis, or pulmonary hypertension w/ RV failure are examples of
Hemodynamics causes of physiologic splitting
33
A wide and fixed splitting of S2 is caused by an
Atrial Septal Defect
34
The presence of physiologic splitting of S2 decreases the likelihood of an
Atrial Septal Defect
35
A low frequency sound that requires the bell to hear
Ventricular or S3 gallop
36
As a general rule, if there is an S3 gallop than the heart is
Dilated
37
An atrial or S4 gallop is also a low frequency sound that needs the
Bell
38
An “opening snap” is indicative of
Mitral stenosis
39
An “early ejection click” is indicative of
Aortic stenosis
40
A “midsystolic click” is indicative of
Mitral valve prolapse
41
Audible vibrations due to increased turbulence -Defined by timing within the cardiac cycle
Heart Murmurs
42
Begin with or after S1 and end at or before S2
Systolic Murmurs
43
Begin with or after S2 and end at or before S1
Diastolic murmurs
44
Any murmur with a grade of 4/6 or above will also have an accompanying
Thrill