Cardiovascular System

Question 1

S1 Heart Sound

Answer 1

closing of mitral valve (+ tricuspid valve)

Question 2

S2 Heart Sound

Answer 2

closing of aortic valve (+ pulmonic valve)

Question 3

S3 Heart Sound

Answer 3

Children and young adults: deceleration of column of blood against ventricular wall
S3 gallop in older adults: pathologic ventricular compliance

Question 4

S4 Heart Sound

Answer 4

Heard just before S1, marking atrial contraction

reflects a change in ventricular compliance

Question 5

Heart Murmurs

Answer 5

Distinguishable by long duration of sound attributed to turbulent blood flow
innocent or diagnostic of valvular disease (stenosis or regurg)

Question 6

Mitral Valve Sound

Answer 6

Best heard at cardiac apex

Question 7

Tricuspid Valve Sound

Answer 7

Best heard at lower left sternal border

Question 8

Pulmonic Valve Sound

Answer 8

Best heard at left sternal 2nd intercostal

Question 9

Aortic Valve Sound

Answer 9

Best heard at right sternal 2nd intercostal

Question 10

Jugular Venous Pressure

Answer 10

JVP

reflects RA pressure

Question 11

Metabolic Equivalent of the Task

Answer 11

METs
measures how hard your body is working 
1 MET = consumption of 3.5 ml O2/min/kg
Complete rest = 1 MET
METs >/= 4 for elective surgery

Question 12

Thrills

Answer 12

Humming vibrations felt during palpation of carotid artery

Question 13

Bruits

Answer 13

Murmur like sound of vascular origin (as opposed to heart)

Question 14

Point of Maximal Impulse

Answer 14

PMI
early pulsation of LV as it moves anteriorly during contraction and touches chest wall
Usu at 4th or 5th intercostal at midclavicular line
document distance from midsternal line

Question 15

Stethoscope Diaphragm

Answer 15

For high pitch sounds

S1, S2, murmurs of regurgitation, bruits

Question 16

Stethoscope Bell

Answer 16

For low pitch sounds

S3, S4, murmurs of mitral stenosis

Question 17

Systolic Murmurs

Answer 17

"Innocent," physiologic, or pathologic
Aortic stenosis (radiates to neck)
Mitral valve prolapse
Mitral regurgitation
Tricuspid regurgitation

Question 18

Diastolic Murmurs

Answer 18

Usually indicate heart disease
Aortic regurgitation
Mitral stenosis