Cardiovascular System Evaluation

Question 1

What position should the CV system evaluation be done in?

Answer 1

supine

Question 2

The diaphragm is used to auscultate ____ pitched sounds

Answer 2

high

Question 3

The bell is used to auscultate ____ pitched sounds

Answer 3

low

Question 4

What 4 heart sounds can the diaphragm be used to hear?

Answer 4

• S1
• S2
• murmurs of aortic or mitral regurgitation
• pericardial friction

Question 5

What 3 heart sounds can the bell be used to hear?

Answer 5

• S3
• S4
• murmurs of mitral stenosis

Question 6

Describe the location of the aortic area

Answer 6

2nd intercostal space just right of sternum

Question 7

Describe the location of the pulmonary area

Answer 7

2nd intercostal space just left of the sternum

Question 8

Describe the location of the tricuspid area

Answer 8

Lower left sternal border, approximately the 4th to 5th intercostal space

Question 9

Describe the location of the mitral area

Answer 9

5th left intercostal space, medial to the midclavicular line

Question 10

Where can murmurs of both aortic and pulmonary origin be heard at?

Answer 10

3rd Left Intercostal Space

Question 11

When first beginning assessment with the stethoscope you should use the diaphragm, what are the areas in which you should listen?

Answer 11

• Aortic Area
• Pulmonic Area
• Left 3rd ICS
• Left 4th ICS
• Left 5th ICS
• Apex

Question 12

What sounds are you listening for when using the diaphragm?

Answer 12

S1 and S2

Question 13

After assessing S1 and S2 with the diaphragm you should use the bell, what are the areas in which you should listen?

Answer 13

• Left 4th ICS
• Left 5th ICS
• Apex

Question 14

Where and how should you listen for S1?

Answer 14

In the apex/tricuspid area with the diaphragm

Question 15

What does S1 signify?

Answer 15

Closing of the mitral valves

Question 16

Where and how should you listen for S2?

Answer 16

At the either the aortic or pulmonary areas with the diaphragm

Question 17

S2 signifies the closing of what valves?

Answer 17

aortic and pulmonary

Question 18

S1 corresponds with ventricular _____

S2 corresponds with ventricular _____

Answer 18

systole

diastole

Question 19

What are S1 and S2 typically heard?

Answer 19

During inspiration

Question 20

Where can S1 splitting best be heard?

Answer 20

over the tricuspid area

Question 21

Where can S2 splitting be heard best?

Answer 21

over the pulmonary area

Question 22

Both S1 and S2 splitting are considered normal and are indicative of what?

Answer 22

slight timing differences between closure of the left and right heart valves

Question 23

When does S3 happen?

Answer 23

Immediately following S2 while the ventricle is filling rapidly (diastole)

Question 24

What does S3 sound like?

Answer 24

“lub-dub-dub” or “lub-dub-dee” or “Kentucky”

Question 25

In what position should the patient be positoned in order to hear S3 best?

Answer 25

in L side-lying so that the apex of the heart is closest to the chest wall

Question 26

S3 is aka as a _____ gallop

Answer 26

ventricular

Question 27

What does S3 indicate in people under the age of 30? Over the age of 30?

Answer 27

Healthy

Loss of ventricular compliance (failure)

Question 28

When does S3 happen?

Answer 28

Just before S1 (late diastole)

Question 29

What does S4 sound like?

Answer 29

“la-lub-dub” or “la-lub-dee” or “Tennessee”

Question 30

S4 is aka a _____ gallop

Answer 30

atrial

Question 31

S4 is assocaited with increased resistance to what?

Answer 31

ventircular filling/atrial contraction

Question 32

What does S4 indicate?

Answer 32

• Hypertensive cardiac disease
• CAD
• Pulmonary disease
• Individual has a history of MI or CABG

Question 33

Where and how can murmurs be heard?

Answer 33

With the bell at the 3rd, 4th, and 5th ICS

Question 34

What type of murmur is most common? What does it sound like?

Answer 34

Systolic

Sounds like a “swishing” sound associated with S1

Question 35

How and where can friction rub be heard?

Answer 35

With the diaphragm at the 3rd intercostal space along the left border of the sternum

Question 36

What does pericardial friction indicate?

Answer 36

pericarditis