Exam 2 Heart sounds Flashcards
Atrioventricular valves include?
Mitral
Tricuspid
Semilunar valves include?
Aortic
Pulmonic
Bell used for what sound?
Diaphragm used for what sounds?
low pitched
high pitched
Auscultation sitting up/leaning forward best for what sounds?
soft murmurs at base
aortic or pulmonic regurg
Auscultation in left lateral recumbent position best for what sounds?
(on left side, left arm above head)
low pitched filling sounds (gallop/murmur) at apical impulse
S1 is?
Systole -> closure of mitral/tricuspid start of vent contraction
S2 is?
Diastole -> closure of aortic/pulmonic start of vent filling
S3 is?
Heard best where?
Early diastole -> vibration from rapid filling of vents
w/ bell at apex (low pitched)
S1 + S2 + S3 =?
Ventricular gallop
“KEN-tucky”
S4 is?
Heard best where?
Atria contraction at end of vent filling (atrial kick)
w/ bell at apex (low pitched)
S1 + S2 + S4 = ?
Atrial gallop
“Tenne-SEE”
Systolic murmur is?
Diastolic murmur is?
blood rushing thu leaky/narrow valve or wall b/w chambers during systole
same but during diastole
Thrill is?
Palpable murmur
U from vibration of loud murmur
Caused by stenosis or septal defect
Lift/Heave is?
Vigorous impulse felt thru chest wall
Caused by hypertrophy or hyper vent activity
Split S2 caused by?
Normal when?
Heard where?
A2 = aortic valve closes before pulmonic P2 = pulmonic valve closes before aortic
N during inspiration
Heard at 2nd/3rd L ICS
Pathologic S2 Split caused by?
Presents as?
Delayed pulmonic valve closure:
Atrial septal defect
Pulmonic stenosis
RVHF
RBBB
“Fixed splitting”
Doesn’t change w/ inspiration
Paradoxical S2 Split caused by?
Presents as?
A2 following P2:
LBBB
Split present during expiration, gone during inspiration
Ejection Click caused by?
Sound like?
Aortic or Pulmonic valve dz
Dilated aorta or pulmonary artery
Pulmonary HTN
High pitched
Systolic Click caused by?
Sounds like?
May be accompanied by?
Mitral valve prolapse (leaf balloons into L atrium during systole)
Mid-late click of variable pitch
Mitral regurg
Murmur Grades:
1/6
2/6
3/6
4/6
5/6
6/6
1/6 = barely audible in quite room
2/6 = quite but clearly audible
3/6 = moderately loud
4/6 = loud w/ thrill
5/6 = very loud, heard w/ stetho partly off chest, obvious thrill
6/6 = very loud, heard w/ stetho off chest, obvious thrill
Systolic Ejection Murmur pattern?
Caused by?
Heard where?
crescendo - decrescendo
High pressure to High pressure
blood flow across semilunar valve
aortic or pulmonic stenosis
atrial septal defect
base, R and LSB
Innocent Systolic Ejection Murmur caused by?
Sounds like?
C in who?
from turbulent blood flow w/o narrowing, obstruction or dz
Med pitch
↓ when sitting
Kids/young adults
Preggos
Anemia, hyperthyroid
Atrial Septal Defect is?
Sounds like?
Congenital L to R shunt b/w LA/RA
RV enlargement and ↑ flow thru pulmonic valve
systolic eject murmur
fixed S2 split
Pansystolic Murmur pattern?
Caused by?
plateau (stays same)
High pressure to Low pressure
regurg across AV valves or Ventricular septal defect
Ventral Septal Defect is?
Sounds like?
L to R shunt b/w LV/RV
harsh pansystolic murmur at LLSB
Late Systolic Murmur pattern?
Caused by?
starts mid way b/w S1/2
mitral prolapse
Early Diastolic Murmur pattern?
Caused by?
decrescendo
regurg across leaky aortic or pulmonic (semilunar) valve
Mid Diastolic Murmur pattern?
Caused by?
low decrescendo
turbulence across AV valves from stenosis
Late Diastolic Murmur pattern?
Caused by?
low decrescendo lasting up to S1
Opening Snap/Diastolic Rumble is?
Caused by?
very low-pitched sound at apex
Mitral stenosis -> snap w/ opening followed by rumble
To-and-Fro Murmur is?
Caused by?
systolic/diastolic
severe aortic regurg
aortic stenosis
