General

Question 1

Where do you hear the aortic valve

Answer 1

Right sternal border, second intercostal space

Question 2

Where do you hear the pulmonic valve

Answer 2

Left sternal border, 2nd intercostal space

Question 3

Where do you hear the tricuspid valve

Answer 3

Left sternal bored, 4-5th intercostal space

Question 4

Where do you hear the mitral valve?

Answer 4

Left mid clavicular line, 5th intercostal space

Question 5

What does S1 signify?

Answer 5

• Closure of mitral and tricuspid valve
  -systole
• hear best over mitral valve

Question 6

What does S2 signify?

Answer 6

-closure over pulmonic and aortic valve
-diastole
-hear best over aortic valve

Question 7

When do you hear an s3?

Answer 7

-Fluid over load / elevated preload
- hear over apex
- cause : rapid rush of blood into a dilated over filled ventricle, cardiomyopathy, mitral / tricuspid regurgitation

Question 8

When do you hear an s4?

Answer 8

• ischemia (increased resistance to ventricular filling) *, HTN, pulm stenosis, CAD, aortic stenosis, left ventricular hypertrophy
• caused by vibration of atria ejecting into non compliant ventricles
  -listen over mitral / tricuspid area

Question 9

When do you hear a split heart sound

Answer 9

-when one valve closes before another
- best heard with inspiration