Heart and Lungs Auscultation

Question 1

Stethoscope Diaphragm

Answer 1

-high frequency sounds

Question 2

Stethoscope Bell

Answer 2

-low frequency sounds

Question 3

S1

Answer 3

-first heart sound (higher frequency)
-closure of M1 and T1
-best heard in Mitral Area

Question 4

S2

Answer 4

-second heart sound (lower frequency)
-closure of semilunar valves valves
-best heard in Aortic Area

Question 5

Aortic Area

Answer 5

-right sternal border
-2nd intercostal space
-S2 best heard

Question 6

Pulmonic Area

Answer 6

-left sternal border
-2nd intercostal space

Question 7

Tricuspid Area

Answer 7

-left sternal border
-4th intercostal space

Question 8

Mitral Area

Answer 8

-left side under nipple
-apex of heart
-5th intercostal space
-S1, S3, S4 best heard

Question 9

Apical Pulse

Answer 9

Listen to apex of heart for 1 min

Question 10

S3

Answer 10

-could be abnormal (heart failure, late diastole) or normal (pregnancy/children)
-extra heart sound after S2
-“kenTUCKy”
-caused by rapid filling of ventricle
-listen with bell @ apex

Question 11

S4

Answer 11

-always abnormal (HTN, MI, atrial kick of blood into stiff ventricle diastolic bad)
-right before S1
-gallop

Question 12

Systolic Click

Answer 12

-prolapse of AV

Question 13

Opening Snap

Answer 13

-forceful opening of stenotic mitral valve

Question 14

Pericardial friction

Answer 14

-rubbing sound
-increased pericardial fluid

Question 15

Respiratory Cycle

Answer 15

Inspiration: 1/3, faster and louder

Expiration: 2/3, slower and softer

Question 16

Vesicular Breath Sounds

Answer 16

-most of lung area
-inspiratory longer than expiatory
-soft

Question 17

Brocho-Vesicular Breath Sounds

Answer 17

-near midline around upper spine and sternum
-inspiratory equal expiatory

Question 18

Bronchial Breath Sounds

Answer 18

-above manubrium
-loud
-inspiratory shorter than expiatory

Question 19

Lung Auscultation Areas

Answer 19

2 for each lobe
-3 on anterior right (upper,middle,lower), 2 on left (upper, lower or basal)

Anterior: Apical, upper sternal, lower sternal, lower pec

Posterior: Apical, upper scapular, mid scapular sternal, lower scapular

Question 20

Lung Ascultation Checkout Steps

Answer 20

1. Explain (I’m going to be usuing this stethescope to listen to your lungs and see how well they are working)
2. Position them properly
3. Drapes for modesty
4. Listen to front and back

Question 21

Heart Ascultation Checkout

Answer 21

1. Explain (I’m going to be usuing this stethescope to listen to your heart and see how well it’s working)
2. Position them properly
3. Drapes for modesty
4. Listen to front and back, switching stethiscope to bell for apical, S3 and S4