Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Cardiovascular > Heart Sounds > Flashcards

Heart Sounds Flashcards

1
Q

What is happening during the S1 heart sound?

A

MV and TV close, AV and PV open

noises are valves closing, systole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is happening during the S2 heart sound?

A

MV and TV open, AV and PV close

diastole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

S1 marks the beginning of ____

A

systole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

S2 marks the beginning of _____

A

diastole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What causes the heart sounds?

A

Changing intracardiac pressure and closing of heart valves

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What types of sounds is the bell better at assessing?

A

low pitched sounds such as S3, S4, mitral stenosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What types of sounds is the diaphragm better at assessing?

A

High pitched sounds, such as S1, S2, AR, MR, pericardial friction rub

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Where is the aortic area?

A

Second intercostal space, right sternal border

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Where is the pulmonic area?

A

second intercostal space, left sternal border

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Where is Erb’s point?

A

third intercostal space, left sternal border

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Where is the tricuspid area?

A

Fourth (or fifth) intercostal space, left sternal border

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Where is the mitral area or apex?

A

fifth intercostal space, left midclavicular line

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How should a patient be positioned when listening over precordial areas with diaphragm?

A

lying supine with head at 30 degrees

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What position should the patient be in when listening for S3, S4 & MS (mitral valve posts)

A

Left lateral decubitus

with bell

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

If something is heart at the aortic post, what should you do?

A

have the patient sit up, lean forward, and listen again with diaphragm after deep exhalation to distinguish aortic murmurs, especially AR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What does standing do to blood flow? What does this do to cardiac sounds?

A
  • Decreases venous return, arterial BP and stroke volume
  • Increases MVP; increases outflow obstruction of HCM; decreases intensity of AS murmur
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What does squatting do to blood flow? What does this do to cardiac sounds?

A
  • increases venous return, LV volume, arterial BP
  • Decreases MVP; decreases obstruction of HCM; increases intensity of AS

more blood going across LV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is the valsalva maneuver?

A

while patient is lying, have them bear down as if have a BM; can also place hand on patient’s abdomen and have them strain against it

same as standing, decreases venous return can hear HCM better

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What happens during S1?

A

closure of mitral valve at beginning of systole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what happens during S2?

A

closure of aortic valve at end of systole and beginning of diastole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what is an ejection click?

A

results from opening of AV or PV immediately following S1
* due to dilated aorta, aortic stenosis, or bicuspid AV or dilated pulmonary artery, pulmonary HTN, or pulmonic stenosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is an opening snap?

A
  • Caused by opening of MV, as in MS following S2

`

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is a S3 heart sound?

A

“Kentucky gallop”
* Dull, low pitched sound occuring in early diastole
* Best heard with bell at apex with patient in left lateral decubitus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

In which patients is S3 physiologic?

A
  • children and young adults
  • 3rd trimester of pregnancy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What can cause a pathologic S3 sound?

A
  • change in ventricular compliance
  • decreased myocardial contractility, CHF, or volume overload
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What is a S4 sound?

A

“Tennessee gallop”
* late diastole, immediately before S1
* Dull, low pitch heard with bell at apex while patient is in left lateral decubitus position
* Marks atrial contraction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What is the cause of a S4 sound?

A

“Tennessee” gallop
* Change in ventricular compliance due to increased resistance to ventricular filling
* Hypertensive heart disease, CAD, AS, and cardiomyopathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Where is S1 softer than S2? Where is it louder?

A

at the base, at the apex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

When is S1 accentuated?

A
  • Tachycardia
  • Rhythms with a short PR interval
  • High cardiac output states
  • Mitral stenosis
30
Q

When is S1 diminished?

A
  • First degree AVB (AV block, electrical activity not transmitted to ventricle)
  • Mitral regurgitation
  • Reduced LV contractility
31
Q

When does S1 vary

A
  • complete heart block and any irregular rhythm, such as A. fib
32
Q

When would a split S1 be normal?

A
  • Along left lower sternal border where TV component is heard
33
Q

What conditions cause abnormal S1 splitting?

A

RBBB and PVCs

34
Q

What is physiologic splitting of S2?

A

2nd and 3rd left intercostal space where pulmonic valve is best heard (hearing pulmonic and aortic valve close)
accentuated by inspiration and disappears on expiration

35
Q

What is pathologic splitting of S2?

A
  • Persists through respiratory cycle
  • delayed closure of PV (PS, RBBB)or early closure of AV (MR)
  • caused by ASD, or RV failure
36
Q

How are murmurs differentiated from extra heart sounds?

A

By their longer duration

37
Q

How are murmurs described?

A
  • Timing
  • Shape
  • Location of maximum intensity
  • Radiation
  • Intensity
  • Pitch
  • Quality
38
Q

How would you describe a systolic murmurs timing?

A

Midsystolic, pansystolic (holosystolic), late systolic

39
Q

How would you describe a diastolic murmurs timing?

A

Early, mid-diastolic, late diastolic

40
Q

What does a continuous murmur mean? What are examples of causes of this?

A

Both systolic and diastolic components; PDA, pericardial friction rub, venous hum

41
Q

How is the shape of a murmur described?

A
  • Crescendo
  • Decrescendo
  • Crescendo-decrescendo
  • Plateau
42
Q

What is the location of maximal intensity describing?

A

Where the murmur originates

43
Q

What is radiation?

A

Direction of blood flow and intensity of murmur

44
Q

How is the intensity of a murmur described?

A

On a 6-point scale
* Grade I: very faint have to “tune in”
* Grade II: quiet, but can hear immediately with stethoscope
* Grade III: moderately loud
* Grade IV: loud, with palpable thrill
* Grade V: very loud with thrill; may be heard with stethoscope partly off chest
* Grade VI: very loud with thrill; may hear with stethoscope fully off chest

45
Q

What influences the intensity of a murmur?

A

Thickness of chest wall and presence of intervening tissue

46
Q

How could you describe the pitch of a murmur?

A

High, medium, or low

47
Q

How would you describe the quality of a murmur?

A

Blowing, harsh, rumbling or musical

48
Q

What causes a pansystolic murmur?

A

Always pathologic

Blood flow from a chamber of high pressure to one of low pressure through a valve that should be closed

EX: mitral regurgitation, tricuspid regurgitation, ventricular septal defect

49
Q

Should you be concerned about a midsystolic murmur?

A

possibly? May be innocent, physiologic, or pathologic
MC heart murmur!

50
Q

What would be innocent causes of a midsystolic heart murmur?

A
  • Turbulent blood flow
  • Grade I-III murmur heard between 2nd to 4th left intercostal spaces with minimal radiation
51
Q

What are characteristics of a innocent midsystolic heart murmur?

A
  • Disappears or decreases with sitting
  • Typically blowing, mid-systolic
  • No other associated PE findings
52
Q

What are characteristics of physiologic midsystolic murmur?

A
  • Signs of underlying cause
  • Normal blood turbulence enhanced by conditions that increase blood flow such as anemia, fever, and hyperthyroidism
53
Q

What are characteristics of a pathologic midsystolic murmur?

A

Harsh, mid-systolic murmur

54
Q

What are causes of a pathologic midsystolic murmur?

A

aortic stenosis, HCM, pulmonic stenosis

55
Q

What are characteristics of a pathologic diastolic murmur?

A
  • Early or mid-late
56
Q

What are causes of a early decrescendo murmur?

A

Regurgitation through incompetent semilunar valves, most often aortic regurgitation

57
Q

What are causes of a mid-late diastolic murmur?

A
  • Stenosis of AV valve, most commonly mitral stenosis
58
Q

What is the cause of a venous hum?

A

turbulence of blood flow in jugular veins
common in kids

59
Q

What are characteristics of a venous hum?

A
  • continuous murmur that is louder in diastole
  • soft, low pitched
  • heard above the medial third of the clavicles with radiation into the 1st and 2nd intercostal spaces
60
Q

What causes a pericardial friction rub?

A

Inflammation of the pericardium

61
Q

What are the 3 components of a pericardial friction rub?

A

atrial systole, ventricular systole, and ventricular diastole

62
Q

What are characteristics of a pericardial friction rub?

A
  • High pitched, scratching/scraping noise similar to rubbing the back of your stethoscope
  • Increases as patient leans forward, exhales, and holds their breath
  • Location varies
  • Radiation is not typical
63
Q

What is a patent ductus arteriosus?

A

Congenital abnormality resulting in a channel between the aorta and pulmonary artery

64
Q

What are characteristics of a patent ductus arteriosus?

A
  • Loudest in systole and fades in diastole
  • Best heard at left 2nd intercostal space, radiating to left clavicle
  • Harsh, machinery-like, medium pitched
  • Typically associated with a thrill
65
Q

What is the most common study ordered for cardiac disorders?

A

Transthoracic 2D echocardiogram with doppler imaging

66
Q

What information can you gather from echocardiography?

A

Info about the size of all 4 chambers, regional and global systolic function, and chamber wall thickness

  • Provides images of valve motion, intracardiac masses, cardiac abnormalities/anomalies, and pericardial fluid
67
Q

What is a benefit of echocardiography?

A

Non-invasive and requires no radiation or prep

68
Q

What diagnostic test gives a visual image of blood flow velocities superimposed over anatomic 2D images?

A

Color flow doppler

69
Q

What does color flow doppler allow the viewer to see?

A
  • Turbulence from valvular stenosis or regurgitation
  • Intracardiac defects
70
Q

When would a TEE with doppler ultrasound be used?

A
  • if surface sound transmission is poor foor a TTE
  • If need better view of posterior heart structures, specifically atria, atrial appendage, and A-V valves
  • Better than TTE for dx LAA thrombus
  • Prosthetic heart valves and intracardiac masses difficult to see on TTE
  • septal defects or patent foramen ovale
  • aortic dissection and severe atherosclerosis of the ascending aorta
71
Q

What are diagnostic methods for transesophageal echocardiography with doppler ultrasound?

A
  • Patient has to be NPO for 6-8 hours prior to procedure
  • Patient given IV sedation and local anesthetic to reduce gag reflex
  • Patient monitored during procedure
  • Signed consent required
72
Q

What are risks of Transesophageal echocardiography with doppler ultrasound?

A
  • Aspiration
  • Throat irritation
  • Esophageal perforation

Cardiovascular (17 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions