Heart sounds

Question 1

S1 and S2 are caused by what?

Answer 1

S1= closing of atrioventricular valves. S2= closing of aortic/pulmonic valves

Question 2

S3 is caused by?

Answer 2

oscillation of blood back and forth between the walls of the ventricles initiated by blood rushing in from the atria

Question 3

S4 is casued by?

Answer 3

Associated with atrial contraction

Question 4

Splitting of S2 is heard during___________

Answer 4

inhalation

Question 5

What causes splitting of S2

Answer 5

The aortic valve closes slightly early and the pulmonic valve closes slightly later because there is increased blood flow into the right atrium/ventricle but decreased blood flow into the left atrium/ventricle during inspiration

Question 6

Splitting of S2 is NOT heard in what conditions?

Answer 6

aortic stenosis, calcification and limited movement of aortic valve (aortic closure is not heard)

Question 7

What is paradoxical splitting of S2?

Answer 7

split occurs during expiration because of a heavy load on left ventricle (during severe aortic stenosis) causes delay of the aortic valve closure. Can occur in HTN or other increased load, left bundle branch block

Question 8

What is aortic regurgitation? Describe the heart sounds

Answer 8

During diastole, blood flows backwards from aorta into left ventricle due to a leaky aortic valve. Starts at S2 then decreases. S1 still audible

Question 9

Why does diastolic pressure usually drop really low in aortic regurgitation?

Answer 9

peripheral vasculature usually dilates A LOT to try to promote blood flow, since so much of the blood is flowing backwards into the ventricle.

Question 10

What is aortic stenosis? Describe heart sounds

Answer 10

opening of aortic valve is narrowed (ie. Due to calcification). Gets louder then quieter from S1 to S2. Both S1 and S2 are audible

Question 11

What is hypertrophic obstructive cardiomyopathy?

Answer 11

obstruction below aortic valve with hypertrophy of ventricle. Holosystolic murmur with qualities of aortic stenosis

Question 12

compare the pressure in the LV vs the aorta in aortic stenosis

Answer 12

LV pressure&raquo_space; aortic pressure

Question 13

What is mitral regurgitation? Describe heart sounds

Answer 13

Mitral valve doesn’t close properly, so blood goes backwards from left ventricle into left atrium during systole. Holosystolic murmur lasts from S1-S2

Question 14

What is mitral stenosis? Describe heart sounds

Answer 14

Narrowing of mitral valve. Has an opening snap after S2

Question 15

All right sided murmurs increase (get louder) with ___________

Answer 15

inspiration

Question 16

The 3rd sound is present in who? (normally?

Answer 16

young kids

Question 17

S4 is common in who?

Answer 17

> 55 years old due to stiffer ventricle

Question 18

What produces holosystolic murmur?

Answer 18

ventricular septal defect, mitral regurgitation and tricuspid regurgitation

Question 19

Insufficiency murmurs heart sounds

Answer 19

no space between S1-murmur, and murmur-S2

Question 20

aortic/pulmonic insufficiency sounds

Answer 20

high pitch sounds, decrescendo.