Heart Sounds Flashcards
location of apical impulse
midcalvicular line
-5th left intercostal space
how should the table be placed to do a heart exam
30 degress
what are abnormal findings on palpation
Heave
Thrust
Lift
what do we need to know about at thrill
location
timing ( systole/diastole)
what is the probably cause if there is a systolic thrill at the suprasternal notch and/or 2nd and 3rd right intercostal space
aortic and pulmonary stenosis
what is the probably cause if there is a systolic thrill at 4th left intercostal space
ventricular septal defects
what is the probably cause if there is a systolic thrill at the apex
mitral regurgitation
what is the probably cause if there is a systolic thrill at the left lower sternal border
Tetralogy of fallot
what is the probably cause if there is a systolic thrill at the left upper sternal border
patent ductus arteriosus
what is the probably cause if there is a diastolic thrill at the right sternal border
- aortic regurgitation
- aneurysm of ascending aorta
what is the probably cause if there is a diastolic thrill at the apex
mitral stenosis
what position is best for high-pitched murmurs
sitting up and leaning slightly forward
what position is best for low-pitched filling sounds in diastole
supine in the left lateral recumbent position
What is the S1 sound
closure of AV valves (mitral and tricuspid)
begining systole
what is the S2 sound
closure of semilunar
- end of systole
when is the splitting of S1 best heard
- usually not heard because tricuspid is too faint to hear
- heard during inspiration at tricuspid region
splitting of which heart sound is expected
S2
for S2 wwhere are pressures higher and where are ejectiont times longer
pressure higher on left side
- ejection time longer on right
when is splitting of S2 heard the greatest
during peak inspiration
What is S3
rapid passive filling of ventricles during diastole
-early diastole
what is S4 sound
forceful atrial ejection of blood
-late diastole
what are 4 questions you should as yourself with hearing a murmur
timing location radiation shape intensity pitch quality
bruit
murmur heard in blood vessel
how does clench fist and hand grip change heart sound
- increase ventricular volume
- increases afterload
