Heart Sounds

Question 1

4 areas of heart auscultation

Answer 1

1) Aortic area
2) Pulmonic area
3) Tricuspid area
5) Mitral area

Question 2

Aortic area auscultation

Answer 2

2nd IC space, right sternal border

Question 3

Pulmonic area auscultation

Answer 3

2nd IC space, left sternal border

Question 4

Tricuspid area auscultation

Answer 4

4th IC space, left sternal border

Question 5

Mitral area auscultation

Answer 5

5th IC space, medial to left midclavicular line (aka at apex of heart)

Question 6

S1 (lub)

Answer 6

Closure of tricuspid and mitral valves

Beginning of systole

Question 7

S2 (dub)

Answer 7

Closure of pulmonic and aortic valves

Beginning of diastole

Question 8

S3

Answer 8

Vibrations of distended ventricular walls from passive bloodflow from atria
Normal in kids, heart failure in adults i.e. “ventricular gallop”

Question 9

S4

Answer 9

Vibration of ventricular wall with ventricular filling and atrial contraction
Associated with HTN, stenosis, hypertensive heart disease, or MI
i.e. “atrial gallop”

Question 10

Murmurs

Answer 10

extended heart sounds; soft, blowing, or swishing

Due to stenotic or regurgitant valve