Heart Sounds

Question 1

Normal Range

Answer 1

60-100bpm

Question 2

Bradycardia

Answer 2

less than 60 bpm

Question 3

Tachycardia/Tachyarrhythmia

Answer 3

more than 100 bpm

Question 4

Irregular/Abnormal Pulse

Answer 4

irregular GAPS between each contraction

Question 5

Pulse of the Older Adult

Answer 5

Pulse is slower
can be due to: 
-age
-medication 
        digoxin [used for atrial fibrillation] 
        Lol [betablocker]

Question 6

Locations For Pulse

Answer 6

Carotid - either side of neck 
radial- wrist, under thumb
brachial- used for bp
femoral- by the groin, on both sides
dorsalis pedis- metatarsal
posterior tibial- inner side of ankle

Question 7

Location for Pulse: Apical

Answer 7

-measures pulse at apex of heart
midclavicular/5th intercostal space
measured w/ stethoscope

Question 8

Heart Sounds: S1

Answer 8

(normal)

• LUB
• noise is made during the CLOSING OF THE MITRAL AND TRICUSPID VALVES
• contracting
• SYSTOLE
• heard strongest over the APEX

Question 9

Heart Sounds: S2

Answer 9

(normal)
-DUB
-this noise is made during the CLOSING OF THE AORTIC/PULMONIC VALVES
-heard strongest over the 2ND INTERCOSTAL SPACES
- if you listen closely, it is split into two:
-A2 (closing of aortic) best heard on
the right side of sternum, 2nd inter.
space
-P2 (closing of pulmonic) best heard
on the left side of sternum, 2nd
inter. space
-ventricular DIASTOLE
-relaxing

Question 10

Heart Sounds: S3

Answer 10

(abnormal)
=turn patient over to their left
-best heard over the APEX of heart
-use BELL OF STETHOSCOPE (it's a low pitch sound)
->> volume blood in ventricle
-in older adults it can indicate:
        -cardiomyopathy
        -heart failure
        -regurgitation of mitral or tricuspid
-heard directly after S2
        -S1\_\_\_\_S2_S3

Question 11

Heart Sounds: S4

Answer 11

(abnormal)

• turn patient over to their left
• best heart over APEX with the bell
• can indicate diastolic heart failure
• occurs when atrial contraction forces blood into a NONCOMPLIANT ventricle
• clicking sound
• heard directly before S1
  - S4_S1_____S2

Question 12

Heart Sounds: Tips For Distinguishing Between S1 and S2

Answer 12

• S1 is loudest over the apex (5th intercostal space)
• S2 is loudest over the base (2nd intercostal space)
• feel carotid pulse while taking apical pulse, every time you feel the pulse, the corresponding noise is S1