Heart Sounds

Question 1

aortic area

Answer 1

2nd intercostal space at the right sternal border

Question 2

pulmonic area

Answer 2

2nd intercostal space at the left sternal border

Question 3

mitral area

Answer 3

5th intercostal space, medial to the left midclavicular line

Question 4

tricuspid area

Answer 4

4th intercostal space at the left sternal border

Question 5

S1 lub

Answer 5

• 1st heart sound- closure of the aortic and pulmonary valves at the onset of ventricular systole
• high frequency sound with lower pitch and longer duration than S2

Question 6

S2 dub

Answer 6

• 2nd heart sound- closure of the aortic and pulmonary valves at the onset of ventricular diastole
• high frequency sound with higher pitch and shorter duration than S1

Question 7

S3

Answer 7

• 3rd heart sound- vibrations of the distended ventricle walls due to passive flow of blood from the atria during the rapid filling phase of diastole
• normal in healthy young children
• abnormal in adults, my be associated with heart failure; often called ventricular gallop

Question 8

S4

Answer 8

• 4th heart sound: pathological sound of vibration of the ventricular wall with ventricular filling and atrial contraction
• may be associated with hypertension, stenosis, hypertensive heart disease or MI< often called atrial gallop

Question 9

murmers

Answer 9

• vibrations of longer duration than the heart sounds and are often due to disruption of blood flow past a stenotic or regurgitant valve, the sounds are variable described as soft, blowing, or swishing
• when the leaflets of the heart valves are thickened, the forward flow of the blood is restricted; when the leaflets lose competency, and fail to close tightly, blood can flow backwards