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CardioPulm > Heart Sounds and Their Description > Flashcards

Heart Sounds and Their Description Flashcards

1
Q

Thrill on R Base

A

Aortic Stenosis/ Systemic HTN

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2
Q

Thrill on L Base

A

Pulmonic Stenosis/ Pulmonic HTN

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3
Q

Lift (Heave)

A

Left Lower Sternal Border: RVH/ Chronic Lung Disease

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4
Q

PMI: Volume Overload

A

LVH- Displaced lateral and wide spread

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5
Q

PMI: Pressure Overload

A

Increase in force and duration but not displaced

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6
Q

Aortic Region

A

Between 2nd and 3rd intercostal spaces at the R sternal border

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7
Q

Pulmonic Region

A

Between 2nd and 3rd intercostal spaces at the L sternal border

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8
Q

Tricuspid Region

A

Between the 3rd, 4th, 5th and 6th intercostal spaces at the left sternal border

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9
Q

Mitral Region

A

Near the apex of the heard between the 5th and 6th L intercostal spaces (apex of the heart)

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10
Q

Diaphragm

A

High frequency sounds (systolic murmurs, S1, S2, Ejection clicks, and opening snaps)

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11
Q

Bell

A

Low frequency sounds (diastolic murmurs, S3, S4)

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12
Q

S1

A

Closure of Mitral and Tricuspid valces

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13
Q

S2

A

Closure of aortic and pulmonary valves (pulmonary valve closes 60 msec after aortic valve)

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14
Q

Semilunar Valves

A
  • Aortic and pulmonary valves close after isometric relaxation period
  • Pulmonary component is softer than aortic component
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15
Q

S3

A

Rapid filling of ventricles from atrium during diastole

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16
Q

S4

A

Atrial contraction

- always abnormal due to noncompliant ventricle

17
Q

S1 Intensity:

A
  • Position of AV valve at the start of systole
  • Structure of the valve leaflets
  • how quickly the pressure rises in the ventricle
18
Q

Accentuated S1:

A

AV valve wide open and no time to drift together:
- Hyperkinetics states ( Exercise, fever, hyperthyroidism)
Calcification in valve structure

Mitral Stenosis with leaflets still mobile

19
Q

Diminished S1:

A

Delayed conduction from atria to ventricles; Change in valve structure

  • 1st degree heart block
  • Mitral insufficiency (decreased mobility)

Forceful atrial contraction into noncompliant ventricle (delays in the ventricular contraction)
- Severe HTN

20
Q

Accentuated S2:

A

Higher Closing pressure
- Systemic HTN Exs

Pulmonary HTN

  • Mitral Stenoiss
  • CHF

Semilunar valves calcified but mobile
- Aortic/Pulmonic Stenosis

21
Q

Diminished S2:

A

Fall in systemic blood pressure
- shock

Semilunar valve calcified and immobile
-Aortic/Pulmonic Stenosis

22
Q

S2 Split: Unaffected by respiration

A

Atrial Septal Defect

R Ventricular Failure

23
Q

S2 Split: Paradoxical (P2A2)

A

Aortic Stenosis
LBBB
PDA

24
Q

S3: Ventricular Gallup

A
  • Pitch: Low
  • Abnormal in adults >40
  • Decreased ventricle compliance /CHF
  • Volume overload
  • Mitral, Aortic, Tricuspid Regurgitation
  • Heard at the apex in L lateral position
25
Q

S4: Atrial Gallup

A
  • Apex
  • Decreased Compliance of the ventricle
  • CAD
  • Aortic Pulmonary Stenosis
  • Systolic Afterload
  • HTN
26
Q

Systolic Aortic Stenosis

A
  • Flow through semilunar valves
  • LVH develops
  • Thrill Present
  • S1 normal
  • paradoxical split S2, S4 present with LVH
27
Q

Systolic Pulmonary Stenosis

A
  • Calcification of the pulmonic valve
  • Thrill present
  • Diminished S2
  • S4 common with RVH
28
Q

Systolic Mitral Regurgitant

A
  • Stream of blood regurgitates back into LA during systole through incompetent mitral valve
  • In diastole, blood passes back into LV along with new flow
  • Results in LV dilation and hypertrophy
  • Thrill in systole at the apex
  • S1 diminished
  • S2 accentuated
  • S3 at apex often present
29
Q

Systolic Tricuspid Regurgitation

A
  • Backflow of blood through incompetent tricuspid valve into RA
  • Engorged pulsating neck veins
  • Lift at sternum of RVH
  • Thrill at the left lower sternal border
30
Q

Distolic Mitral Stenosis

A
  • Filling murmur at low pressure
  • Calcified mitral valve will not open properly
  • impeding forward flow of blood into LV during diastole
  • Results in LA enlargement and LA pressure increased
  • S1 accentuated
  • Opening snap after S2
31
Q

Diastolic Tricuspid Stenosis

A
  • Filling murmur at low pressure
  • Calcification of tricuspid valve impedes forward flow of blood into the right ventrilce during diastole
  • diminished arterial pulse
  • Jugular venous pulse prominent
32
Q

Diastolic Aortic Regurgitation

A
  • Due to semilunar valve incompetence
  • Stream of blood regurgitates back through incompetent aortic valve into LV during diastole
  • LV dialation and hypertrophy due to increased LV stroke volume
  • Rapid ejection of large stroke volume into poorly filled aorta
  • Rapid runoff in diastole as part of the blood is pushed back into LV
  • Bounding pulse in carotid, brachial, and femoral arteries
  • BP has wide pulse pressure
  • Apical PMI displace left and inferior
33
Q

Diastolic Pulmonic Regurgitation

A
  • Due to semilunar valve incompetence
  • backflow of blood through incompetent pulmonic valve from pulmonary artery to RV
  • Bounding pulse in carotid, brachial, and femoral arteries
  • BP has wide pulse pressure
  • Apical PMI displace left and inferior

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