Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Cardio > Heart Sounds - Exam 1 > Flashcards

Heart Sounds - Exam 1 Flashcards

1
Q

Draw the heart sound diagram from med phys

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

The _____ is better for picking up the relatively high pitched sounds of S1 and S2

The ____ is more sensitive to the low-pitched sounds of S3 and S4

A

diaphragm

bell

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the listening posts for heart sounds?

A

All Physicians Take Money

Aortic
Pulmonic
Tricuspid
Money

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

The patient is in the left lateral decubitus position, what and where are you listening for?

A

because it brings the heart forward using the bell at the MV post

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What does sitting up and leaning forward help you find? What is the pt instruction?

A

Helps distinguish aortic murmurs, have the pt exhale deeply and hold

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

How does standing affect venous return? squatting? Valsalva maneuver?

A

standing decreases venous return, arterial BP and stroke volume

squatting increases venous return, LV volume and arterial BP

Valsalva maneuver decreases venous return, arterial BP and stroke volume

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Why does a heart murmur get softer when you stand?

A

because the heart stretches

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

SI makes what sound? Where is it louder? When does it occur? What valves are closing?

A

S1 (“lub”)

Louder at the APEX

Occurs at the beginning of ventricular systole

Closure of AV valves (TV/MV).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

does S1 or S2 correspond with the pulse?

A

S1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is an S1 split?

A

Heard when the MV closure significantly precedes TV closure. May be normal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

S2 makes what sound? Where is it louder? What valves are closing? When does it occur?

A

S2 (“dub”)
Louder at the BASE

Closure of semilunar valves (AV/PV).

Occurs at the end of ventricular systole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is an S2 split? Where is it heard the best?

A

– S2 is physiologically split because AV closure (A2) normally precedes PV closure (P2) and it’s usually louder.

Heard best at 2nd and 3rd ICS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

In an S2 split _____ splitting is normal and _____ splitting is abnormal. What does it indicate?

A

inspiratory splitting is normal

expiratory splitting is abnormal- right heart disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the difference between a split S1 and S4?

A

S4 heart sound is in a lower frequency than S1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

When can it be normal to hear a split S2?

A

during deep inspiration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Where is a split S2 best heard at?

A

pulmonic area

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is the difference between S3 and a split S2?

A

S3 is heard later in the cardiac cycle and is a lower pitch

split S2 are a higher pitch

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is the slang term for S3? When does it occur?

A

S3 “Kentucky” “ventricular gallop”

Occurs in the beginning of diastole after S2; not of valvular origin.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What does S3 sound represent? Where is it best heard? What side of the stethoscope?

A

Represents increased volume of blood striking a compliant ventricle (dilation)

Best heard with bell at apex in LLD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

S3 is normal in what pt populations?

A

Normal in children, trained athletes and sometimes in pregnancy. In adults over 40 yrs, assoc with a dilated ventricle (as in systolic ventricular failure).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is the slang term for S4? When does it occur?

A

S4 “Tennessee” “atrial gallop”

Occurs just after atrial contraction at the end of diastole, just before S1.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Why does S4 sound happen? Where and with what side of the stethoscope is it heard the best?

A

Produced by the sound of blood being forced into a noncompliant (stiff/ hypertrophic) ventricle - atria has to contract harder

Best heard with bell at apex in LLD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What pt population is S4 commonly seen in?

A

NEVER A NORMAL FINDING!!!

Usually associated with a stiffened ventricle (heard in patients with ventricular hypertrophy, myocardial ischemia, older adults) aka long-standing HTN

24
Q

S3 is heard in ____ diastole and S4 is heard in ____ diastole

A

S3: EARLY diastole

S4: LATE diastole

25
Q

What is an ejection click a result of? Immediately follows _____

A

Result of opening of AV (dilated aorta, aortic stenosis, or bicuspid AV) or PV (dilated pulmonary artery, pulm HTN, or pulmonic stenosis)

S1

26
Q

What is an opening snap caused by? What does it follow?

A

Caused by opening of MV, as in MS

Follows S2

27
Q

What phase are S3 and S4 heard in?

A

diastole

28
Q

How are murmurs differentiated from extra heart sounds?

A

murmurs are longer than extra heart sounds

29
Q

_____ have an abnormally narrowed valvular orifice that obstructs blood flow. AKA do not ____ well

A

Stenotic valves

do not OPEN well

30
Q

______ fail to fully close. A valve that allows blood to leak backwards in a retrograde direction produces a regurgitant murmur. Aka do not ____ well

A

Insufficient or regurgitant valves

do not CLOSE well

31
Q

What do you evaluate cardiac murmurs for?

A

S: site: what listening post?
C: character
R: radiation
I: intensity
P: pitch: high or low
T: timing: when is it happening?

32
Q

**What is the grading scale for cardiac murmurs?

A
33
Q

What are the options for cardiac murmurs?

A

systolic, diastolic or continuous

34
Q

What does crescendo sound like? decresendo?

A

crescendo: getting louder

decrescendo: getting softer

35
Q

Carotid pulse is _______

A

systolic

36
Q

What is the cause behind a pansystolic murmur? Is it a problem? What is a major example?

A

Arising from blood flow from a chamber of high pressure to one of low pressure through a valve that should be closed

YES, this is pathologic

mitral regurgitation

37
Q

_____ is the MC heart murmur? ** What is the clinical pearl associated with it? What is it a result of?

A

midsystolic murmur

blowing

turbulent blood flow

38
Q

What does pathologic midsystolic murmur indicate?

A

aortic stenosis

39
Q

diastolic murmurs may be _____ or ____

A

early or mid-late

40
Q

early diastolic murmurs are due to regurgitation through ______ most often aortic regurg

A

incompetent semilunar valves,

41
Q

In diastolic murmurs mid-late diastolic murmurs suggest ______, most commonly mitral stenosis

A

stenosis of an A-V valve

42
Q

**if you hear a diastolic murmur in the middle of a cycle, the most likely cause is _____

A

stenosis

43
Q

**Venous hum are considered _____ murmurs. What are they produced by? What are they characterized by?

A

combined

Produced by turbulence of blood flow in jugular veins

Characterized by a continuous murmur that is louder in diastole and has a soft, low pitch

44
Q

Pericardial Friction Rub are classified as ______ murmurs. What are they a result of? What makes these increase?

A

combined murmurs that last the entirety of the cycle

A result of inflammation of the pericardium

Increases as the patient leans forward, exhales, and holds their breath

45
Q

What is a Patent Ductus Arteriosus (PDA)? What type of murmur?

A

Congenital abnormality resulting in a channel between the aorta and pulmonary artery

combined murmur

46
Q

**a heart sound is described as harsh, machinery-like, medium pitched that is typically associated with a thrill. What am I?

A

Patent Ductus Arteriosus (PDA)

47
Q

Where is a PDA the loudest? Where is it heard the best?

A

Loudest in systole and fades in diastole

Best heard at left 2nd intercostal space, radiating to left clavicle

48
Q

What are the 2 different kinds of echocardiograms?

A

Transthoracic (TTE) 2D echocardiogram

and

Transesophageal Echo (TEE)

49
Q

_____ is the most common study ordered for valvular abnormalities

A

Transthoracic (TTE) 2D echocardiogram w/Doppler imaging

50
Q

What attributes of the heart does TTE give a good view of?

A

Provides excellent images of valve motion, intracardiac masses, cardiac abnormalities / anomalies, and pericardial fluid

Gives info about the size of all 4 chambers, regional and global systolic function, and chamber wall thickness

51
Q

What is the advantage of the TEE?

A

Gives better view of posterior heart structures, specifically the atria, atrial appendage, and A-V valves

52
Q

TEE are better than a TTE for dx ______ and to confirm ______. TEE helps define _____ or ______

A

left atrial appendage (LAA) thrombus

severe valvular disease

septal defects

patent foramen ovale (PFO)

53
Q

What is the important pt education prior to TEE procedure?

A

Patient has to be NPO for 6-8 hours prior to procedure

54
Q

What are the risk of TEE? It is performed under ________

A

Aspiration
Throat irritation
Esophageal perforation

IV sedation and local anesthetic to reduce gag reflex

55
Q
A

Cardio (24 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions