Heart Sounds I Lecture Powerpoint Flashcards

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1
Q

Heart sounds are heard in the spots they are in the chest because…

A

…that is the rough direction of where blood is flowing in the vessels

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2
Q

During diastole, what valves are open?

A

Mitral and tricuspid valves

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3
Q

S1 heart sound occurs during what phase of the heart cycle? What about S2?

A
  • At the end of diastole/start of systole

- At the end of systole/start of diastole

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4
Q

Blood FLOWS during which phase of the cardiac cycle?

A

BOTH!!!!!!!!!!!!

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5
Q

Diagnostic study for abnormal heart sounds

A

Echocardiogram

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6
Q

Stenotic valve definition

A

A valve that is partially occluded or narrowed

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7
Q

Sclerosis of valve definition

A

Thickening of valve that causes it to lose its compliance that could result in stenosis

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8
Q

Insufficiency/regurgitation definition

A

When a valve leaks allowing backward flow when it should be closed

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9
Q

Pulse pressure definition

A

Difference between systolic and diastolic blood pressure

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10
Q

Atrial systole and diastole ___ ventricular systole and diastole

A

precede

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11
Q

End systolic volume

A

Volume of blood remaining in LV following cardiac contraction and ejection of blood

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12
Q

Stroke volume + end systolic volume =

A

end diastolic volume

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13
Q

Ejection fraction and avg value

A

Stroke volue/end diastolic volume, should be about 55%

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14
Q
Aortic area
Pulmonic area
Erb's point
Tricuspid area
Mitral area
Locations
A
  • 2nd intercostal space right sternal border
  • 2nd intercostal space, left sternal border
  • third intercostal space, left sternal border
  • 4th intercostal space, left sternal border
  • 5th intercostal space, mid clavicular line
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15
Q

Carotid pulsation to determine S1 vs S2

A

Should be able to feel the carotid pulse between S1 and S2 if you are having trouble determining which is which

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16
Q

S1 is loudest at the ___, S2 at the ___

A

apex, base

17
Q

Physiological splitting of S2

A

Refers to splitting of S2 into A2 (aortic valve closing) and P2 (pulmonic valve closing) that is exacerbated during inspiration because of the impedance of the pulmonary circulation vascular beds

18
Q

Decreased S1 causes (2)

A
  • thickened chest wall

- calcification of AV valves

19
Q

Increased S1 causes (2)

A
  • increased cardiac output

- increased AV valve flow velocity (acquired stenosis)

20
Q

Wide splitting of S2 causes (4)

A
  • delayed P2 from pulmonary stenosis or pulmonary hypertension
  • Early A2 from mitral regurgitation or VSD
21
Q

Paradoxical splitting of S2 and causes (2)

A

Occurs where split is widened during expiration and hsortened during inspiration (with A2 after P2)

  • aortic stenosis
  • aortic insufficiency
22
Q

S3 gallop

A

Early diastolic sound following S2 with new blood entering a dilated ventricle, may be normal in children or indicative of CHF, CAD, or aortic/mitral insufficiency

23
Q

S4 gallop

A

Late diastolic sound right before S1 due to ejection of blood from atria during atrial contraction hitting a stiff noncompliant wall, long standing hypertension causing LV hypertrophy is key, may be normal but almost always pathologic

24
Q

Summation gallop

A

Occurs where S3 and S4 combine in a rapid heart which sounds like 3 heart sounds lined up in a row

25
Q

Aortic ejection click

A

Early systolic sound heart just after S1, does not vary with inspiration, due to a mobile but abnormally shaped or stenotic aortic valve, usually pathologic for aortic stenosis

26
Q

Opening snap

A

Opening of abnormal tricuspid or mitral valve, early diastolic sound heard just after S2 associated with mitral stenosis

27
Q

Cardiac friction rub

A

Creaking, grating, or scratching sound heard with pericardial inflammation, classically has 2 systolic and one diastolic component, heard best at the left sternal border (increased when leaning forward) when patient is not breathing