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ECOS II Exam 2 > (L4) Cardiac Sounds & Murmurs (Stewart) > Flashcards

(L4) Cardiac Sounds & Murmurs (Stewart) Flashcards

1
Q

What is Erb’s point?

A

3rd ICS lateral to LSB

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2
Q

What does S2 mark end of?

A

Systole

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3
Q

S3 heart sound is listened to with the __ & occurs after __ during ___. It is __ pitched.

A

S3 heart sound is listened to with the bell occurs after S2 during diastole. It is low pitched.

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4
Q

What is a systolic murmur?

A
  • occurs during ventricular systole
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5
Q

What is diastolic murmur?

A

Occurs during atrial systole

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6
Q

KNOW

A
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7
Q

S1 occurs between

A

Closing of mitral valve to opening of aortic valve

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8
Q

As Left vent pressure drops, it is the physiological cause for _____.

(know)

A

aortic valve closure

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9
Q

Describe a continuos murmur

A
  • Begins in systole and extends into all or part of diastole
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10
Q

Position for listening for a aortic regurgitation?

A

Patient leans forward

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11
Q

Position for detecting mitral stenosis?

A
  • Left lateral decubitus
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12
Q

What is being heard in an aortic stenosis?

A

Disrupted forward flow through stenotic A valve

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13
Q

What is being heard in a pulmonic stenosis?

A

Disrupted foward flow through stenoitc P valve

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14
Q

What is being heard with Tricuspid regurgitation?

A
  • Backflow through semi closed T valve
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15
Q

What is being heard with Mitral regurgitation

A

backflow through a semi closed M valve

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16
Q

Describe tricuspid and mitral stenosis?

A

They are ventricular diastolic murmurs

  • Triscupid stenosis is disrupted forward flow through T valve
  • Mitral is disrupted forward flow through M valve
17
Q

Describe pulmonic and aortic regurgitations.

A
  • Ventricular diastolic murmurs
  • Backflow against semi closed P valve
  • Backflow against semi closed A valve
18
Q
  • Aortic stenosis- Old valves are SAD. What is SAD?
A
  • Syncopal
  • Angina
  • Dyspnea

Calcified aortic valve, crescendo-decrescendo, radiates UP to the carotids

19
Q

Aortic regurgitation, how to remember? What is it assoc with?

A
  • ARR there she BLOWS
  • Early blowing diastolic murmur
  • associated with:
    • CT disorders
    • Marfan’s syndrome
    • Head bobbing
    • Water hammer pulse
    • Femoral bruits
20
Q

what type of murmur is triscupid regurgitation? Associated with?

A

Holosystolic

  • assoc with hx of IV drug abuse
  • its the murmur you get if you want to TRI drugs
21
Q

78 yo male in ED presents with SOA and chest pain on exertion for past three months. On PE you hear II/VI systolic ejection murmur over the apical area of the heart. Where would the valvular pathology be located?

A
  • Mitral valve stenosis
22
Q

Mitral stenosis, way to remember and assoc with?

A
  • The Operating System is MicroSoft
  • There is an opening snap
  • Associated with hisotry of rheumatic fever
23
Q

What is mitral valve prolapse?

A
  • Midsystolic click
  • Clinical presentation of young woman with psychiatric hx
  • Can be due to Myxomatous valvular pathology in stem question
  • See the MVPand everything willClick.
24
Q

Mitral regurgitation? POSSIBLE TEST QUESTION

A
  • Rheumatic heart disesase assoc with this
  • Described as holocystolic plateau murmur
  • Best heard at apex radiating to axilla
  • S1 diminished
  • Loud and blowing
25
Q

In most cases as preload increases the murmur will get ____.

A

In most cases as preload increases the murmur will get louder.

26
Q

In most cases as preload decreases the murmur will get ___.

A

In most cases as preload decreases the murmur will get softer

27
Q

During inspiration what happens to right heart sounds?

A

Right sideed murmur will get louder (T &P)

28
Q

With expiration what happens to murmurs on left heart?

A

Louder M& A

29
Q

Hypertropic obstrutive cardiomyopathy difference in increasing and decreasing preload?

A
  • Increase in preload decreases an aortic murmur by pushing the septum away from the aortic outflow tract allowing blood to be easier ejected
  • Decrease in preload causes increasing aortic murmur due to less blood to push outflow track open obstructing and disrupting blood flow
30
Q

How does MVP change preload?

A
  • Leaflets of MV prolapse into left atria under normal pressure and cause disruption of blood flow
  • Increase in preload improves the midsystolic click heard by allowing the prolapsed leaflets to return to normal orientation
31
Q

Fhx of HOCM? Specific maneuvers to ID it?

A
  • Sudden cardiac death at young age
  • Louder with decreased preload & afterload
  • Softer with increased preload and afterload
32
Q

How does afterlaod impact murmurs?

A
  • Increased afterload the murmur gets louder
  • Decreased afterload the murmur gets softer
33
Q

In MVP and HOCM how does afterlaod impact the murmur?

A
  • Increased afterlaod = soft
  • Decreased afterlaod = louder

ECOS II Exam 2 (34 decks)

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