murmurs

Question 1

what type of sounds do you use the diaphragm for

Answer 1

high pitched sounds

Question 2

what type of sounds do you use the bell for

Answer 2

low pitched sounds

Question 3

what is the best position to hear gallops in

Answer 3

left lateral decubius position (also good for low pitched sounds)

Question 4

whats the best position for listening to high pitched sounds?

Answer 4

patient sitting up and leaning forward

Question 5

what is S1? where is it best heard?

Answer 5

start of systole. closure of mitral and tricuspid valves. best heard at apex

Question 6

what is S2

Answer 6

end of systole. closure of aortic and pulmonic valves

Question 7

what does a ventricular gallop mean?

Answer 7

S3 gallop. represents early passive diastolic filling of ventricle (will occur when filling pressure is elevated)

Question 8

is a ventricular gallop (S3 gallop) normal? then what?

Answer 8

in children can be normal

adults- can be a big dilated ventricle and mean you are in HF

Question 9

what does S4 represent?

Answer 9

active atrial filling of ventricle

Question 10

what is an atrial gallop? what does it mean?

Answer 10

S4
LV hypertrophy and myocardial ischemia
(ventricle is stiff)
seen in ppl with long standing HTN

Question 11

what are the 2 systolic murmurs we have to know

Answer 11

mitral regurg

aortic stenosis

Question 12

describe the intensity of a mitral regurg murmur

Answer 12

plateau-intensity doesn’t change

Question 13

what happens to the mitral regurg murmur during isometric exercise

Answer 13

intensity of murmur increasing

Question 14

what is the “character” of an aortic stenosis murmur

Answer 14

crescendo-descrescendo

Question 15

where does an aortic stenosis murmur radiate to?

Answer 15

neck

Question 16

what happens to the aortic stenosis murmur during isometric exercise? during squatting?

Answer 16

isometric exercise-intensity decreases

squatting-decreases

Question 17

where does a mitral regurg murmur radiate?

Answer 17

back and to clavical

Question 18

what are the 2 diastolic murmurs we have to know

Answer 18

aortic regurg

mitral stenosis

Question 19

where is aortic regurg murmur best heard?

Answer 19

in 3rd left intercostal space

Question 20

where does an aortic regurg murmur radiate

Answer 20

along left sternal border

Question 21

describe the character of an aortic regurg murmur

Answer 21

early diastolic and decresendo in nature

Question 22

what happens to an aortic regurg murmur with isometric exercise?

Answer 22

isometric exercise-increase intensity

Question 23

where is a mitral stenosis murmur best heard?

Answer 23

at apex

Question 24

what happens to mitral stenosis murmur with isometric exercise?

Answer 24

increases intensity

Question 25

where is a mitral regurg murmur best heard?

Answer 25

over cardiac apex