murmurs Flashcards
what type of sounds do you use the diaphragm for
high pitched sounds
what type of sounds do you use the bell for
low pitched sounds
what is the best position to hear gallops in
left lateral decubius position (also good for low pitched sounds)
whats the best position for listening to high pitched sounds?
patient sitting up and leaning forward
what is S1? where is it best heard?
start of systole. closure of mitral and tricuspid valves. best heard at apex
what is S2
end of systole. closure of aortic and pulmonic valves
what does a ventricular gallop mean?
S3 gallop. represents early passive diastolic filling of ventricle (will occur when filling pressure is elevated)
is a ventricular gallop (S3 gallop) normal? then what?
in children can be normal
adults- can be a big dilated ventricle and mean you are in HF
what does S4 represent?
active atrial filling of ventricle
what is an atrial gallop? what does it mean?
S4
LV hypertrophy and myocardial ischemia
(ventricle is stiff)
seen in ppl with long standing HTN
what are the 2 systolic murmurs we have to know
mitral regurg
aortic stenosis
describe the intensity of a mitral regurg murmur
plateau-intensity doesn’t change
what happens to the mitral regurg murmur during isometric exercise
intensity of murmur increasing
what is the “character” of an aortic stenosis murmur
crescendo-descrescendo
where does an aortic stenosis murmur radiate to?
neck
what happens to the aortic stenosis murmur during isometric exercise? during squatting?
isometric exercise-intensity decreases
squatting-decreases
where does a mitral regurg murmur radiate?
back and to clavical
what are the 2 diastolic murmurs we have to know
aortic regurg
mitral stenosis
where is aortic regurg murmur best heard?
in 3rd left intercostal space
where does an aortic regurg murmur radiate
along left sternal border
describe the character of an aortic regurg murmur
early diastolic and decresendo in nature
what happens to an aortic regurg murmur with isometric exercise?
isometric exercise-increase intensity
where is a mitral stenosis murmur best heard?
at apex
what happens to mitral stenosis murmur with isometric exercise?
increases intensity
where is a mitral regurg murmur best heard?
over cardiac apex
