Phonos

Question 1

Normal phonos

Answer 1

• S1: 1st heart sound
  o At R wave downstroke
  o Closure of AV valves
• S2: 2nd heart sound
  o At end of ventricular contraction
  o Closure of semilunar valves
• S3: 3rd heart sound
  o 1st ½ of diastole
  o Early/passive ventricular filling
• S4: 4th heart sound
  o Late diastole, following P wave on ECG
  o Atrial contraction

Question 2

PS/SAS

Answer 2

• Systolic murmur
• Ejection type
• Crescendo-decrescendo → diamond shaped

Question 3

MR

Answer 3

• Systolic murmur: pan
• Plateau/band shaped type

Question 4

MS

Answer 4

• Diastolic murmur
• Start at 2nd ½ of diastole → ↑ turbulence with atrial contraction

Question 5

VSD

Answer 5

• Holosystolic murmur

Question 6

ASD

Answer 6

• Systolic murmur from functional pulmonic stenosis
  o LA → RA shunting → ↑ blood flow through pulmonic valve
• Ejection type
• Split S2 since longer ejection

Question 7

PDA

Answer 7

• Continuous murmur
• Variable intensity throughout cardiac cycle
  o Peak intensity close to S2

Question 8

AI/PI

Answer 8

• Diastolic murmur
• Decrescendo