Thoracic Auscultation Tutorials

Question 1

Laryngeal/tracheal sounds.

Answer 1

Air in and out.

Question 2

1. Vesicular sounds.
2. Bronchovesicular and bronchial sounds.

Answer 2

1. Low pitched and normally heard over most lung fields.
2. Further cranial over lungs.
   Closer to heart so may hear beat.
   Inspiration normally longer than expiration.

Question 3

1. Purring.
2. What are some abnormal respiratory sounds?
3. Stridors.

Answer 3

1. Like normal purring but a little muffled.
2. Crackles, wheezes, ronchi (bubbling or gurgling).
3. Obstructive airway sounds.

Question 4

1. On the left side of the chest, which heart valves can be assessed?
2. On the right side of the chest, which heart valves can be assessed?

Answer 4

1. Pulmonic.
   Aortic.
   Mitral (left AV).
2. Tricuspid (right AV).

Question 5

1. What is the first heart sound heard in a normal cardiac cycle?
2. What causes this first heart sound?
3. What is the second heart sound in a normal cardiac cycle?
4. What causes this second heart sound?

Answer 5

1. S1.
2. Closure of the mitral and tricuspid valves (AV valves).
3. S2.
4. Closure of aortic and pulmonic valves.

Question 6

1. What is the 3rd heart sound heard in normal cardiac cycle?
2. What causes this 3rd heart sound?
3. What is the 4th heart sound heard in normal cardiac cycle?
4. What causes this 4th heart sound?

Answer 6

1. S3 (comes shortly after S2).
2. Passive diastolic filling early in diastole.
3. S4. (just before S1).
4. Late diastolic ventricular filling w/ atrial contraction.

Question 7

Gallop rhythm.

Answer 7

Hear S3 and S4 which are not normally heard.
3-beat rhythm.
Usually due to hypertrophic cardiomyopathy in cats.
Usually due to dilated cardiomyopathy in dogs.

Question 8

Atrial fibrillation.

Answer 8

R intervals are irregularly irregular.
Disorganised and chaotic rhythm.

Question 9

Murmurs.

Answer 9

Result of turbulent blood flow.
Can be systolic, diastolic, or continuous.
High-pitched murmurs best heard w/ the stethoscope diaphragm.
Low-pitched murmurs best heard w/ the bell of the stethoscope.
Regurgitation murmurs = when a valve is meant to be closed but is not.
Stenotic murmurs = when a valve a valve is meant to be fully open but is not.

Question 10

Heart murmur grading.

Answer 10

1 = only audible w/ absolute concentration.
2 = soft but easily heard.
3 = moderately loud and easily heard.
4 = loud but no palpable thrill.
5 = loud w/ palpable thrill.
6 = very loud, heard w/ stethoscope and away from the chest.

Question 11

Systolic murmurs.

Answer 11

Ejection murmurs.
Originate from turbulent flow through narrowed or irregular valves or outflow tracts.
Crescendo-decrescendo (diamond shaped) character.
Caused by aortic stenosis, pulmonic stenosis.

Question 12

Holosystolic murmurs.

Answer 12

Regurgitant murmurs.
Regurgitation or shunts into chambers that throughout systole are at lower resistance.
VSD (heard at R sternal edge).
Mitral or tricuspid valve insufficiency.

Question 13

Diastolic murmurs.

Answer 13

Rare.
Aortic regurgitation.
(Pulmonic regurgitation).

Question 14

Continuous murmurs.

Answer 14

Constant shunt flow throughout systole and diastole.
PDA (at L base).
(Systemic or pulmonic AV fistulas).