Week 1 Auscultation Flashcards
what landmarks do we use to start our auscultation
angle of Louis, sternal angle, aka the manubriosternal junction which is also T4
what are we listening for
the valves closing
what happens when we feel a pulse with the sound
that is the systole, so the mitral and tricuspid valves
what valves make sounds when you hear it, but feel no pulse
the semilunar valves.
where can you hear the aortic valve
the right second intercostal space,
where can you hear the pulmonic valve
left second intercostal space.
what is Erb’s point
left third intercostal space, or the left lower sternal border.
tricuspid can be heard…
left 4th intercostal space,
the mitral can be hear in the
left 5th intercostal space, midclavicular.
what acronym can we use to remember that
all PT’s move
what is the S1 Lub first heart sound
the closure of the AV valves, tricuspid and mitral. its the larger sound
S1 occurs with
ventricular contraction
the S1 sound marks the beginning of
systole
what is the S2 Dub heart sound
the closure of the semilunar valves, the aortic and pulmonary
the S2 marks the beginning of what
the beginning of ventricular relaxation and the end of systole, or the start of diastole. .
is the second sound shorter or longer? higher or lower frequency
shorter and higher
what is an S1 splitting? meaning?
the mitral and tricuspid valves are slightly asynchronous, so you hear two audible components. can be normal, but long split, not normal, need eval
what is S2 splitting
the closure of the semilunar valves are asynchronous, so you hear two sounds
when is S2 normal
in kids and well conditioned athletes, and demonstrated when inspiring (because the splitting interval widens due to delayed P2)
persistence splitting of S2 occurs in… and is resolved with…
occurs in supine or recumbent, but should resolve with expiration following sitting, standing or the valsalva.
what is S3 and what does it signify
S3 comes at the beginning of diastole, after S2. can indicate ventricular failure or HF.
what sound does S3 make
SLOSH-ing-in
what is an S4 heart sound
before S1, and it is when blood is being forced into a stiff or hypertrophic ventricle. can indicate LVH or HCOM.
what does the S4 heart sound sound like
a-STIFF-wall
S3 and S4 are known as
gallops
murmur definition
extra sound during the cardiac cycle, such as whooshing or swishing, made by turbulent flow, often due to faulty valve or changes in the myocardium
what characteristics should we use to assess murmurs,
shape (crescendo, decrescendo)
location (where, around which valve)
timing (longer than the heart sound?)
what scale is used to measure murmur intensity
1-6. 6 is when you can hear it without a stethoscope.
how does an aortic stenosis murmur change when you are squatting or standing
decreases with standing, increases with squatting
how does an HCOM murmur change when you are squatting or standing
decreases with squatting, and increases with standing.
what does a mitral valve prolapse sound like
swoosh, opening snap after S1.
