Week 1 Auscultation

Question 1

what landmarks do we use to start our auscultation

Answer 1

angle of Louis, sternal angle, aka the manubriosternal junction which is also T4

Question 2

what are we listening for

Answer 2

the valves closing

Question 3

what happens when we feel a pulse with the sound

Answer 3

that is the systole, so the mitral and tricuspid valves

Question 4

what valves make sounds when you hear it, but feel no pulse

Answer 4

the semilunar valves.

Question 5

where can you hear the aortic valve

Answer 5

the right second intercostal space,

Question 6

where can you hear the pulmonic valve

Answer 6

left second intercostal space.

Question 7

what is Erb’s point

Answer 7

left third intercostal space, or the left lower sternal border.

Question 8

tricuspid can be heard…

Answer 8

left 4th intercostal space,

Question 9

the mitral can be hear in the

Answer 9

left 5th intercostal space, midclavicular.

Question 10

what acronym can we use to remember that

Answer 10

all PT’s move

Question 11

what is the S1 Lub first heart sound

Answer 11

the closure of the AV valves, tricuspid and mitral. its the larger sound

Question 12

S1 occurs with

Answer 12

ventricular contraction

Question 13

the S1 sound marks the beginning of

Answer 13

systole

Question 14

what is the S2 Dub heart sound

Answer 14

the closure of the semilunar valves, the aortic and pulmonary

Question 15

the S2 marks the beginning of what

Answer 15

the beginning of ventricular relaxation and the end of systole, or the start of diastole. .

Question 16

is the second sound shorter or longer? higher or lower frequency

Answer 16

shorter and higher

Question 17

what is an S1 splitting? meaning?

Answer 17

the mitral and tricuspid valves are slightly asynchronous, so you hear two audible components. can be normal, but long split, not normal, need eval

Question 18

what is S2 splitting

Answer 18

the closure of the semilunar valves are asynchronous, so you hear two sounds

Question 19

when is S2 normal

Answer 19

in kids and well conditioned athletes, and demonstrated when inspiring (because the splitting interval widens due to delayed P2)

Question 20

persistence splitting of S2 occurs in… and is resolved with…

Answer 20

occurs in supine or recumbent, but should resolve with expiration following sitting, standing or the valsalva.

Question 21

what is S3 and what does it signify

Answer 21

S3 comes at the beginning of diastole, after S2. can indicate ventricular failure or HF.

Question 22

what sound does S3 make

Answer 22

SLOSH-ing-in

Question 23

what is an S4 heart sound

Answer 23

before S1, and it is when blood is being forced into a stiff or hypertrophic ventricle. can indicate LVH or HCOM.

Question 24

what does the S4 heart sound sound like

Answer 24

a-STIFF-wall

Question 25

S3 and S4 are known as

Answer 25

gallops

Question 26

murmur definition

Answer 26

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

Question 27

what characteristics should we use to assess murmurs,

Answer 27

shape (crescendo, decrescendo)
location (where, around which valve)
timing (longer than the heart sound?)

Question 28

what scale is used to measure murmur intensity

Answer 28

1-6. 6 is when you can hear it without a stethoscope.

Question 29

how does an aortic stenosis murmur change when you are squatting or standing

Answer 29

decreases with standing, increases with squatting

Question 30

how does an HCOM murmur change when you are squatting or standing

Answer 30

decreases with squatting, and increases with standing.

Question 31

what does a mitral valve prolapse sound like

Answer 31

swoosh, opening snap after S1.