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Cardiopulmonary PSW 2
Heart Sounds
19
Medical
Graduate
12/15/2012

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Cards

Term
where is the stethoscope placed when listening to the aortic region?
Definition
between the 2nd and 3rd intercostal spaces at the right sternal border (RUSB)
Term
where is the stethoscope placed when listening to the pulmonic region?
Definition
between the 2nd and 3rd intercostal spaces at the left sternal border (LUSB)
Term
where is the stethoscope placed when listening to the tricuspid region?
Definition
between the 3rd, 4th, 5th and 6th intercostal spaces at the left sternal border (LLSB)
Term
where is the stethoscope placed when listening to the mitral region?
Definition
near the apex of the heart between the 5th and 6th intercostal spaces in the mid-clavicular line (apex)
Term
how does breathing affect the sound of right and left sided heart murmurs?
Definition
right sided murmurs increase with inspiration
and left sided murmurs increase with expiration
Term
when do the heart sounds occur?
Definition
S1 occurs during isometric contraction
S2 occurs during isometric relaxation
S3 (if present) occurs shortly after S2 during diastole
S4 (if present) occurs before S1 during diastole
Term
list the order of valve closure in the heart.
Definition
mitral, tricuspid, aortic, pulmonic

AV valves close before semilunar and
left side valves close before right side
Term
what are some causes of an abnormal S4 heart sound?
Definition
usually related to LVH, decreased LV distensibility, aortic stenosis, HTN
Term
what can cause a widening of the S2 heart sound?
Definition
during inspiration venous return increases, and as a result pulmonary circulation increases, this causes the pulmonic valve to close later, resulting in a widening of the S2 sound (physiological)

during expiration the aortic and pulmonic valves can close separately due to a LBBB which causes delayed LV contraction (pathological)
Term
what is a heart murmur?
Definition
an abnormal sound that occurs when there is an abnormality of the heart valve

it can be caused by stenosis or regurgitation
Term
true or false, physiological (innocent) murmurs are caused by high flow through a normal valve?
Definition
true
Term
true or false, diastolic murmurs are always pathological?
Definition
true
Term
what are the four properties of an abnormal heart sound?
Definition
location of the sound
timing of the sound
grade or intensity of the sound
quality or shape of the sound
Term
what is a pansystolic murmur and what is a potential cause of it?
Definition
a heart murmur heard throughout the entire systolic phase

it can because by AV valve prolapse
Term
what is levine's scale of grading murmurs?
Definition
rates the intensity of the murmur on a scale of 1 to 6
with 1 being the faintest and 6 being the loudest
Term
what are four pathological diastolic murmurs?
Definition
mitral and tricuspid stenosis

aortic and pulmonic insufficiency (regurgitation)
Term
what are four pathological systolic murmurs?
Definition
aortic and pulmonic stenosis

mitral and tricuspid insufficiency (regurgitation)
Term
what are the two main causes of pathological murmurs?
Definition
normal flow through a stenotic valve
and redirected flow (regurgitation)
Term
what is the most common clinical heart murmur?
Definition
aortic stenosis
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