Term
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Definition
Location of mitral and tricuspid valves closing
Apex of heart, LLSB |
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Term
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Definition
Location of aortic and pulmonic valves closing
2nd ICS @ R and L sternal border, respectively |
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Term
| Differentiating S1 and S2 |
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Definition
Location
S1 louder at apex
S2 louder at base
Timing
Systole < diastole
Association
S1 followed quickly by carotid pulse |
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Term
| Abnormalities of S1 intensity |
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Definition
| Ventricular pressure, contractility, valve condition and position, distance of heart from chest wall (obesity or pericardial effusion) |
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Term
| Abnormalities of S2 intensity |
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Definition
Change in systolic pressure
condition of the valve |
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Term
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Definition
S3 and 4
Valves aren't closing but it's a mass of blood hitting ventricular walls creating a noise |
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Term
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Definition
S3
Present in volume overloaded states
anemia, hyperthyroidism, pregnancy
regurgitant valvular lesions(MR/TR)
congestive heart failure(CHF) |
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Term
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Definition
S4
Present with noncompliant/“stiff” ventricle
HTN
CAD
Valvular stenosis(AS/PS)
Cardiomyopathy |
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Term
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Definition
semilunar stenoisis you may hear valve open.
Occurs after S1; is systolic |
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Term
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Definition
AV valve stenosis hear opening of valve
Occurs after S2, is diastolic |
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Term
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Definition
| Distinguishable sounds from normal heart sounds that are attributed to turbulent flow |
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Term
|
Definition
Partial obsturction:
Valve stenosis, hypertrophic obstructive cardiomyopathy
Backward flow
Valve regurgitation, mitral leavlet prolapse
Dilated chamber
Shunting
Atrial and vent septal defect
patent ductus arteriosus
Increased cardiac output
Hyperthyroid
Anemia
Pregnancy
Fever |
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Term
|
Definition
Seen in athletes, Genetic
Types are obstructive/nonobstructive |
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Term
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Definition
| Blood being backed up into atria |
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Term
|
Definition
Timing(in cardiac cycle)
Location of maximal intensity
Radiation
Intensity
Pitch
Quality
Shape |
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Term
|
Definition
AS – radiates to right clavicle or neck
PS – radiates to left clavicle or neck
MR – radiates to left axilla or scapula
AR – radiates downward towards LLSB and apex |
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Term
|
Definition
Barely Audible
II Soft but audible
III Moderately loud
IV Loud, associated with a thrill
V Very loud with a thrill easily palpable
VI Very loud, audible without stethoscope on chest thrill is palpable and visible |
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Term
|
Definition
High
Best heard with the diaphragm
Regurgitant murmurs/VSD
Medium
Flow murmurs (AS, PS, HOCM)
Low
Flow murmurs (MS)
Best heard with the bell |
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Term
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Definition
Rumbling(TS,MS)
Harsh(AS)
Blowing(Regurgitant murmurs)
Musical(MVP)
Machinery(PDA)
Scratchy(rub) |
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Term
|
Definition
Normal direction of flow
AS, PS(stiff valve)
HOCM(outlet flow tract obstruction)
ASD, VSD(high pressure to low pressure)
MVP(flow against billowing MV)
Retrograde direction of flow
MR, TR(incompetent valve) |
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Term
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Definition
| Murmur produced by a turbulence across a semilunar valve during systole(AS, PS) |
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Term
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Definition
harsh-Medium pitch, heard best at R 2nd ICS
radiates to neck, may hear S4 gallop |
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Term
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Definition
Harsh-medium pitch, radiates to left shoulder and neck, left 2nd ICS
wide split S2 |
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Term
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Definition
Harsh-medium pitch, radiates to left shoulder and neck, left 2nd ICS
wide split S2 |
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Term
|
Definition
Harsh-medium pitch, heard at 3rd and 4th ICS-LSB,
Decareases intensity when you increase venous return
Increase when decrease venous return |
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Term
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Definition
Heard in mitral region
high pitched crescendo
may be preceded by systolic click
occurs in late systole
valsalva increases and squatting decreases intensity |
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Term
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Definition
Produced by retrograde flow from a higher pressure area to lower pressure area during systole(MR, TR)
They begin with S1 and end after S2 |
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Term
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Definition
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Term
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Definition
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Term
| Paradoxical splitting of S2 |
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Definition
Any condition delaying LV emptying (P2 occurs before A2)
Left Bundle Branch Block(LBBB)
Aortic Stenosis(AS) |
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Term
| Pathalogical splitting of S2 |
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Definition
A pathologic split occurs during expiration.
Wide Splitting
Paradoxical Splitting
Fixed Splitting |
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Term
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Definition
RV emptying takes longer (P2 occurs later)
Right Bundle Branch Block(RBBB)
Pulmonic Stenosis(PS)
LV emptying is shorter (A2 occurs earlier)
Mitral Regurgitation(MR)
Ventricular Septal Defect(VSD)
Patent Ductus Arteriosus(PDA) |
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Term
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Definition
Ausculatory hallmark of an atrial septal defect(ASD)
Split is wide and does not change with respiration
This is because left-to-right atrial shunt keeps volume in the RA constant during respiration |
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Term
| physiological splitting of S2 |
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Definition
With inspiration you increase blood return to the heart and the right ventricle(RV) enlarges
Blood takes longer to be ejected into the Pulmonary artery
The Pulmonic Valve stays open longer and P2 occurs later
Is called physiologic split of S2(A2+P2) |
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Term
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Definition
Continuous sound
Best heard above clavicle over jugular vein
Disappears with pressure over jugular vein
Humming – Low pitch |
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Term
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Definition
Continuous murmur – throughout systole and diastole
Harsh/Machinery-like
Best heard in Pulmonic region
May radiate to left clavicle
Loud - ± thrill |
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Term
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Definition
High pitched
Scratchy in quality
Best heard in LSB and apex
Patient leaning forward
3 separate components |
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Term
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Definition
Low pitched sound
Best heard with the bell with the patient in the left lateral decubitus position
Opening snap (OS) often follows S2 |
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Term
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Definition
Begin a finite time after S2 with the opening of the AV valves(MS, TS)
Decrescendo in shape
May begin w/ an opening snap
Low pitched
Best heard in left lateral decubitus position |
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Term
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Definition
Best heard in 2nd – 4th ICS LSB
“Blowing” quality – high pitch (diaphragm)
Radiates to the apex
Increases in intensity with the patient leaning forward
Austin Flint |
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