Ab/thorax Final

Front 1

what is the period of ventricular contraction?

Back 1

systole

Front 2

what valve is open during systole?

Back 2

aortic

Front 3

normally, maximal left ______ pressure corresponds to systolic pressure .

Back 3

ventricular

Front 4

during systole, what valve is closed, preventing blood from regurgitating back into the atrium?

Back 4

mitral (bicuspid)

Front 5

what produces the first heart sound (S1)?

Back 5

closure of the mitral valve

Front 6

when does the mitral valve close?

Back 6

when the left ventricle starts to contract and ventricular pressure rapidly exceeds left atrial pressure

Front 7

what is the period of ventricular relaxation?

Back 7

diastole

Front 8

what valve is closed during diastole?

Back 8

aortic & pulmonic

Front 9

why is the aortic valve closed during diastole?

Back 9

to prevent regurgitation of blood from the aorta back into the L ventricle

Front 10

when does the aortic valve shut?

Back 10

when L ventricular pressure drops below aortic pressure

Front 11

what produces the second heart sound (S2)?

Back 11

the aortic valve closure

Front 12

what valve is open during diastole?

Back 12

mitral and tricuspid

Front 13

what term is used to describe an audible opening as a snap sound during when the mitral valve opens?

Back 13

mitral stenosis

Front 14

when might you hear a third heart sound (S3) after a mitral valve opens?

Back 14

it may arise in children and young adults from rapid decelleration of the column of blood agaist the ventricular wall

Front 15

although not often heard in adults, a fourth heart sound (S4) marks

Back 15

atrial contraction

Front 16

when is a fourth heart sound heard?

Back 16

immediately preceding S1 of the next beat

Front 17

what valves open during systole

Back 17

Aortic & pulmonic

Front 18

what valves open during diastole

Back 18

mitral & tricuspid

Front 19

what is an S3 sound due to if present?

Back 19

rapid ventricular filling

Front 20

what is an S4 sound due to?

Back 20

atrial contraction "top off"

Front 21

what ICS do you hear aortic valve sound @?

Back 21

2nd ICS on R

Front 22

what ICS do you hear pulmonic valve sound @?

Back 22

2nd ICS on L

Front 23

what ICS do you hear erb's point?

Back 23

3rd ICS on L

Front 24

what ICS do you hear tricuspid valve sounds?

Back 24

4th and 5th ICS on L

Front 25

what ICS do you hear mitral valve sound?

Back 25

5th ICS @ midclavicular

Front 26

how does one distinguish a heart murmer from a heart sound?

Back 26

by their longer duration

Front 27

what are heart murmurs attributed to?

Back 27

turbulent blood flow

Front 28

what can turbulence of blood flow be due to?

Back 28

1)valve is open and narrow- stenotic
2)valve should be shut and leaks- regurgitation

Front 29

a defective mitral valve that leaks when it is shut will create a sound on S1

Back 29

true

Front 30

if a person has aortic or pulmonic stenosis and squeeze occurs, and it is supposed to be open, you will hear a funny sound on ____?

Back 30

S1

Front 31

if A/P valve is supposed to be shut and has a backward leak you get a murmur on...

Back 31

S2

Front 32

when is aortic regurgitation heard?

Back 32

on S2

Front 33

M & T valves are supposed to be opened on S2, so if stenosis is there it will create a murmur on S2

Back 33

T

Front 34

what is a murmur in a blood vessel called?

Back 34

a bruit

Front 35

what is a bruit?

Back 35

turbulence in a blood vessel

Front 36

where you hear a murmur the loudest is indicative of where the problem is

Back 36

T

Front 37

aortic stenosis occurs when?

Back 37

S1, systolic

Front 38

aortic regurgitation occurs during

Back 38

s2, diastolic

Front 39

pulmonic stenosis during

Back 39

S1

Front 40

pulmonic regurgitation

Back 40

S2

Front 41

mitral stenosis

Back 41

S2

Front 42

mitral regurgitation

Back 42

S1

Front 43

what part of the stethoscope do you use for the mitral maneuver?

Back 43

bell

Front 44

why place pt. on side during the mitral maneuver?

Back 44

this brings out left sided S3 and S4 and mitral murmur (esp. stenosis)

Front 45

during the mitral maneuver, pt breathes in & out

Back 45

T

Front 46

during aortic maneuver, pt. breathes in & out

Back 46

F, exhale & hold

Front 47

use bell for aortic maneuver

Back 47

F, diaphragm

Front 48

with aortic maneuver, auscultate APETTM areas

Back 48

F, don't do A

Front 49

what is the purpose of the aortic maneuver?

Back 49

it brings out aortic murmurs

Front 50

when would you hear a systolic murmur?

Back 50

b/n S1 and S2

Front 51

when would you hear a diastolic murmur?

Back 51

b/n S2 and S1

Front 52

when does a midsystolic murmur start?

Back 52

after S1

Front 53

when does a midsystolic murmur stop?

Back 53

before s2

Front 54

when does a pansystolic murmur start?

Back 54

w/S1

Front 55

when does a pansystolic murmur stop?

Back 55

@ s2

Front 56

when does a late systolic murmur start?

Back 56

in mid-late systole

Front 57

when does a late systolic murmur stop?

Back 57

persists up to S2

Front 58

when does an early diastolic murmur start?

Back 58

right after S2 w/o a gap

Front 59

when does an early diastolic murmur stop?

Back 59

usually fades into silence before the next S1

Front 60

when does a middiastolic murmur stop?

Back 60

may fade away or merge into a late diastolic murmur

Front 61

when does a late diastolic murmur start?

Back 61

late in diastole

Front 62

when are thrills usually felt?

Back 62

in murmurs 4 through 6

Front 63

what are the 2 components of the 2nd heart sound?

Back 63

A2 and P2

Front 64

during what stage of breathing do A2 and P2 separate slightly and S2 splits into its 2 audible components?

Back 64

inspiration

Front 65

in split heart sounds, what is delayed?

Back 65

P2

Front 66

in split heart sounds, what comes slightly earlier?

Back 66

A2

Front 67

what split heart sound is louder?

Back 67

A2

Front 68

split heart sounds are also heard in S1

Back 68

T

Front 69

what S1 split heart sound is normally louder?

Back 69

mitral

Front 70

what S1 split sound is softer?

Back 70

tricuspid

Front 71

splitting of the first heart sound varies with respiration

Back 71

F, it does not vary

Front 72

a split S2 on inspiration and disappears on expiration is OK

Back 72

T

Front 73

any split S2 sound that doesn't disappear is a problemo

Back 73

T (split sounds on expiration are pathological)

Front 74

any split S1 is a problem

Back 74

T

Front 75

normally, a notch in the pulse is NOT palpable

Back 75

T

Front 76

name 3 things that cause a small, weak pulse

Back 76

shock
hypovolemia
severe aortic stenosis

Front 77

what is the aka for a lg. boundary pulse?

Back 77

waterhammer

Front 78

what 4 things can cause a lg. boundary pulse?

Back 78

fever
anemia
hyperthyroidism
aortic regurgitation

Front 79

what causes a bisferen's pulse?

Back 79

combined aortic regurgiatation and stenosis.

Front 80

what is pulses alternans indicative of?

Back 80

L ventricular failure