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18 Cards in this Set

  • Front
  • Back
What does a diminished S1 mean?
-First-degree heart block
-Mitral regurgitation
-Reduced LV contractility in CHF or CHD
What does an accentuated S1 mean?
-Tachycardia
-Rhythms w/ short PR intervals
-High CO states
-Mitral stenosis
What does an accentuated S2 mean?
A2-HTN or dilated aortic root
P2-Pulmonary HTN or dilated pulmonary A
What does a diminished S2 mean?
A2-Calcified aortic stenosis
P2-Increased anteroposterior diameter of the chest ass'd w/ aging or pulmonic stenosis
Wide splitting of S2
Increase in the usual splitting that persists throughout the respiratory cycle; caused by:
-Pulmonic stenosis
-R BBB
-Mitral regurgitation
Fixed splitting of S2
Wide splitting that does not vary w/ respiration; causes:
-Atrial septal defect
-RVF
Mitral regurgitation
Holosystolic
Where: Apex
Radiates: L axilla, LSB
Pitch: med to high
Quality: Harsh
Aids: Not louder with inspiration
Tricuspid regurgitation
Where: Lower LSB
Radiates: RSB, xiphoid, LMCL
Holosystolic
Pitch: med
Quality: Blowing
Aids: Increased intensity w/ inspiration
Innocent murmur
Midsystolic
Where: 2nd to 4th ICS & apex
Radiates: little
Pitch: soft to med
Quality: variable
Aids: Decreases w/ sitting
Aortic stenosis
Midsystolic
Where: R 2nd ICS
Radiates: carotids, LSB, & apex
Intensity: loud w/ thrill
Pitch: med to harsh w/ crescedo-decrescendo
Quality: Harsh
Aids: Increased w/ pt sitting up & leaning forward
Pulmonic stenosis
Midsystolic
Where: 2nd & 3rd ICS
Radiates: L shoulder & neck
Pitch: med, crescendo-decrescendo
Quality: Harsh
Aortic regurgitation
Diastolic
Where: 2nd to 4th ICS
Radiates: apex, RSB
Intensity: grade 1 to 3
Pitch: High
Quality: Blowing decrescendo
Aids: Increased w/ pt sitting, leaning forward w/ breath held
Mitral stenosis
Diastolic
Where: Apex
Radiates: little
Pitch: Low
Quality: Rumble
Aids: Increased in LLDP w/ exhalation
Pericardial friction rub
Occurs in 3 components:
-Atrial systole
-Ventricular systole
-Ventricular diastole
Where: 3rd ICS
Pitch: High
Quality: Scratchy, scraping
Aids: increased w/ pt sitting, leaning forward w/ breath held
Diaphragm is better for....
-S1 & S2
-Pericardial friction rub
-Aortic and mitral regurgitation -Midsystolic click
-Ejection click
-Opening snap
Bell is better for....
-S3 & S4
-Mitral stenosis
LLDB for....
-Mitral stenosis
-S3 & S4
Sitting up & leaning forward for....
-Aortic murmurs