Heart Sounds Ict-134 Unit 4

Front 1

In terms of Wigger's Diagram, S1 occurs during:

Back 1

isovolumic contraction

Front 2

In terms of Wigger's Diagram, S2 occurs during:

Back 2

isovolumic relaxation

Front 3

S1 is produced by the closing of which two valves?

Back 3

Mitral & Tricuspid

Front 4

S2 is produced by the closing of which two valves?

Back 4

Aortic & Pulmonic

Front 5

Which heart sounds occur during ventricular systole?

Back 5

S1

Front 6

Which heart sounds occur during ventricular diastole?

Back 6

S2, S3, S4

Front 7

Which heart sounds occur during atrial systole?

Back 7

S4

Front 8

Which heart sounds occur during rapid ventricular filling?

Back 8

S3

Front 9

Which heart murmurs are diastolic murmurs?

Back 9

AR
PR
MS
TS
PDA
Austin-Flint

Front 10

Which heart murmurs are systolic murmurs?

Back 10

AS
PS
ASD
HOCM
MR
TR
VSD
MVP

Front 11

Name the four mid-systolic murmurs.

Back 11

AS
PS
ASD
HOCM

Front 12

Name the three Holosystolic murmurs.

Back 12

MR
TR
VSD

Front 13

Name the late systolic murmur.

Back 13

MVP

Front 14

Name the early diastolic murmurs.

Back 14

AR
PR
Austin-Flint

Front 15

Name the mid-late diastolic murmurs.

Back 15

MS
TS

Front 16

The mnemonic for sites of auscultation APTM:

Back 16

All Physicians Take Money

Front 17

Location of the Aortic Area for auscultation.

Back 17

2nd RICS

Front 18

Location of the Pulmonic Area for auscultation.

Back 18

2nd LICS

Front 19

Location for the Tricuspid Area for auscultation.

Back 19

Lower Left Sternal Border

Front 20

Location for the Mitral Area for auscultation.

Back 20

Cardiac apex

Front 21

Which part of the stethescope is used to detect high-pitched sounds such as S1 & S2?

Back 21

diaphragm

Front 22

Which part of the stethoscope is used to detect low-pitched sounds?

Back 22

bell

Front 23

What is the best position for the patient for auscultation of the heart sounds?

Back 23

Supine 45 degrees

Front 24

What is the best position for the patient for auscultation of the mitral area?

Back 24

left lateral position

Front 25

Which grades of heart murmur is a loud murmur associated with a thrill?

Back 25

IV, V, VI

Front 26

A dilated ventricle is associated with which heart sound?

Back 26

S3

Front 27

A stiff ventricle is associated with which heart sound?

Back 27

S4

Front 28

What two sounds is S1 composed of?

Back 28

M1 & T1

Front 29

M1 is best heard at the:

Back 29

apex (may be heard at all sites)

Front 30

T1 is best heard at the:

Back 30

LLSB

Front 31

A split S1 occurs when the MV closes significantly before/after the TCV.

Back 31

before

Front 32

Inspiration delays the closing of which valve in a normal person?

Back 32

TV due to increased venous return.

Front 33

Which type of bundle branch block is often associated with a split in S1?

Back 33

Right BBB

Front 34

What two sounds is S2 composed of?

Back 34

A2 & P2

Front 35

A2 & M1 are normally louder than P2 & T2 because:

Back 35

Left sided pressures are higher.

Front 36

A2 is loudest at which auscultation site?

Back 36

RUSB

Front 37

P2 is only heard at which auscultation site?

Back 37

LUSB

Front 38

A normal physiologic split of S2 occurs during:

Back 38

inhalation

Front 39

The physiologic split of S2 during inhalation is due to increased:

Back 39

venous return

Front 40

Increased venous return keeps which valve open longer thus increasing the split of S2.

Back 40

Pulmonic

Front 41

A paradoxical split of S2 occurs when splitting is heard during:

Back 41

exhalation

Front 42

A paradoxical split of S2 occurs when the aortic valve closure is delayed as during which cardiac defects?

Back 42

Severe AS
HOCM
LBBB

Front 43

A widened S2 split occurs when both A2 & P2 are heard during the entire respiratory cycle although the splitting is greater during:

Back 43

inhalation

Front 44

A fixed S2 split occurs when there is always a delay in closure of which valve and there is no change with inhalation or exhalation.

Back 44

Pulmonic valve

Front 45

S3 should disappear when which part of the stethescope is used for auscultation?

Back 45

diaphragm

Front 46

A split S2 is best heard at which auscultation site?

Back 46

LUSB

Front 47

What is the best position for the patient to be in for auscultation of S3?

Back 47

left lateral decubitus position

Front 48

S3 can be an important sign of:

Back 48

systolic heart failure

Front 49

S3 is called which type of gallop?

Back 49

ventricular

Front 50

S3 occurs during which phase of the cardiac cycle?

Back 50

early diastole

Front 51

S3 occurs during which type of ventricular filling?

Back 51

passive

Front 52

True/False: S3 can be present in athletes, pregnant females and other young healthy individuals.

Back 52

True

Front 53

S3 requires a very compliant/non-compliant left ventricle.

Back 53

compliant

Front 54

Regarding pitch, S3 is low/high while S2 is low/high.

Back 54

low
high

Front 55

S4 is best heard at the:

Back 55

cardiac apex

Front 56

S4 is best heard with the patient in which position?

Back 56

left lateral decubitus position

Front 57

S4 requires a very compliant/non-compliant left ventricle.

Back 57

non-compliant

Front 58

S4 is known as which type of gallop?

Back 58

atrial

Front 59

S4 occurs during which phase of the cardiac cycle?

Back 59

late diastole

Front 60

S4 occurs during active/passive ventricular filling.

Back 60

active

Front 61

S4 can be a sign of diastolic/systolic CHF.

Back 61

diastolic

Front 62

S3 can be a sign of diastolic/systolic heart failure.

Back 62

systolic

Front 63

This sound frequently indicates a bicuspid aortic valve.

Back 63

systolic ejection click

Front 64

This sound is mid-systolic and is usually followed by a uniform, high-pitched murmur.

Back 64

MV Prolapse click

Front 65

This sound caused by increased left atrial opening pressure is present in mitral stenosis.

Back 65

Opening snap

Front 66

This sound is an early diastolic low-pitched sound just after the S2 and may be followed by a low-pitched diastolic murmur.

Back 66

Tumor Plop

Front 67

This sound can be present with constrictive pericarditis because early filling of the LV is limited. This sound occurs earlier than the S3 which distinguishes it.

Back 67

Pericardial knock

Front 68

What are the six distinguishing characteristics of murmur? SCRIPT

Back 68

Site (location)
Configuration (shape)
Radiation
Intensity
Pitch
Timing (systolic or diastolic)

Front 69

Draw an Aortic Stenosis murmur.
-systolic
-crescendo/decrescendo
-ejection click after S1 if calcified bicuspid aortic valve.
-best heard RUSB

Back 69

Front 70

Draw an Aortic Insufficiency (regurgitation) murmur.
-diastolic
-decrescendo
-best heard LLSB

Back 70

Front 71

Draw a Pulmonic Stenosis murmur.
-systolic
-crescendo-decrescendo
-ejection click
-best heard LUSB

Back 71

Front 72

Draw Pulmonic Insufficiency (regurgitation) murmur.
-diastolic
-decrescendo
-best heard LLSB

Back 72

Front 73

Draw a Mitral Stenosis murmur.
-diastolic
-decrescendo
-best heard cardiac apex in left lateral decubitus
-opening snap

Back 73

Front 74

Draw a Mitral Insufficiency (regurgitation) murmur.
-holosystolic
-best heard cardiac apex
-systolic click if MVP

Back 74

Front 75

Draw a Tricuspid Insufficiency (regurgitation) murmur.
-holosystolic
-best heard LLSB
-increase with inspiration

Back 75

Front 76

Draw an ASD (atrial septal defect) murmur.
-systolic
-crescendo-decrescendo
-best heard RUSB
-fixed split S2

Back 76

Front 77

Draw a VSD (ventricular spetal defect) murmur.
-holosystolic
-best heard LLSB
-palpable thrill

Back 77

Front 78

Draw a PDA (patent ductus arteriosus) murmur.
-continuous

Back 78

Front 79

Draw an S3 heart sound.

Back 79

Front 80

Draw an S4 heart sound.

Back 80

Front 81

Draw a HOCM (hypertrophic obstructive cardiomyopathy) murmur.
-systolic
-crescendo/decrescendo
-best heard LLSB
-Valsalva and squat/stand to increase intensity

Back 81

Front 82

True/False: An S4 can be present during atrial fibrillation.

Back 82

False
Atrial kick is required for S4 to occur.

Front 83

True/False: An S4 is always pathologic and indicates diastolic heart failure.

Back 83

True

Front 84

True/False: S3 can indicate severe diastolic heart failure.

Back 84

False
S3 can be normal or indicate systolic heart failure.

Front 85

True/False: A wide split S2 can be from an ASD.

Back 85

False
A fixed split S2 can be from an ASD.

Front 86

True/False: A paradoxical S2 split can be caused by AS, HOCM or RBBB.

Back 86

False
A paradoxical S2 split can be caused by AS, HOCM, or LBBB

Front 87

True/False: A wide S2 split can be caused by severe MR, PS, or RBBB.

Back 87

True

Front 88

True/False: A holosystolic murmur at the left lower sternal border louder with inspiration is due to tricuspid regurgitation

Back 88

True

Front 89

True/False: The best position to hear the murmur of aortic regurgitation is to have the patient lean forward and listen after a forced, held expiration.

Back 89

True

Front 90

True/False: The Austin-Flint murmur is a systolic rumble at the cardiac apex in a patient with aortic regurgitation

Back 90

False
The Austin-Flint murmur is a diastolic rumble at the cardiac apex in a patient with aortic regurgitation

Front 91

True/False: The murmur of mitral regurgitation decreases with handgrip and transient arterial occlusion since these maneuvers increase afterload.

Back 91

False
The murmur of mitral regurgitation increases with handgrip and transient arterial occlusion since these maneuvers increase afterload.