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103 Cards in this Set
- Front
- Back
Pericardium
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Covering of the heart
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3 layers of the pericardium
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1. Fibrous layer
2. Parietal layer of serous pericardium 3. Visceral layer of serous pericardium |
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Which pericardial layer is continuous with walls of great vessels
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Fibrous
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Pericardial cavity found between _____ layers of the pericardium
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Parietal layer of serous & visceral layer of serous pericardium
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_____ forms the outmost covering of the actual heart
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Visceral layer of serous pericardium
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Transverse sinus
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Potential space between serous pericardium & visceral pericardium
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Cardiac tamponade
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Excess fluid in pericardial space
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Causes of cardiac tamponade
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Blunt trauma
Malignancy Infection |
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Symptoms of cardiac tamponade
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Decreasing BP
Faint heart sounds Low voltage EKG PEA |
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PEA
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Pulseless electrical activity
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2 causes of PEA so far
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1. Cardiac tamponade
2. Tension pneumothorax |
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Treatment of cardiac tamponade
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Pericardiocentesis
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Layers of heart deep --> superficial
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Endocardium --> Myocardium --> Epicardium
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Epidcardium AKA
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Visceral layer of serous pericardium
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Endocardium becomes continuous with:
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Lining of great vessels
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Enlargement of right side of heart on x ray, ___ is the cause
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Right atrium
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Apex of heart formed by:
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Left ventricle
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Groove dividing atrium & ventricles
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Coronary groove
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Groove dividing ventricles
-- -- |
Interventricular groove
--Anterior --Posterior |
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Base of heart located near ___-
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Sternum
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Right atrium valves (3)
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IVC
Tricuspid Valve of coronary sinus |
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LA valves
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Mitral
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Blood route
1. Deoxygenated blood into ___ 2. 3. Valve 4. 5. Valve 6. 7. Oxygenated blood 8. 9. 10. Valve 11. 12. Valve 13. |
1. Vena Cava
2. Right atrium 3. Tricuspid valve 4. Right ventricle 5. Pulmonary valve 6. Pulmonary a. 7. Lungs 8. Pulmonary v. 9. Left atrium 10. Mitral valve 11. Left ventricle 12. Aortic valve 13. Aorta |
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Supply of Blood to periphery occurs during:
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Systole
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During systole, heart muscle cannot be supplied because
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It's at max contraction
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Blood supply to heart itself occurs during:
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Diastole
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how coronary a. gets blood
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Backflow of blood from aorta
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____ are the first branches of anterior aorta
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Right and left coronary
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Coronary means
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Crown
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Right coronary a. found between ____; on the _____ surface of the heart
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Anterior aorta & right atrium; anterior
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Right coronary a. descends in ____ towards:
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Coronary groove; inferior margin of the heart
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2 Branches of coronary a.
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1. Nodal a.
2. Right marginal a. |
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Nodal a. supplies; descend in:
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SA node; coronary groove
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Right marginal a. supplies
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Inferior surface of heart
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Left coronary a. location
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Posterior aorta
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2 branches of left coronary a.
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1. Circumflex
2. LAD - Left anterior descending |
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Circumflex travels in ____; continuous with
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Coronary sulcus; right marginal
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LAD descends towards ____ in _____ groove
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Apex (lateral); interventricular
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LAD continues to posterior heart in
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posterior interventricular groove
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Most commonly obstructed & sclerosed coronary a.
-Nickname |
LAD
-Widow maker |
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Left coronary a. dominant =
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-Circumflex comes down to form posterior interventricular
-LAD comes down to form posterior interventricular |
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Right coronary dominant
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Right coronary forming posterior interventricular
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Coronary dominance has implications in
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Infarction
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LAD can cause ___ infarctions (
1. 2. 3. --Most common |
1. Anterior
2. Septal 3. Lateral --Most common |
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Circumflex can cause ___ infarctions
1. 2. |
Anterior lateral
Posterior lateral |
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Artery determining coronary dominance
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Posterior interventricular
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Right coronary can cause ____ infarctions
1. 2. |
Posterior
Inferior |
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If blockage is high enough in right coronary can also cause ____, because of
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Disturbance of rhythym of SA or AV node; nodal a.
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Right marginal can cause ___ infarctions
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Inferior
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Right marginal can cause ___ infarctions
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Inferior
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Test allowing you to see which a. is blocked
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EKG
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How EKG allos you to seek which a. is block
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Allows you to see whether it's an anterior, septal, lateral, inferior, posterior or combo infarction
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Venous drainage of the heart muscle
1. 2. 3. |
Great cardiac
Middle cardiac Small cardiac |
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Great cardiac v. location
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Anterior interventricular sulcus; follows circumflex a. to posterior coronary sulcus
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Middle cardiac v. location
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Posterior interventricular sulcus
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Small cardiac v. location
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Inferior heart
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Coronary veins drain to:
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Coronary sinus
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Coronary sinus returns venous blood to:
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Right atrium
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2 portions of heart drained separately from the 3 cardiac v.
- - -Drained by |
Anterior surface of heart - RA & proximal RV
-Anterior cardiac v. |
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SA node location
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Base of superior vena cava, RA
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AV node location
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Opening of tricuspid valve RA
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Tissue type of nodes
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Not myocardial, but specialized
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Vein of the RA containing no valve
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SVC
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Fossa ovalis
-Location -Remnant of |
-Septa
-Fetal foramen ovalis |
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Foramen ovalis function
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Blood to RA --> LA (instead of RV --> Lungs)
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Patent foramen ovalis is dangerous with:
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Embolus (stroke)
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Rough muscles of RA wall
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Pectinate muscles
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Crista terminalis
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Transition from pectinate muscle to smooth
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Ear like appendage of each atrium
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Auricle
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Clinical relevance of auricle
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Clots can form here
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Protrusions of muscles in RV
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Papillary m.
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Papillary m. connected to cusp by:
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Cordae tendinae
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Papillary m. & cordae tendinae prevent:
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Cusp folding back into atrium during systole
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Rough muscles of RV
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Trabeculae carnae
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Moderater band
-AKA -Connects |
-Septomarginal trabeculae
-Anterior papillary m. to septum |
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Which ventricle is thicker
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Left
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Valves that have 3 cusps
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Pulmonary (2 valves)
Aortic |
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Valves contain ____ to fill the hole in the middle of the 3 cusps
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Nodules
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Fibrous skeleton function
1. 2. |
1. Provides structure for valves of heart
2. Divides Atria and ventral physically & electrically |
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Intrinsic automaticity
-SA - ____ BPM -AV |
60
40 |
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Heart rate is determined by influence of ____ to SA/AV nodes
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Sympathetic/parasympathetic input
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SA/AV Pathway is neither ____ or ___; descrived as "specialized pathway"
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Neural; myocardial
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Result of all heart cells connected by gap junction
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What happens to one will happen to another
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The intrinsic pacemaker of the heart
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SA node
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When AV is stimulated, it's pulse travels to ____ through ____
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Fibrous skeleton; Bundle of His
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Bundle of His divisions
1. 2 |
Right
Left |
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Right bundle branch location
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Moderator band
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Left bundle branch branches
1. 2. |
Anterior hemi
Posterior hemi |
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Electrical impulses from skeleton/bundle fibers released through:
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Perkinje fibers
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Junctional rhythm occurs when
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AV is pacemaker
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Heart block
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Delay in communication
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3rd degree heart block
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No communication between SA & AV
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If neither node is firing ____ takes over firing; ___BPM
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Ventricles; 20 BPM
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Ausculation of heart sounds produced by
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Closing of valves
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Valves closing at systole:
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Tricuspid & mitral
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Valves closing at diastole
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Pulmonary & aortic
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Best place to hear heart sounds:
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Along the axis of projection down the vessel
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Best place to hear aortic heart sounds ( & whether systole/diastole?)
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Right 2nd intercostal space next to sternum
-Diastole |
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Pulmonic heart sounds (systole/diastole?)
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Left 2nd intercostal
-Diastole |
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Tricuspid heart sounds (systole/diastole?)
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-Xiphoid
-Systole |
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Mitral heart sounds
(systole/diastole?) |
-5th intercostal space, midclavicular line
-Systole |
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Loudest valve heart sound
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Mitral
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Mitral heart sound location in male
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Inferolateral to nipple
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