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30 Cards in this Set
- Front
- Back
Which sound is closer to S2, mid-diastolic, low-pitched, described as a gallop, S3 or S4? |
S3 |
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S3 or S4: Which is closer to S1, late diastolic, higher pitch, described as a triple gallop? |
S4 |
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S3 or S4? Caused by decreased ventricular compliance, like in aortic stenosis, mitral regurgitation, HTN, angina, MI, and old age |
S4 |
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S3 or S4? Can be caused physiologically by rapid filling during diastole such as what happens in increased cardiac output (thyrotoxicosis, pregnancy, pediatric) |
S3 |
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What are some causes of a pathological S3? (causes of decreased compliance of the ventricle) |
Ventricular failure or dilation, aortic regurgitation, mitral regurg, patent ductus arteriosus, ventricular septal defect, constrictive pericarditis |
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T/F a physiological murmur is heard when there is an increased turbulence of blood flow across an abnormal valve. |
False: A physiological murmur is heard when there is an increased turbulence of blood flow across an normal valve. A pathologic murmur occurs when there is turbulence across an abnormal valve due to stenosis or regurgitation. |
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Which group of murmurs have their highest intensity in the middle of systole, have a crescendo-decrescendo quality? |
midsystolic ejection murmurs |
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Which group of murmurs occur when there is a gap between S1 and the murmur and can be caused by MR as in the case of papillary muscle dysfunction or MVP? |
Late systolic murmurs |
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These murmurs extend from S1 to S2, pitch and loudness stay the same, caused by leakage from a high-pressure chamger to low, causes include MR, TR and ventricular septal defect |
Pansystolic murmurs |
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These murmurs are always pathological, are softer and more difficult to hear than their counterpart |
Diastolic murmurs |
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These murmurs start with S2 and are a decrescendo murmur, loudest at its commencement, producing a high-pitched sound. Causes include AR or PR. |
Early diastolic murmurs |
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These murmurs occur in the later phase of diastole, they are lower in pitch, can be caused by MS or TS or atrial myoma (rare). |
mid-diastolic murmur |
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These murmurs occur during both systole and diastole without pause. Causes include patent ductus arteriosus, atrteriovenous fistula, and venous hum. |
Continuous murmurs |
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Which murmur grade is the quietest accompanied by a thrill? Pathological or not? |
4, pathological |
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Which murmur grade is so loud that it is audible even without direct placement of the stethoscope to the chest? |
6 |
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T/F A mid-systolic murmur in an asymptomatic individual is most likely physiological. |
True |
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T/F the intensity of the murmur doesn't always correlate to the severity of the lesion |
True (small lesions can be loud) |
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T/F Murmurs of grade 2 and above are usually pathological |
False (grade 3 and above) |
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Palpation of the pulse while listening to the heart can help discern S1 from S2: T/F The pulse indicates diastole, therefore corresponding to the 2nd heart sound |
False: The pulse indicates systole, therefore corresponding to the 1st heart sound |
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Which area do you want to listen to with both the bell and diaphragm of the stethoscope and why? |
Mitral area because low-pitched sounds like MS and S3 can be heard better with the bell while |
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Inspiration cause right or left sided murmurs to accentuate |
right-sided |
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Expiration cause right or left sided murmurs to accentuate |
Left-sided |
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Auscultating during deep expiration with the patient leaning forward will accentuate what murmur |
aortic regurgitation |
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The valsalva maneuver will accentuate these murmurs |
hypertrophic cardiomyopathy and MVP when listening over the left sternal edge |
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Squatting increases venous return which will make which murmurs louder |
those associated with AS and MR |
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Squatting makes these murmurs softer |
hypertrophic cardiomyopathy and MVP |
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MR PASS MVP means |
mitral regurgitation physiologic aortic stenosis systolic Mitral valve prolapse |
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MS ARD means |
Mitral stenosis Aortic regurgitation Diastolic |
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A person with clinical significant aortic stenosis can be SAD (symptoms of AS are...) |
syncope, angina, dyspnea |
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When assessing JVD, the IJV and carotid both pulsate. If you note the pulsation of the radial pulse matches one of these vessel's pulsation, then you have found which? |
the carotid artery |