Lec 6 Auscultation and Heart Sounds Flashcards Preview

[OS 213] CVS Trans Cluster 1 > Lec 6 Auscultation and Heart Sounds > Flashcards

Flashcards in Lec 6 Auscultation and Heart Sounds Deck (24)
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1
Q

What does the P wave signify?

A

atrial depolarization

2
Q

When does atrial contraction normally occur?

A

last third of diastole

3
Q

What does the QRS complex signify?

A

ventricular depolarization

4
Q

Which is relatively louder in males and females, S1 or S2?

A

in females: S1>S2

in males: S2>S1

5
Q

What is the significance of the length of PR interval?

A

determines softness of loudness:
long PR interval- soft sound
short PR interval- loud sound

6
Q

What does an abnormally loud S1 indicate?

A

early rheumatic mitral stenosis, hyperkinetic states

7
Q

What does an abnormally soft S1 indicate?

A

late mitral stenosis, contractile dysfunction, beta-adrenergic receptor blockade

8
Q

When does physiologic splitting occur?

A

during inspiration

9
Q

What are the possible causes of wide splitting between S1 and S2

A

right bundle branch block, severe pulmonary hypertension, pulmonic stenosis

10
Q

What are the possible causes of a delay in A2 (paradoxical splitting)

A

left bundle branch block, aortic stenosis, left ventricular dysfunction, left hypertrophic cardiomyopathy

11
Q

What heart condition causes a fixed/persistent splitting upon auscultation?

A

ASD

12
Q

What heart condition causes an ejection sound to be heard upon auscultation?

A

bicuspid semilunar valves, stenotic semilunar valve

13
Q

factors that decrease LV volume

A

standing, amyl nitrate

14
Q

factors that increase LV volume

A

squatting, phenylephrine

15
Q

What causes an opening snap to be heard?

A

stenosed AV valve (usually mitral)

16
Q

Where is an opening snap sound best heard?

A

slightly medial to cardiac apex

17
Q

How is the A2-OS interval related to the severity of stenosis?

A

A2-OS interval is inversely proportional to the severity of stenosis

18
Q

How can OS be differentiated from split S2?

A
  1. OS does not vary with respiration

2. Split S2 is normally confined to 2nd ICS while OS radiates to a larger area over the left sternal border

19
Q

What is the significance of a pericardial knock?

A

abrupt cessation of ventricular expansion after tricuspid valve opening (corresponds to an exaggerated y descent in JVP)

20
Q

Which heart sounds are part of the so-called gallop rhythm?

A

S1, S2, and possibly S3 and/or S4

21
Q

What is the significance of a S3 sound?

A

abrupt cessation of ventricular distention; oscillation of blood between the ventricular walls

22
Q

What is the cut-off age for determining whether a S3 sound is physiologic or pathologic?

A

40

23
Q

What is the significance of a S4 sound?

A

turbulence in blood flow in the ventricle due to forceful atrial contraction (indicates a ventricular compliance problem)

24
Q

In what position is the S4 sound best heard?

A

cardiac apex on left lateral decubitus position