Heart Sounds Flashcards

1
Q

What happens during S1?

A

MV and TV closure

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2
Q

Where is S1 the loudest?

A

Mitral area

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3
Q

What happens during S2?

A

AV and PV closure

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4
Q

Where is S2 the loudest?

A

Left sternal border

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5
Q

When is S3 heard?

A

In early diastole during rapid ventricular filling phase

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6
Q

What is S3 associated with?

A
  • Increased filling pressure (mitral regurgitation, CHF)
  • Dilated Ventricles
  • Normal in children and pregnant women
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7
Q

When is S4 heard?

A

Late diastole

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8
Q

Why do we hear S4?

A

High atrial pressure

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9
Q

What is S4 associated with?

A
  • Ventricular hyptertrophy

- LA must push against stiff LV wall

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10
Q

In normal splitting, you hear a ___ in intrathoracic P

A

decrease

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11
Q

In normal splitting, during inspiration you have _____ VR to the RV and _____ RV SV

A

Increase, increase

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12
Q

In normal splitting, during inspiration, you have a _____ RV ejection time leading to ____

A

Increased, delayed closure of PV

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13
Q

What also occurs during normal splitting that contributes to the delayed PV closure?

A

Decreased PV impedance

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14
Q

Wide splitting is seen in conditions that ______

A

Delay RV emptying

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15
Q

Examples of conditions in which wide splitting may occur

A
  • Pulmonic Stenosis

- RBBB

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16
Q

Fixed splitting is seen in

A

ASD

17
Q

Fixed splitting is seen in ____ that causes a _____ shunt, therefore _______ RA and RV volumes and ______ flow through pulmonary valve

A

ASD, L to R, Increase, Increase

18
Q

Paradoxical splitting is seen in conditions that….

A

delay LV emptying

19
Q

Examples of conditions in which paradoxical splitting is seen

A

Aortic Stenosis, LBBB

20
Q

What are the features of paradoxical splitting?

A
  • Normal order reversed so P2 before A2

- On inspiration, P2 closes later and moves closer to A2 causing it to paradoxically eliminate the split