Topic 26 - Auscultation of the heart, the characteristics and changes of the heart sounds.

Question 1

Method of examination of the heart:

Answer 1

Inspection
Palpation
Percussion
Auscultation

Question 2

Proper technique to auscultate the heart:

Answer 2

silent surroundings, phonendoscope, systematic examination

Question 3

In normal cases, how many heart sounds can we hear?

Answer 3

4
In small animals, we usually hear only 2 first

Question 4

What is the 1st heart sound?

Answer 4

Start of systole =Ventricular contraction

Semilunar valves open
Perparation of atrioventricular to close

Question 5

What is the 2nd heart sound?

Answer 5

End of systole = Change of blood flow direction

The semilunar valves closes

Question 6

What is the 3rd heart sound?

Answer 6

Start of diastole = relaxation
Termination of rapid ventricular filling

Question 7

What is the 4th heart sound?

Answer 7

End of diastole
Atrial contraction and sudden arrest

Question 8

What is diastole and systole?

Answer 8

Diastole = ventricular filling (working)

Systole = ventricular contraction (relaxing)

Question 9

Name the different valves if the heart:

Answer 9

mitral valve, tricuspid valve, aortic valve, pulmonary valve

Question 10

Which heart valves can you hear on the right side?

Answer 10

tricuspid valve

Question 11

Which location can we hear the tricuspid valve?

Answer 11

3rd to 4th intercostal space at costochondral junction

Question 12

Which heart valves can you hear on the left side?

Answer 12

Mitral valve
Aortic valve
Pulmonary valve

Question 13

Which location can we hear the mitral valve?

Answer 13

5th intercostal space around costochondral junction

Question 14

Which location can we hear the aortic valve?

Answer 14

4th intercostal space dorsal to mitral valve

Question 15

Which location can we hear the pulmonary valve?

Answer 15

3rd intercostal space at sternal border

Question 16

What do we use to describe alterations of the cardiac sounds?

Answer 16

FRIDA

Question 17

What does FRIDA stand for?

Answer 17

Frequency
Rhythm
Insensitivity
Demarcation
Adventitious sounds

Question 18

Normal heart frequency in dogs and cats

Answer 18

Frequency = heart rate

Dog: 60-100
Cat: 120-180

Question 19

Abnormal frequency of the heart:

Answer 19

Pulse deficit = always pathological

Normal to have elevation if the animal es excited or nervous

Question 20

Normal heart rhythm:

Answer 20

Regular - Always same frequency

Question 21

Abnormal changes of the heart rhythm:

Answer 21

1. Respiratory arrhythmia
2. Arrhythmia

Question 22

What is respiratory arrhythmia?

Answer 22

Slower rhythm during expiration

Question 23

What is arrhythmia?

Answer 23

pathological rhythm, often with pulse deficit

Question 24

Normal intensity of the cardiac sounds

Answer 24

Strong and even

Question 25

Abnormal intensity of the cardiac sounds:

Answer 25

Pounding beat
Reduced heart sounds

Question 26

What is pounding heart beat?

Answer 26

increasing of the first and/or second sound

Question 27

What is reduced heart sounds?

Answer 27

decreased cardiac output

Can be: pleural effusion

Question 28

Normal demarcation of the cardiac sounds:

Answer 28

Demarcation = distinctness

Horse: LUB-LUB-DUP-DUP
Other species: 1st and 2nd heart sound

Question 29

Abnormal demarcation of the cardiac sounds:

Answer 29

1. Cardiomyopathy: have galopp sounds
2. Splitting of the heart sounds

Question 30

How come we can hear a splitting of the heart sounds?

Answer 30

e.g. the 2nd heart sound - closure of the aortic and pulmonary valves in different times, due to cor pulmonale causing increased pulmonary arterial pressure.

Question 31

Name adventitious sounds:

Answer 31

Endocardial murmur
Extracardiac murmur