Heart - Lecture

Question 1

heart sound created by disruption of blood flow when the aortic and pulmonic valves close

Answer 1

S2, the second heart sound
ventricular pressure is lower than aortic pressure, pulmonic and aortic valves close, reverses blood flow, sound is heard

Question 2

heart sound produced by vibrations or turbulence created when the mitral and tricuspid valves close and disrupt the laminar flow of blood.

Answer 2

S1, the first heart sound

left ventricle contracts, blood flow reverses, mitral valves closes

Question 3

heart sound created by turbulent blood flow in a ventricle as the atrium contracts to eject any remaining blood during late diastole. occurs when diminished ventricular compliance increases the resistance to ventricular filling

Answer 3

S4, the fourth heart sound

Question 4

heart sound created when blood flows passively from atria to ventricle. in young people or physically fit individuals, presence of this heart sound is common. in elders or in persons with cardiac disease, this sound is usually pathologic

Answer 4

S3, the third heart sound

Question 5

period when the ventricles relax

Answer 5

diastole

Question 6

period when the ventricles contract

Answer 6

systole

Question 7

What happens to the pressure of the chest when you take a deep breath?

Answer 7

pressure drops, which delays closure of pulmonic valve. This is physiological splitting of S2 occurs

Question 8

What are some chief complaints related to the heart?

Answer 8

1) chest pain
2) palpitations
3) shortness of breath
4) ankle swelling

Question 9

What questions should be asked when their chief complaint is chest pain?

Answer 9

same whenever you take a history: OPPPQQRRSSTT and associated symptoms

Question 10

What PROS questions should be asked related to the heart?

Answer 10

1) General - fatigue, fever
2) HEENT - usually negative
3) Respiratory - cough, sputum, blood, pillows, orthopnea, paroxysmal nocturnal dyspnea
4) GI - heart burn, related to food, epigastric pain, history, waterbrash
5) rash, trauma, psychiatric

Question 11

How many of THECHADS can present as chest pain?

Answer 11

7 out of 8

Question 12

What is the most common cause of sudden death in younger individuals (related to the heart)? What is a close second?

Answer 12

1) asymmetric hypertrophic cardiomyopathy

2) arrhythmia

Question 13

Which part of the stethoscope do you use to listen to S1 and S2 sounds?

Answer 13

diaphragm (high-pitched)

Question 14

Which part of the stethoscope do you use to listen to S3 and S4 sounds?

Answer 14

bell (low-pitched)

Question 15

diastolic event that is the sound of the opening of a pathologically deformed mitral valve commonly heard in cases of mitral valve stenosis. this sound is hear very briefly in early diastole, before an S3 is heard. it is a high-pitched, sharp snap or click sound, not affected by respiration, and easily confused with S2

Answer 15

opening snap

Question 16

heard in early systole, high-pitched, often radiates up into carotids, and is not affected by respiration

Answer 16

aortic ejection sound

Question 17

heard in early systole, less intense than aortic ejection sounds, intensifies on expiration and decreases on inspiration

Answer 17

pulmonic ejection sound

Question 18

intense, grating sound that may be loud enough to mimic a murmur. best heard at the apex. may be heard in both systole and diastole

Answer 18

pericardial friction rub

Question 19

commonly associated with a midsystolic click over the mitral area and a soft mid to late systolic murmur. at times referred to as the “click-murmur” syndrome

Answer 19

mitral valve prolapse

Question 20

The jugular venous pulse is 5cm above the sternal angle with the head of bed elevated to 50 degrees. carotid upstrokes are brisk; a bruit is heard over the left carotid artery. PMI is diffuse, at the anterior axillary line and is the 6th intercostal interspace. S1 and S2 are soft. S3 present at the apex. high-pitched harsh 2/6 holosystolic murmur best heard at the apex with radiation to the axilla. no S4 or extra heart sounds. What is the diagnosis?

Answer 20

Congestive heart failure

Question 21

The jugular venous pulse is less than 3 cm above the sternal angle with the head of the bed elevated to 45 degrees. carotid upstrokes are brisk, without bruits. PMI is tapping at the mid-clavicular line in the 5th intercostal interspace. crisp S1 and S2. at the base, S2 is greater than S1 and physiologically split, with A2 greater than P2. at the apex, S1 is greater than S2 and constant. No murmurs, S3, S4, or extra heart sounds. What is the diagnosis?

Answer 21

normal