Cardiac cycle

Question 1

What is associated with S4 heart sound?

Answer 1

End of atrial emptying, after atrial contraction

Question 2

What is associated with S1 heart sound?

Answer 2

Closing of AV valves

Question 3

What is associated with S2 heart sound?

Answer 3

Semilunar valves close

Question 4

What is the cause of the physiological split of S2?

Answer 4

Aortic valve closes earlier than pulmonary valve

Question 5

What is associated with S3 heart sound?

Answer 5

Filling of ventricles –> increased turbulence

Question 6

What is the normal pressure range of the R atrium?

Answer 6

2-8 mmHg

Question 7

What are the normal pressure ranges of the R ventricle?

Answer 7

Systolic: 15-30 mmHg
Diastolic: 2-8 mmHg

Question 8

What are the normal pressure ranges of the pulmonary arteries?

Answer 8

Systolic: 15-30 mmHg
Diastolic: 4-12 mmHg

Question 9

What is the normal pressure range of the pulmonary capillaries?

Answer 9

2-10 mmHg

Question 10

What is the normal pressure range of the L atrium?

Answer 10

2-10 mmHg

Question 11

What are the normal pressure ranges of the L ventricle?

Answer 11

Systolic: 100-140 mmHg
Diastolic: 3-12 mmHg

Question 12

What are the normal pressure ranges of the aorta?

Answer 12

Systolic: 100-140 mmHg
Diastolic: 60-90 mmHg

Question 13

What causes the jugular venous pulse?

Answer 13

Pressure fluctuations in the R atrium

Question 14

What does the a wave/peak in jugular venous pressure represent?

Answer 14

R atrial systole

Question 15

What does the c wave/peak in jugular venous pressure represent?

Answer 15

R ventricular contraction causing bulging of tricuspid valve into the R atrium

Question 16

What does the v wave/peak in jugular venous pressure represent?

Answer 16

Atrial filling with closed tricuspid valve –> increase in pressure form increased venous return

Question 17

What is indicated by the x descent in jugular venous pressure graph?

Answer 17

Atrial relaxation

Question 18

What is indicated by the y descent in jugular venous pressure graph?

Answer 18

Passive emptying of R atrium

Question 19

Explain the abdominojugular reflex test.

Answer 19

Pressing on the liver to increase venous return
Normal: slight rise in JV distention that quickly returns to previous
RHF: Prominent JV distension that is maintained

Question 20

What is Kussmaul’s sign and what does it indicate?

Answer 20

Increase in JV distension during inspiration, when it should decrease
Sign of RHF

Question 21

What is indicated by splitting of S1?

Answer 21

Right bundle branch block

Question 22

What is indicated by wide splitting of S2?

Answer 22

Pulmonic stenosis
R bundle branch block

Question 23

What is indicated by fixed splitting of S2?

Answer 23

ASD

Question 24

What is indicated by paradoxical splitting of S2?

Answer 24

Aortic stenosis
L bundle branch block

Question 25

When is S3 physiological?

Answer 25

Children and pregnancy

Question 26

What heart sound is associated with LVH?

Answer 26

S4

Question 27

What are the important aspects to note if there is a murmur?

Answer 27

Site of origin/maximum intensity Timing Duration Character Radiation/conduction Relation to respiration

Question 28

Where would a murmur from mitral stenosis radiate?

Answer 28

localized

Question 29

Where would a murmur from mitral incompetence radiate?

Answer 29

Towards axilla

Question 30

What is indicated by a murmur that is louder during inspiration?

Answer 30

Murmur originates from the RV

Question 31

What is indicated by a murmur that is louder during expiration?

Answer 31

Originates from the LV

Question 32

What type of timing is seen with a stenotic semilunar murmur?

Answer 32

Systolic

Question 33

What type of timing is seen with an insufficient semilunar murmur?

Answer 33

Diastolic

Question 34

What type of timing is seen with a stenotic AV murmur?

Answer 34

Diastolic

Question 35

What type of timing is seen with an insufficiency AV murmur?

Answer 35

Systolic

Question 36

What murmur has a characteristic opening snap?

Answer 36

Mitral stenosis