cardiac cycle

Question 1

Which sound can you auscultate in the 2nd R/L intercostal space?

Answer 1

L- pulmonic
R- aortic

Question 2

What sound can you auscultate at the 4th parasternal space?

Answer 2

tricuspid valve

Question 3

What can you auscultate at the 5th midclavicular line?

Answer 3

mitral

Question 4

If they have a regurg or stenosis, where do you listen?

Answer 4

2nd parasternal ICS

Question 5

What is the S1 sound?

Answer 5

close the mitral and tricuspid valve (onset of systole) best heard at the cardiac apex

Question 6

What is the S2 sound?

Answer 6

closure of pulmonary and aortic valve

Question 7

Where is the S2 sound heard the best?

Answer 7

P2= =pulmonic valve at the 2nd L parasternal ICS, and A2= 2nd R parasternal ICS

Question 8

S1 is the onset of which phase of the cardiac cycle?

Answer 8

systole

Question 9

S2 is onset of which part of the cardiac cycle

Answer 9

onset of diastole

Question 10

What would widen the P2?

Answer 10

Inspiration, ASD (pulmonic valve), pulmonary stenosis, Right bundle branch block

Question 11

What is the paradoxical split?

Answer 11

P2 comes before A2, severe aortic stenosis, left bundle branch block. anything that increases the afterload against the aortic valve

Question 12

narrowing of s2 split in inspiration is indicative of of what?

Answer 12

paradoxical splitting ( severe aortic stenosis)

Question 13

When is S3 pathologic?

Answer 13

heart failure, mitral regurg, aortic regurg

Question 14

When is S3 normal?

Answer 14

young, fit, pregnancy

Question 15

What is S3 produced by?

Answer 15

rapid passive ventricular filling increase in left ventricular volumes, heard at the apex

Question 16

When is the s3 heard?

Answer 16

early diastole, after S2 gallop.

Question 17

What is S4 produced by?

Answer 17

atrial kick, increased left ventricular pressures.

Question 18

When is it heard?

Answer 18

Late diastole, before S1

Question 19

When is it physiologic? S3

Answer 19

elderly

Question 20

When is S4 pathological?

Answer 20

heart failure (diastolic), hypertension, aortic stenosis

Question 21

Which phase of the cardiac cycle has the highest oxygen consumption

Answer 21

isovolumetric contraction

Question 22

In isovolumetric contraction, what changes?

Answer 22

pressure, ventricular depolarization (ECG)

Question 23

A wave on JVP

Answer 23

atrial systole

Question 24

c wave on JVP

Answer 24

ventricular contraction, tricuspid valve pushes into atrium

Question 25

x wave descent on JVP

Answer 25

atrial relaxation

Question 26

y descent

Answer 26

ventricular filling

Question 27

cannon a waves pathology

Answer 27

premature atrial kick, 3rd degree av block: atria and ventricle not syncing up

Question 28

When v wave is higher than a wave- what condition

Answer 28

regurgitation

Question 29

aortic regurgitation, there is an incompetent aortic valve that results in regurgitation of blood from the aorta back into the left ventricle; as a result, diastolic blood pressure is/ vs systolic

Answer 29

decreased, To compensate for the reduced efficiency of left ventricular ejection (due to backflow) in aortic regurgitation, the heart will contract harder, thus increasing the systolic blood pressure.

Question 30

What happens to the dicrotic notch in aortic regurg?

Answer 30

The dicrotic notch results from a sudden pressure increase when the aortic valve closes after ventricular systole. In aortic regurgitation, the dicrotic notch classically disappears because the aortic valve fails to close properly