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Flashcards in cardiovascular Deck (14):
1

 

 

What causes the S1 sound and

in what phase of the cardiac cycle does it occur?

 

 

  • closure of the R & L AV values (tricuspid and bicuspid/mitral)
  • beginning of ventricular systole

2

What causes the S2 sound 

and in which phase of the cardiac cycle does it occur?

 

 

  • closure of the aortic and pulmonic semilunar valves
  • marks the end of ventricular systole

3

 

When the S2 is split, which valve closes 1st and which closes 2nd?

 

What causes this split?

 

  • aortic valve closes 1st (A2)
  • pulmonic valve closes 2nd (P2)

 

  • Caused by the more muscular left ventricle emptying sooner than R ventricle.
  • pronounced splitting is pathologic: RV volume overload (ex: w/ ASD), RV outflow obstruction (pulmonic stenosis), delayed RV repolarization (ex: complete Rt bundle branch block)

4

 

Describe S3 and it's cause

  • heard in early diastole
  • "Kentucky" cadence
  • ventricular gallop
  • low pitch
  • best heard with bell at apex

Cause: rapid ventricular filling

-can be normal, especially in children

-can be due to fluid overload

5

 

Describe S4 and it's cause

  • late diastole sound
  • atrial gallop
  • "Tennessee" cadence
  • low pitched
  • best heard with bell at apex

 

  • Caused by forcible atrial contraction against ventricle with decreased compliance
  • always abnormal

6

 

During ventricular systole, which valves are open and which are closed?

 

 

  • open: aortic and pulmonic semilunar valves

 

  • closed: mitral and tricuspid (L and R AV valves)

7

 

During ventricular diastole, which valves are open and which are closed?

 

open: tricuspid and bicuspid (mitral)  (R & L AV)

 

closed: aortic and pulmonic valves

8

 

What are the possible valvular defects when a systolic murmur is heard?

 

  • aortic stenosis
  • pulmonic stenosis
  • tricuspid regurgitation
  • mitral regurgitation

9

 

What are the possible valvular defects when a diastolic murmur is heard?

 

  • tricuspid stenosis
  • mitral valve stenosis
  • aortic regurgitation (insufficiency)
  • pulmonic regurgitation (insufficiency)

10

 

describe the grading system for pitting edema

 

  • 1+             2 mm, rebounds rapidly
  • 2+            4 mm, rebounds within 10-15 seconds
  • 3+            6 mm, rebounds ~60 seconds
  • 4+            8 mm, rebounds after 2-5 minutes

11

 

describe the grading system for pulses

 

0          absent

1           weak, barely palpable

2          normal

3           full, increased

4           bounding

12

describe the grading system for murmurs

 

I/VI            barely audible in a quiet room

II/VI           quiet but clearly audible

III/VI          moderately loud, no thrill

IV/VI         loud, associated with a thrill

V/VI          very loud, easily palpable thrill

VI/VI         very loud, palpable and visible thrill, audible with

                  stethescope off chest wall

13

 

 

What heart sounds are associated with mitral valve prolapse?

  • mid-to-late systolic click
  • high pitched
  • best heard with diaphragm at apex
  • may be followed by late systolic murmur if accompanied by mitral regurg

14

 

Trace the pathway of the cardiac electrical conduction system

  • SA node -->
  • AV node -->
  • AV Bundle (Bundle of His) -->
  • Left and Right Bundle Branches -->
  • Perkinje fibers