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Flashcards in cardiovascular Deck (14)
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1
Q

What causes the S1 sound and

in what phase of the cardiac cycle does it occur?

A
  • closure of the R & L AV values (tricuspid and bicuspid/mitral)
  • beginning of ventricular systole
2
Q

What causes the S2 sound

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

A
  • closure of the aortic and pulmonic semilunar valves
  • marks the end of ventricular systole
3
Q

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

What causes this split?

A
  • 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
Q

Describe S3 and it’s cause

A
  • 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
Q

Describe S4 and it’s cause

A
  • 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
Q

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

A
  • open: aortic and pulmonic semilunar valves
  • closed: mitral and tricuspid (L and R AV valves)
7
Q

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

A

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

closed: aortic and pulmonic valves

8
Q

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

A
  • aortic stenosis
  • pulmonic stenosis
  • tricuspid regurgitation
  • mitral regurgitation
9
Q

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

A
  • tricuspid stenosis
  • mitral valve stenosis
  • aortic regurgitation (insufficiency)
  • pulmonic regurgitation (insufficiency)
10
Q

describe the grading system for pitting edema

A
  • 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
Q

describe the grading system for pulses

A

0 absent

1 weak, barely palpable

2 normal

3 full, increased

4 bounding

12
Q

describe the grading system for murmurs

A

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
Q

What heart sounds are associated with mitral valve prolapse?

A
  • 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
Q

Trace the pathway of the cardiac electrical conduction system

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