PCMI - Cardiac Cycle and Heart Sounds

Question 1

What is the mnemonic for auscultation locations of the heart? What does it mean?

Answer 1

All Physicians Take Money.

Aortic, Pulmonic, Tricuspid, Mitral

Question 2

Where can you hear the aortic valve?

Answer 2

2nd intercostal space, right sternal border

Question 3

Where can you hear the pulmonic valve?

Answer 3

2nd intercostal space, left sternal border

Question 4

Where can you hear the tricuspid valve?

Answer 4

4th intercostal space, left sternal border

Question 5

Where can you hear the mitral valve?

Answer 5

5th intercostal space, left mid-clavicular line

Question 6

What is a murmur?

Answer 6

Sound produced when the flow of blood through a valve is turbulent or disrupted

Question 7

When does a murmur occur?

Answer 7

When a valve is non-compliant, incompetent, stiff, or damaged

Question 8

Does a murmur mean there is an underlying pathology?

Answer 8

Not necessarily

Question 9

When are murmurs concerning?

Answer 9

When they are associated with other symptoms

Question 10

How should murmurs be evaluated?

Answer 10

With echocardiograms

Question 11

Systole is aka what 2 things?

Answer 11

1. ) contraction

2. ) depolarization

Question 12

What is SBP?

Answer 12

Systolic blood pressure. The pressure exerted upon the artery during heart contraction

Question 13

Diastole is aka what 2 things?

Answer 13

1. ) Relaxation

2. ) Repolarization

Question 14

What is DBP?

Answer 14

Diastolic blood pressure. The pressure exerted upon the artery during heart relaxation

Question 15

What does S1 indicate?

Answer 15

Closure of the AV valves

Question 16

What does S2 indicate?

Answer 16

Closure of the semilunar valves

Question 17

What is S3?

Answer 17

A vibratory sound that occurs from blood filling the relaxed and empty ventricle

Question 18

When is it normal to hear S3?

Answer 18

In children and athletes

Question 19

What is S4?

Answer 19

Atrial filling from high pressure from SVC/IVC and pulmonary venous return.

Question 20

When does S4 occur?

Answer 20

Before S1

Question 21

What is regurgitation?

Answer 21

Turbulent flow sound when the blood is moving in an opposite direction

Question 22

What is stenosis?

Answer 22

Turbulent flow when blood is moving through a stiff, damaged valve

Question 23

When can you hear aortic and pulmonic stenosis?

Answer 23

During ventricular systole

Question 24

When can you hear tricuspid and mitral stenosis?

Answer 24

During atrial systole

Question 25

What is preload?

Answer 25

Volume of blood sent to the heart

Question 26

Does increasing preload make a murmur louder or softer?

Answer 26

Louder (in most cases)

Question 27

Does decreasing preload make a murmur louder or softer?

Answer 27

Softer (in most cases)

Question 28

What are the two exceptions to the rules of preload?

Answer 28

1. ) HOCM (Hypertrophic Obstructive Cardiomyopathy) | 2. ) Mitral Valve Prolapse

Question 29

In HOCM, does an increase in preload improve or worsen the aortic murmur?

Answer 29

Improves, which is opposite of most murmurs

Question 30

In HOCM, does a decreased in preload improve or worsen the aortic murmur?

Answer 30

Worsens, which is opposite of most murmurs

Question 31

In MVP, does an increase in preload improve or worsen the aortic murmur?

Answer 31

Improves.

Question 32

Does inspiration make right or left valve murmurs louder or softer?

Answer 32

Right. Louder. RINspiration

Question 33

Does expiration make right or left valve murmurs louder or softer?

Answer 33

Left. Louder. LEXpiration

Question 34

Does an increased after load make a murmur louder or softer?

Answer 34

Louder

Question 35

Does a decreased after load make a murmur louder or softer?

Answer 35

Softer

Question 36

What are the after load exceptions?

Answer 36

HOCM and MVP

Question 37

Aortic stenosis is characterized by what type of murmur?

Answer 37

Crescendo - Decrescendo

Question 38

Where is mitral regurgitation best heard?

Answer 38

At the apex of the heart

Question 39

What kind of murmur is mitral regurgitation?

Answer 39

Holosystolic

Question 40

What is a holosystolic murmur?

Answer 40

Continuing from S1 to S2

Question 41

What is the general cause for tricuspid regurgitation?

Answer 41

IVDA "want to TRI some drugs?"

Question 42

What kind of murmur is tricuspid regurgitation?

Answer 42

Holosystolic

Question 43

What kind of murmur is aortic regurgitation?

Answer 43

Early blowing diastolic murmur. "AR, thar she BLOWS!"

Question 44

What things does aortic regurgitation present with?

Answer 44

- Marfans (connective tissue disorder) - Head bobbing - Water-hammer pulse

Question 45

What kind of murmur is mitral stenosis?

Answer 45

Opening "snap"

Question 46

What causes mitral valve stenosis?

Answer 46

Rheumatic fever "RheuMITRAL fever"

Question 47

Mitral stenosis mnemonic

Answer 47

The Operating System is MicroSoft Opening Snap is Mitral Stenosis

Question 48

What kind of murmur is MVP?

Answer 48

Midsystolic click "See the MVP to be the MVP and everything will CLICK"