Cardiopulmonary: heart sounds

What's he relevance of heart sounds?

Listening to the intensity and quality of heart sounds over the surface of the chest can provide useful information about the condition and function of the heart. Although considered an advanced skill, with supervised practice, the therapist should be able to differentiate normal heart sounds from blatantly abnormal sounds such as loud murmurs and gallops.

Which abnormal heart sound is associated with congestive heart failure? S1 S2 S3 S4

S3 S1 and S2 are normal heart sounds. S3 heard in early diastole, is associated with congestive heart failure. S3 is typically softer than S1 and S2 and is easier heard with the bell of the stethoscope. S3 is also known as ventricular gallop.

Which abnormal heart sound is associated with myocardial infarction or hypertension? S1 S2 S3 S4

S4 S1 and S2 are normal heart sounds. S4 heard in late diastole is associated with myocardial infarction or hypertension. S4 is the result of an abnormally forceful contraction of the left atrium to overcome resistance caused by stiffness in the left ventricle. S4 is also known as atrial gallop.

Which area of the heart would be assessed by auscultating over the blue marking on the chest wall? mitral area aortic area pulmonic area tricuspid area

aortic area The second right intercostal space at the right sternal border denotes the aortic area and is the best location for auscultating the aortic valve.

The S2 heart sound is associated with the closure of the: aortic valve mitral valve tricuspid valve atrioventricular valves

aortic valve The S2 heart sound is associated with the closure of the aortic and pulmonic (semilunar) valves. S2 is considered a high frequency sound with higher pitch and shorter duration than S1.

What area of the heart is the S2 heart sound best heard using auscultation? apex of the heart lateral side of the heart medial side of the heart base of the heart

base of the heart The S2 heart sound is best auscultated with the diaphragm of the stethoscope at the base of the heart with a normal finding being a high pitched "dub" sound.

When auscultating the heart, which of the following would not create audible sound? turbulent blood flow laminar blood flow stenotic valves valvular regurgitation

laminar blood flow Laminar blood flow occurs when fluid flows in parallel layers without disruption between layers. As a result, laminar blood flow is typically inaudible. The remaining options would produce an audible sound and may be indicative of cardiac pathology.

What finding is most likely to cause a bruit identified during auscultation? narrowing of an artery narrowing of a vein widening of an artery widening of a vein

narrowing of an artery Bruits, or loud blowing sounds formed during systole or diastole, are due to arterial atherosclerosis (i.e., narrowing) and represent turbulent blood flow. This can often be a predecessor of an aortic aneurysm.

Which auscultatory area would be best assessed over the second intercostal space at the left sternal border? aortic area pulmonic area mitral area tricuspid area

pulmonic area Auscultation occurs by placing the bell or diaphragm of the stethoscope directly on the patient's skin with enough pressure to provide a seal while the patient breathes quietly through the nose.

What sound is often heard as blood flows through an insufficient valve? whistling sound gurgling sound swishing sound popping sound

swishing sound As blood is pumped past the insufficient valve, blood leaks back into the previous chamber, or regurgitates, because the valve does not close completely. This causes a swishing sound that can be readily heard through auscultation.

At what location is the contraction of the left ventricle most pronounced? the jugular notch the second intercostal space the fifth intercostal space the xiphoid process

the fifth intercostal space The apex of the heart is at the fifth intercostal space at the mid-clavicular line. This point is known as the point of maximal impulse where the contraction of the left ventricle is the most pronounced.

What's the S1 (sub) heart sound?

- 1st heart sound: closure of the mitral and tricuspid (AV) valves at the onset of ventricular systole. - High frequency sound with lower pitch and longer duration than S2.

What's the S2 (dub) heart sound?

- 2nd heart sound: closure of the aortic and pulmonary (semilunar) valves at the onset of ventricular diastole. - High frequency sound with higher pitch and shorter duration than S1.

What's the S3 heart sound?

- 3rd heart sound: vibrations of the distended ventricle walls due to passive flow of blood from the atria during the rapid filling phase of diastole. - Normal in healthy young children; termed "physiologic" 3rd heart sound. - Abnormal in adults; may be associated with heart failure; often called "ventricular gallop."

What's the S4 heart sound?

- 4th heart sound: pathological sound of vibration of the ventricular wall with ventricular filling and atrial contraction = May be associated with hypertension, stenosis, hypertensive heart disease or myocardial infarction; often called an "atrial gallop."

Where is the auscultation location of the pulmonic area?

2nd intercostal space at the L sternal border

Where is the auscultation location of the aortic area?

2nd intercostal space at the R sternal border

Where is the auscultation location of the tricuspid area?

4th intercostal space at the L sternal border

Where is the auscultation location of the mitral area?

5th intercostal space, medial to the L midclavicular line