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Questions and Answers
What is the significance of S4 heart sound?
What is the significance of S4 heart sound?
Which sign is associated with right-sided heart failure?
Which sign is associated with right-sided heart failure?
Where is the pulmonic valve best auscultated?
Where is the pulmonic valve best auscultated?
What condition is suggested by paroxysmal nocturnal dyspnea?
What condition is suggested by paroxysmal nocturnal dyspnea?
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How should S3 be initially assessed with a stethoscope?
How should S3 be initially assessed with a stethoscope?
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Study Notes
Heart Sounds and Murmurs
- S1: closure of tricuspid and mitral valves (start of systole)
- S2: closure of pulmonic and aortic valves (end of systole)
- Aortic valve: right 2nd intercostal space or cardiac apex
- Pulmonic valve: left 2nd and 3rd intercostal spaces close to the sternum
- Tricuspid valve: at or near the lower left sternal border
- Mitral valve: at and around the cardiac apex
- Orthopnea: shortness of breath while supine
- Paroxysmal nocturnal dyspnea: waking up from SOB and opening a window to breathe
Heart Valves and Conditions
- S3: volume overload status; not always pathologic (pregnancy)
- S4: stiffness of the ventricles; always pathologic
- Use diaphragm for S1 and S2 for aortic and mitral regurgitation and pericardial friction rubs
- Use bell for S3 and S4 and for murmur of mitral stenosis
- Right sided HF: jugular venous distension (neck bulging), hepatomegaly, peripheral edema, pulmonary hypertension
- Left sided HF: lightheaded, pallor, sweating, hair loss, weak pulses, pulmonary edema
Pulsations and Symptoms
- Carotid pulsations: height of pulsations unchanged by position and not affected by inspiration
- Internal jugular pulsations: height of pulsations changes with position, rarely palpable, height falls with inspiration
- Venous thromboembolism (VTE): includes DVT, PE
- Aortic dissection → ripping chest pain and widened mediastinum
- Urgent!
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Description
Dive into the intricacies of heart sounds and murmurs with this informative quiz. Learn about the different heart valves, their associated sounds, and conditions like heart failure. Test your knowledge on clinical signs and auscultation techniques to better understand cardiac health.
