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Heart

Sounds and Surfaces

QuestionAnswer
Wide Splitting Delay RV emptying - PS, RBBB
Fixed Splitting ASD
Paradoxical Splitting Pulmonic before aortic - Delay LV emptying. AS, LBBB. Inspiration eliminates split
Valsalva, standing decreases intensity of most murmurs
Valsalva, standing increases ________ hypertrophic cardiomyopathy murmur
mechanism of valsalva decrease VR
Mechanism of hand grip increase systemic vascular resistance
Hand grip increases MR, AR, VSD
Hand grip decreases AS, hypertrophic CM
Rapid squatting mechanism increased VR, Preload, afterload (with prolonged squat)
Squatting decreases Hypertrophic CM
Squatting increases AS, MVP
Holosystolic, high-pitched, blowing murmur MR/TR
Hlosystolic murmur, loudest at apex, radiating to axilla MR
Enhance MR murmurs increase TPR - squatting, hand grip
Enhance TR murmur Increase VR (inspiration)
Crescendo-decrescendo systolic AS
AS murmur loudest at _________, radiates to ____________- Base. Carotids
Holosystolic, harsh murmur, loudest at tricuspid, accentuated with hand grip VSD
late systolic crescendo w/ midsystolic click, best at apex MVP (most frequent valvular lesion)
Diastolic blowing murmur AR
AR clinical signs head bobbing, bounding pulses
Rumbling, late diastolic murmur, following opening snap MS
Enhance MS sounds Increase LA return (expiration)
Continuous, machine-like murmur PDA
PDA best heard at Left infraclavicular area
Ant. surface RV
Post. Surface/Base LA
Inf. Surface / diaphragmatic LV, RV
Right pulmonary RA
Left Pulmonary Surface LV
R. border RA
L. Border LV
Inf. border LV, RV
Sup. Border LA, RA, Great vessels
LCX supplies Lateral and posterior walls of LV
LAD supplies Ant. 2/3 of IV septum, ant. papillary m., ant. surface of LV
PDA supplies post. 1/3 of IV septum, post and inf. walls of RV and LV
Nodes are supplied by RCA in right dominant, LCX in left dominant
Created by: anamakharashvili