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NUR 622

Heart Sounds

QuestionAnswer
S1 Lubb Mitral and tricuspid valve closing
S1 (Best heard) Apex for Mitral and LLSB for tricuspid
S2 Dubb Aortic and pulmonary valves closing
S2 (Best heard) Right for aortic and left for pulmonic
Split S1 Mitral and tricuspid valves closing at different times.
Split S1 (Best heard) Apex and LLSB
Split S1 Normal sound, but could be abnormal and indicate RBBB
Split S2 Aortic and pulmonary valves closing at different times
Split S2 (best heard) Base Left
Splint S2 Normal: inspiration only Wide Split: mostly inspiration May indicate RBBB or pulmonary HTN Fixed Split: inspiration and expiration equally. SIGN of ATRIAL DEFECT Paradoxical Split: Expiration only: AORTIC STENOSIS and LBBB.
S3 "Kentucky" Ventricles filling with blood
S3 "Kentucky"(best heard) Apex with bell and lying on left side
S3 "Kentucky" Heard immediately after S2 and does not vary with inspiration
Physiologic S3 Normal finding: in children and young adults with increased blood volume(prego,anemic and hyperthyroidism) Disappears when patient sit up
Pathological S3 Ventricular Gallop. Heard in HEART FAILURE MAINLY heard in elderly
S4 "Tennessee" Atrium contracting
S4 "Tennessee" (best heard) Apex with bell laying on left side
S4 "Tennessee" Immediately before S1
Physiological S4 Can be normal in people over 40 years especially after exercise.
Pathological S4 Atrial Gallop. Indicates poor compliance of ventricles and seen with CAD patients
Created by: kpnelson