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PE CW 1

OC BUNYARD

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Across
5.What causes a heart sound originating from 3-4 LICS, with possible radiation down LSB or apex that decreases with squatting and increases with valsalva and standing. (2 Words)
6.What point in the cardiac cycle represents mitral/tricuspid valve closure; best heard at apex; starts systole
9.An S3 in a patient > 40 Y.O. is almost always _________
10.mitral valve prolapse (systolic ballooning of part of the valve into the left atrium) results in what heart sound? (3 Words)
11.What is the effect on right sided murmurs during inspiration?
12.What causes a blowing heart sound heard at the LLSB with radiation to the right sternum/xiphoid that increases in intensity with inspiration. (2 Words)
15.Is S4 a ventricular or atrial sound?
17.most common kind of heart murmur that may be innocent, physiologic, or pathologic (2 Words)
19.In what normal state would we hear an S3? (2 Words)
20.What is the effect of handgrip on AS (aortic stenosis), and HCM murmurs?
21.What is one of the 2 causes of heart murmurs that occur during valsalva or standing? (2 Words)
22.what is the best places to hear an S3 in L lat decubitus?
23.low intensity heart sounds at about the 2-4th ICS between LLSB (left lower sternal border) and apex, usually decrease or disappear with sitting. Etiologies include anemia, pregnancy, fever, and hyperthyroidism (changes in body metabolism). (2 Words)
24.heart sound produced by inflammation of pericardial sac with variable timing and location, but usually heard best in the L3ICS. May increase when pt leans forward, exhales, and holds breath. Scratchy, scraping sound, heard best with DIAPHRAGM. (3 Words)
25.the cadence of S3 is known as what? (2 Words)
27.In what 3 states would we hear an S3? (3 Words)
29.what is the best places to hear an S3 if not in L lat decubitus? (4 Words)
30.low intensity heart sounds at about the 2-4th ICS between LLSB (left lower sternal border) and apex, usually decrease or disappear with sitting. Very common in children and young adults, not indicative of any underlying CV disease (2 Words)
32.What causes a harsh heart sound heard at apex, radiating to the left axilla? (3 Words)
36.What is the effect of handgrip on AS (aortic stenosis), and HCM murmurs?
37.benign sound produced by turbulence of blood in the jugular veins that is common in children. A continuous murmur without silent interval (loudest in diastole). Located above medial third clavicles, esp at night, humming quality, heard best with the BELL (2 Words)
38.What causes a continuous murmur with silent interval late in diastole; heard best in L2ICS, harsh machinery-like and usually with a thrill? (3 Words)
40.What does standing do to preload and afterload? (3 Words)
41._______lowers intra-thoracic pressure which augments the inflow of blood into the RA and RV)
43.Where is S2 best heard? (3 Words)
44.In what good state of health would we hear an S3? (2 Words)
45.What causes a rumbling heart murmur in mid or late diastole, with a decrescendo, low-pitched sound (decrescendo diastolic murmur), opening snap often follows S2 and initiates murmur? (2 Words)
47.when is S4 heard? (2 Words)
49.squatting Increases ______ _________ to the heart and increases arterial resistance) (2 Words)
50.What is the effect of handgrip on MR, AR, MS, S3, S4, murmurs?
51.Name for the pathologic heart sounds arising from blood flow from chamber with high pressure to one of low pressure, through a valve or other structure that should be closed. Begins immediately with S1 and continues through S2. (2 Words)
54.What does valsalva do to preload and afterload?
55.What does inspiration do to preload?
56.What does squatting do to preload and afterload?preload, increases afterload (Increases venous return to the heart and increases arterial resistance)
Down
1.known as normal splitting heard at either L2ICS or L3ICS, is accentuated by inspiration, and disappears with expiration (3 Words)
2.What causes a blowing decrescendo, high pitched heart sound heard at 2-4th LICS, with radiation to apex/RSB. Heard best with pt sitting, leaning forward with breath held after exhalation. (4 Words)
3.very early diastolic sound usually pronouced by the opening of a stenotic mitral valve (2 Words)
4.What is the effect of squatting on MR/HCM murmurs?
6.What decreases heart size and decreases venous return to the heart
7.What causes loud heart sounds with a thrill and medium crescendo-decrescendo pitch heard at R2ICS that radiates to carotids or down apex. Best heard with pt sitting and leaning forward (2 Words)
8.squatting Increases ______ _________ to the heart and increases arterial resistance) (2 Words)
13.where is S1 best heard?
14.What decreases heart size and decreases venous return to the heart
16.the cadence of S4 is known as what? (2 Words)
18.What is the cause of a very loud heart sound with a thrill at the 3-5th LICS (3 Words)
23.a paradoxical splitting during expiration, suggestive of heart disease or a fixed split seen in ASD (atrial septal defect) (3 Words)
26.What causes a loud heart sound with a thrill and medium crescendo-decrescendo pitch, heard at 2-3rd LICS (2 Words)
28.What 2 components (closing valves) make up the first heart sound (S1)? (2 Words)
31.In what good state of health would we hear an S3? (2 Words)
33.S3 will be heard soon ______ S2 in _________ of the cardiac cycle. (2 Words)
34.What does handgrip do to afterload? (2 Words)
35.Is S3 a ventricular or atrial sound?
39.S4 will be heard soon ______ S1 in (late) _________ of the cardiac cycle. (2 Words)
42.What is the effect of SQUATTING on S3/S4 murmurs?
46.What point in the cardiac cycle represents aortic/pulmonary valve closure; best heard at right (A2) and left (P2) 2ICS
48.What point in the cardiac cycle represents an extra diastolic heart sound AKA VENTRICULAR gallop. Results from increased resistance to ventricular filling during passive atrial emptying. Best heard at apex in left lateral decubitus position or along the LLSB (left lower sternal border) or below xiphoid w/pt supine and louder on inspiration
52.What 2 components (closing valves) make up the second heart sound (S2)? (2 Words)
53.What point in the cardiac cycle represents an extra systolic heart sound AKA ATRIAL gallop. Occurs just before S1. Best heard w/Bell at apex in left lateral decubitus position. Occurs when there is increased resistance to ventricular filling during atrial contraction caused by HTN, CAD, aortic stenosis, cardiomyopathy

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