9141883
Description
Flashcards by Victoria Wright, updated more than 1 year ago
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Created by Victoria Wright
over 7 years ago
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| Question | Answer |
| Describe Normal Splitting | Inspiration ---> drop in intrathoracic pressure ---> increased venous return --> increased RV filling ---> increased RV stroke volume ---> increased RV ejection time ---> delayed closure of pulmonic valve. Decreased pulmonary impedance (increased capacity of the pulmonary circulation) also occurs during inspiration, which contributes to delayed closure of pulmonic valve. |
| In Normal Splitting, what leads to delayed closure of the pulmonic valve? | Inspiration ---> drop in intrathoracic pressure ---> increased venous return --> increased RV filling ---> increased RV stroke volume ---> increased RV ejection time ---> delayed closure of pulmonic valve. |
| Describe Wide Splitting | Seen in conditions that delay RV emptying (eg, pulmonic stenosis, right bundle branch block). Causes delayed pulmonic sound (especially on inspiration). An exaggeration of normal splitting. |
| Describe Fixed Splitting | Heard in ASD. ASD ---> left-to-right shunt ---> increased RA and RV volumes ---> increased flow through pulmonic valve such that, regardless of breath, pulmonic closure is greatly delayed |
| Describe Paradoxical Splitting | Heard in conditions that delay aortic valve closure (eg, aortic stenosis, left bundle branch block). Normal order of valve closure is reversed so that P2 sound occurs before delayed A2 sound. Therefore on inspiration, P2 closes later and moves closer to A2, thereby “paradoxically” eliminating the split (usually heard in expiration). |
| What type of splitting does the following describe? Seen in conditions that delay RV emptying | Wide Splitting |
| What type of splitting does the following describe? Seen in pulmonic stenosis | Wide splitting |
| What type of splitting does the following describe? Seen in right bundle branch block | Wide splitting |
| What type of splitting does the following describe? Causes delayed pulmonic sound (especially on inspiration). | Wide Splitting |
| What type of splitting does the following describe? An exaggeration of normal splitting. | Wide Splitting |
| What type of splitting does the following describe? Heard in ASD | Fixed Splitting |
| What type of splitting does the following describe? Regardless of breath, pulmonic closure is greatly delayed. | Fixed Splitting |
| What type of splitting does the following describe? ASD ---> left-to-right shunt ---> increased RA and RV volumes ---> increased flow through pulmonic valve such that, regardless of breath, pulmonic closure is greatly delayed | Fixed Splitting |
| What type of splitting does the following describe? Heard in conditions that delay aortic valve closure | Paradoxical splitting |
| What type of splitting does the following describe? Heard in aortic stenosis | Paradoxical splitting |
| What type of splitting does the following describe? Heard in left bundle branch block | Paradoxical splitting |
| What type of splitting does the following describe? Normal order of valve closure is reversed so that P2 sound occurs before delayed A2 sound. | Paradoxical splitting |
| What type of splitting does the following describe? On inspiration, P2 closes later and moves closer to A2, thereby “paradoxically” eliminating the split (usually heard in expiration). | Paradoxical splitting |
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