HEART SOUNDS

REASON FOR HEART SOUNDS

Heart sounds

CARDIAC EXAM
S1:

Mitral and tricuspid valve closure S2: Aortic and pulmonary valve closure

PHYSIOLOGY OF SPLITTING OF S2.

Valves on the left side of the heart close slightly before those on the right
Aortic valve (A2) closes first Pulmonic valve (P2) closes second

Splitting is accentuated by deep inspiration

CARDIAC CYCLE
Systole: Between the first heart sound (S1) and the second (S2) Diastole: Between the (S2) and (S1)

Lasts longer than systole

ABNORMAL HEART SOUNDS

S3: Created by blood from the left atrium entering into an already overfilled ventricle during diastole S4: Created by blood trying to enter a stiff ventricle during atrial contraction Both are low-pitched extra sounds heard best with the bell of your stethoscope

*Can be normal in athletes; S3 can be normal in pediatric patients

STRUCTURE OF HEART

BLOOD CIRCULATION SYSTEM

HEART SOUNDS

ECG and heart sounds

Explanation

for ventricular contraction (systole) and the lub sound occur immediately after the QRS complex. complex represents the upstroke of the ventricular action potential, with ventricular contraction starting soon after. The lub sound is generally thought to be due to the closure of the AV valves but part of the sound may derive from mechanical events in ventricular muscle.

QRS

HEART SOUNDS

. Explain for ventricular relaxation (diastole) and

the dup sound occur after the T wave.

The

T wave represents ventricular repolarization, with ventricular relaxation following soon after. The dup sound is associated with closure of the aortic and pulmonary valves.

CORRELATION OF FOUR HEART SOUNDS

EXPLANATION FOR THE HEART SOUNDS

STHESCOPES

STETHOSCOPE

Two tunable diaphragms which allow the user to alternate between low- and high-frequency sounds without turning over the chestpiece. The large side can be used for adult patients, while the small side is useful for pediatric or thin patients, around bandages, and for carotid assessment. The pediatric side converts to a traditional bell by replacing the diaphragm with the nonchill bell sleeve included with each stethoscope.

STETHOSCOPE
Only diaphragm(s): Light contact to engage the bell function Low frequency Firm contact to engage the diaphragm function High frequency Bell and a diaphragm: Bell for low frequency sounds Diaphragm for high frequency sounds

STETHOSCOPE PARTS

FREQUENCY RESPONSE OF STETHOSCOPE

STEHOSCOPE

ELECTRONIC STETHOSCOPE - SCHEMATIC

Parts:
R1 10K 1/4W Resistor R2, R3, R9 2.2K 1/4W Resistor R4 47K 1/4W Resistor R5, R6, R7 33K 1/4W Resistor

R8 56K 1/4W Resistor

R10 4.7K 1/4W Resistor R11 2.5K Pot R12 330K 1/4W Resistor R13 1K 1/4W Resistor R14 3.9 Ohm 1/4W Resistor C1 470uF Electrolytic Capacitor

MIC1 Electret Mic J1 1/4" Phone Jack MISC Board, Wire, Sockets for ICs, Knob for pot, Stethoscope, Rubber tube

C2, C3, C4 0.047uF Capacitor C5 0.1uF Capacitor

C6 1000uF Electrolytic Capacitor

D1 Bi-Colour LED U1, U2, U3, U4, U5 741 OpAmp

PHONOCARDIOGRAM

PHONOCARDIOGRAM WAVEFORM

PHONOCARDIOGRAM WAVEFORM GRADE

THANK YOU