1) According to the lesson, the border of the myocardium is generally located about
3 cm lateral to the left of the sternum?
You Answered
True
Correct Answer
False
The border of the myocardium is generally located
...
1) According to the lesson, the border of the myocardium is generally located about
3 cm lateral to the left of the sternum?
You Answered
True
Correct Answer
False
The border of the myocardium is generally located about 6 cm (not 3 cm) lateral to the
left of the sternum.
2) According to the lesson, the JVP is best assessed from pulsations in the right
internal jugular vein, which is directly in line with the superior vena cava and right
atrium?
Correct!
True
False
Estimating the JVP is one of the most important and frequently used skills of physical
examination. The JVP closely parallels pressure in the right atrium, or central venous
pressure, related primarily to volume in the venous system. The JVP is best assessed
from pulsations in the right internal jugular vein, which is directly in line with the superior
vena cava and right atrium.
3) According to the lesson, low-pitched sounds of S3 and S4 and the murmur of
mitral stenosis are best heard using what?
The bell and diaphragm are equally effective for this task
The naked ear
Correct!
The bell of the stethoscope
The diaphragm of the stethoscope
Listen throughout the precordium with the diaphragm, pressing it firmly against the
chest. The bell is more sensitive to the low-pitched sounds of S3 and S4 and the
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murmur of mitral stenosis. Apply the bell lightly, with just enough pressure to produce an
air seal with its full rim. Use the bell at the apex, then move medially along the lower
sternal border. Resting the heel of your hand on the chest like a fulcrum may help you to
maintain light pressure.
4) According to the lesson, heart failure can be assessed using the Framingham
criteria. Which of the following findings are major criteria suggestive of heart
failure? (Select all that apply)
Correct!
S3 gallop
Ankle edema
Correct!
Neck-vein distention
Correct!
Orthopnea
For establishing a diagnosis of CHF using the modified Framingham Criteria, 2 major
criteria or 1 major and 2 minor criteria must be present. Major criteria are: Paroxysmal
nocturnal dyspnea or orthopnea ; Neck-vein distention; Rales; Cardiomegaly; Acute
pulmonary edema; S3 gallop; Increased venous pressure >16 cm of water; and
Hepatojugular reflux.
5) According to the Bates’ Visual Guide video 10.9 Auscultation of Heart Sounds,
splitting of S2 is best heard during inspiration over which area on the chest wall?
Apex
You Answered
Aortic
Correct Answer
Pulmonic
Mitral
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A split S2 is best heard at the pulmonic valve listening post, as P2 is much softer than
A2. Like the S1 heart sound, the S2 sound is described regarding splitting and intensity
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