II курс, семестр IV, лекция IV
Auscultation of the heart. Pulse and blood pressure measurement.
Cardiac cycle
1.Ventricular systole (0,33 sec)
•Isovolumetric contraction (0,08 sec)
•Ventricular ejection (0,25 sec)
oRapid phase
oSlow phase
2.Ventricular diastole (0,47 sec)
•Isovolumetric relaxation (0,08 sec)
•Filling (0,25 sec)
•Rapid filling
•Slow filling
3.Atrial systole (0,1 sec)
Phases of ventricular systole
1.Asynchronous contraction
2.Isovolumetric contraction
3.Ventricular ejection
Cardiac cycle
Phase |
Position of the |
Blood flow |
Timing |
|
valves |
|
|
Atrial systole |
Atrio-ventricular are |
From atrium to |
0,1 sec |
|
opened |
ventricles |
|
|
Semilunar are |
|
|
|
closed |
|
|
Ventricular |
Atrio-ventricular are |
From |
0,3 sec |
systole |
closed |
ventricles to |
|
|
|
vessels |
|
|
Semilunar are |
|
|
|
opened |
|
|
Ventricular |
Atrio-ventricular are |
From atrium to |
0,4 sec |
diastole |
opened |
ventricles |
|
|
Semilunar are |
|
|
|
closed |
|
|
Ventricular diastole
1.Protodiastole 2.Isovolumetric relaxation 3.Rapid filling
4.Slow filling 5.Atrial systole
Auscultation of the heart
Rules of auscultation
•Silent room
•Warm room
•Performed in standing and lying position
•During normal breathing
Additional maneuvers
oAfter physical exertion
oAfter deep inspiration
•In valvular diseases
a.On the left side (mitral valve)
b.Standing, leaning forward with lifted hands (aortic valve)
Points of auscultation
•1 – Apex of the heart (М)
•2. – II intercostal space to the right (А)
•3. – II intercostal space to the left
(Р)
•4 – Left lower sternal border (Т)
•5 – Erb`s point; IV intercostal space to the left. (А)
