1. What is meant by the “splitting” of the heart sounds? What can cause this spl
ID: 3515718 • Letter: 1
Question
1. What is meant by the “splitting” of the heart sounds? What can cause this splitting?2. Can a defective valve the defected by electrocardiography, auscultation, palpating of the radial artery, or all three techniques? Explain.
3. Can the beating of the artia be detected by electrocardiography, auscultation, palpating of the radial artery, or all three techniques? Explain.
1. What is meant by the “splitting” of the heart sounds? What can cause this splitting?
2. Can a defective valve the defected by electrocardiography, auscultation, palpating of the radial artery, or all three techniques? Explain.
3. Can the beating of the artia be detected by electrocardiography, auscultation, palpating of the radial artery, or all three techniques? Explain.
2. Can a defective valve the defected by electrocardiography, auscultation, palpating of the radial artery, or all three techniques? Explain.
3. Can the beating of the artia be detected by electrocardiography, auscultation, palpating of the radial artery, or all three techniques? Explain.
Explanation / Answer
(1)In healthy adult,there are two normal heart sounds these are first heart sound(S1) and second heart sound(S2) produnced by closing of atrioventricular valve and semilunar valves respectively.The second heart sound is caused by the closing of aortic valve and pulmonary valve when this closing of both the valves is not synchronized it creates a spilliting in the heart sound.
PHYSIOLOGICAL REASONS OF SPLITTING:-
(1)INSPIRATION:-During inspiration the chest wall expands and causes intrathoracic pressure to become more negative as a result the lungs fill in with air and expand.while doing so it induces an increase in the venous blood return from body into the right atrium via superior and inferior vena cava and into the right ventricle by increasing the pressure gradient.Simultaneously there is a reduction in the blood volume returning from lungs into the left atrium.Since there is an increase in blood volume in right ventricle during inspiration,pulmonary valve stays open for a long time whereas aortic valve closes slightly earlier causing split in the heart sound.
(2) EXPIRATION:-during expiration the chest wall collapses and decreases the negative intrathoracic pressure.Therefore there is no longer an increase in the blood volume returning to the right ventricle and right ventricle pressure is no more increased,this allows the pulmonary valve to close simultaneously with aortic valve and no split is heard.
PATHOLOGICAL REASONS OF SPLITTING:-
(1)Wide splitting:- an exaggerated normal splitting.
(2)Split during expiration:-reverse splitting can be caused by aortic stenosis,hypertrophic cardiomyopathy,left bundle branch block.
(3)Paradoxial split:-when pulmonary valve closes before aortic valve.
(2) Defective valve can only be detected by ausculation(hearing of heart sound with the help of stethoscope).Electrocardiography (process of recording the electrical activity of heart)cannot depict the valve defect and palpating of the radial artery detects the change in the peripheral pulse of the radial artery.
(3)None,because atrial beat is during P to R interval change of pressure is too small to be detected.None of the techniques are sensitive enough to detect the small pressure.
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