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The pericardium is: a. a synonym for the mediastinum b. the area on the chest where the apical impulse is felt c. the area on the anterior chest overlying the heart and great vessels d. a synonym for the area where the superior and inferior venae cavae return unoxygenated venous blood to the right side of the heart the area on the anterior chest overlying the heart and great vessels Select the best description of the tricuspid valve a. left semilunar valve b. right atrioventricular valve c. left atrioventricular valve d. right semilunar valve right atrioventricular valve The function of the pulmonic valve is to: a. divide the left atrium and left ventricle b. guard the opening between the right atrium and right ventricle c. protect the orifice between the right ventricle and the pulmonary artery d. guard the entrance to the aorta from the left ventricle protect the orifice between the right ventricle and the pulmonary artery Atrial systole occurs: a. during ventricular systole b. during ventricular diastole c. concurrently with ventricular systole d. independently of ventricular function during ventricular diastole The second heart sound is the result of: a. opening of the mitral and tricuspid valves b. closing of the mitral and tricuspid valves c. opening of the aortic and pulmonic valves d. closing of the aortic and pulmonic valves closing of the aortic and pulmonic valves The examiner has estimated the jugular venous pressure. Identify the finding that is abnormal. a. Patient elevated to 30 degrees, internal jugular vein pulsation at 1 cm above sternal angle b. Patient elevated to 30 degrees, internal jugular vein pulsation at 2 cm above sternal angle c. Patient elevated to 40 degrees, internal jugular vein pulsation at 1 cm above sternal angle d. Patient elevated to 45 degrees, internal jugular vein pulsation at 4 cm above sternal angle Patient elevated to 45 degrees, internal jugular vein pulsation at 4 cm above sternal angle The examiner is palpating the apical impulse. The normal size of this impulse: a. is less than 1 cm b. is about 2 cm c. is 3 cm d. varies on the size of the person is about 2 cm The examiner wishes to listen in the pulmonic valve area. To do this the stethoscope would be placed at the: a. second right interspace b. second left interspace c. left lower sternal border d. fifth interspace, left midclavicular line second left interspace Select the statement that best differentiates a split S2 from S3 a. S3 is lower pitched and is heard at the apex b. S2 is heard at the left lower sternal border c. The timing of S2 varies with respirations d. S3 is heard at the base; timing varies with respirations S3 is lower pitched and is heard at the apex The examiner wishes to listen for a pericardial friction rub. Select the best method of listeningl a. with the diaphragm, patient sitting up and leaning forward, breath held in expiration b. using the bell with the patient leaning froward c. at the base during norma respiration d. with the diaphragm, patient turned to the left side with the diaphragm, patient sitting up and leaning forward, breath held in expiration When auscultating the heart, your first step is to: a. identify S1 and S2 b. listen for S3 and S4 c. listen for murmurs d. identify all four sounds on the first round identify S1 and S2 You'll hear a split S2 most clearly in what area? a. apical b. pulmonic' c. tricuspid d. aortic pulmonic The stethoscope bell should be pressed lightly against the skin so that: a. chest hair doesn't simulate crackles b. high-pitched sounds can be heard better c. it doesn't act as a diaphragm d. It doesn' interfere with amplification of heart sounds it doesn't act as a diaphragm A murmur heard afterr S1 and before S2 is classified as: a. diastolic ( possibly benign) b. diastole ( always pathologic) c. systolic ( possibly benign) d. systolic ( always pathologic) systolic ( possibly benign)