During auscultation, the nurse hears a characteristic ______ murmur that increases with inspiration, suggesting tricuspid regurgitation.
1holosystolic✓ 정답
2diastolic
3continuous
4mid-systolic
5early-systolic
해설
A holosystolic murmur heard throughout systole is characteristic of tricuspid regurgitation. The intensity increases during inspiration (Carvallo's sign) due to increased venous return to the right heart, making the regurgitation more prominent.
Tricuspid Regurgitation:
- Definition: Backward flow of blood from right ventricle to right atrium
- Timing: Holosystolic (throughout entire systole)
- Location: Right lower sternal border
- Intensity: Increases with inspiration (Carvallo's sign)
- Characteristics: High-pitched, blowing quality
- Associated findings:
* Jugular venous distention
* Hepatomegaly
* Peripheral edema
* Right-sided heart failure
Auscultation Techniques:
- Best position: Left lateral decubitus
- Bell vs. Diaphragm: Diaphragm preferred
- Grading: 1/6 to 6/6 intensity scale
- Radiation: May radiate to right chest
Cardiac Cycle Timing:
- Systole: Ventricular contraction phase
- Diastole: Ventricular relaxation phase
- Normal S1: Beginning of systole
- Normal S2: Beginning of diastole
핵심 개념
holosystolic — A heart murmur that occurs throughout the entire systolic phase of the cardiac cycle, from the first heart sound (S1) to the second heart sound (S2)
diastolic — A heart murmur that occurs during the diastolic phase of the cardiac cycle, when the heart chambers are filling with blood
continuous — A heart murmur that occurs throughout both systole and diastole without interruption
mid-systolic — A heart murmur that occurs in the middle portion of systole, not extending to either S1 or S2
early-systolic — A heart murmur that occurs at the beginning of systole, immediately after S1, and does not extend throughout the entire systolic phase