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murmur begins after S1 & stops b4 S2 with brief gaps
midsystolic
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murmurs that typically arise from blood flow across SL valves
midsystolic
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murmu starts with S1 & stops at S2 without a gap
pansystolic/holosystolic
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murmur that often occurs w/regurge across atrioventricular valves
pansystolic
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murmur starts in mid to late systole & persists up to S2
late systolic represented by mitral valve prolapse
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murmur starts immediately after S2 w/out a discernible gap that fades into silence b4 the next S1
early diastolic
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murmur starts a short time after S2
middiastolic
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murmurs accompany regurgitant flow across incompetent SL valves
early diastolic
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murmurs reflect turbelent flow across the atrioventricular valves
mid dia & pre sys
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murmur starts in late diastole & continues up to S1
late diastolic/presystolic
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this murmur grows louder
cresendo
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this murmur grows softer
decresendo
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this murmur rises in intensity then falls
cresendo-decresendo
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this murmur has the same intensity throughout
platue
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Give an example of a cresendo murmur
pre sys of mitral stenosis in NSR
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Give an example of a decresendo murmur
early dia of aortic reg
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Give an example of a cres-decr murmur
midsys of aortic stenosis
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Give an example of a platue murmur
pansys of mitral reg
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What are two special maneuvers to identify systolic murmurs
- standing strain of valsalva
- squatting releasing valsalva
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standing strain of valsalva has what effect on cardiovascular system
- decreased LVV from a decreased venous return
- decreased vascular tone=decrease art BP
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A standing strain of valsalva causes a decreased venous return to the heart explain the effects on the 3 systolic murmurs
- MVP=increase prolapse in MV
- HCM=increase outflow obstruction
- AS=decrease BV ejected into aorta
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A standing strain of valsalva cause a decreased vascular tone explain the effects on the 3 systolic murmurs
- MVP=click moves earlier in sys & murmur lengthens
- HCM=increase intensity of murmur
- AS=decrease intensity of murmur
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Squatting or release of valsalva has what effect on the CV system
- increased LVV=increase venous return
- increased vasc tone=increase BP & PVR
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Squatting or release of valsalva causes an increase in venous return resulting in what on the 3 sys murmurs
- MVP=decrease prolapse of MV
- HCM=decrease outflow obstr
- AS=increase BV ejected into aorta
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squatting or release of valsalva cause ain increased vascular tone resulting in what on the 3 sys murmurs
- MVP=delay click & murmur shortens
- HCM=decrease intensity of murmur
- AS=increase intensity of murmur
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what are the 3 pansystolic murmurs
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What are the midsystolic murmurs
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what are the diastolic murmurs
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This murmur is found at the apex, radiates to the left axilla, soft to loud intensity, med to high pitch with a harsh holosystolic quality
MR
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This murmur is found in the lower left sternal border that radiates to the right side of sternum, xiphoid area & perhaps to the left MCL but not into the axilla. It varies in intensity with a medium pitch & has a blowing holosystolic quality
TR
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This murmur is found at the 3,4,5th left interspaces that is often wide while oftening having a very loud intensity with a thrill & high holosystolic pitch with a harsh quality
VSD
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this murmur is found at the right 2nd IS that radiates often to the carotids, down the left sternal border even to the apex. It is soft but often loud w/thrill & has a med harsh cresendo-decresendo pitch that may be higher at the apex. It is often harsh with a musical quality at the apex & heard best with the patient siting while leaning forward
AS
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This murmur is found at the 3,4th left IS that radiates down the left sternal border to the apex maybe even the base but not to the neck. It has a variable intensity & med pitch, harsh quality.
HCM
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this murmur is found at the 2,3 left IS that radiates when loud toward the left shoulder/neck. It is soft to loud in intensity & has a thrill when loud. It is med in pitch;cresendo-decresendo with a harsh quality.
PS
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This murmur is found at the 2 to 4th left IS that if loud will radiate toward the apex & perhaps to the R sternal border. It has an intensity of a grade 1 to 3 with high pitch & a blowing decrescendo that may be mistaken for breath sounds.
AR
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This murmur is found usually at the apex that has very little radiation with an intensity of anywhere from a 1 to 4 that has a decresendo low pitched rumble
MS
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