Which heart valve sound is best heard at the second intercostal space, left sternal border?
Pulmonic valve
Aortic valve
Tricuspid valve
Mitral valve
The Correct Answer is A
A. Pulmonic valve:
The pulmonic valve is auscultated at the second intercostal space, left sternal border. This is where blood exits the right ventricle into the pulmonary artery. Accurate valve auscultation helps identify murmurs, stenosis, or regurgitation in the right side of the heart.
B. Aortic valve:
The aortic valve is best heard at the second intercostal space, right sternal border, where blood exits the left ventricle into the aorta. Confusing these areas may lead to misidentifying murmurs.
C. Tricuspid valve:
The tricuspid valve is auscultated along the lower left sternal border, 4th-5th intercostal space, and controls blood flow from the right atrium to the right ventricle. Murmurs here indicate right-sided valvular problems.
D. Mitral valve:
The mitral valve is heard at the apex, 5th intercostal space at the midclavicular line. This valve regulates flow from the left atrium to the left ventricle. Misidentification can delay recognition of left-sided valvular pathology.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Coronary arteries are filled with blood during atrial contraction:
Coronary arteries are primarily perfused during diastole, not atrial contraction. During systole, contraction of the ventricles compresses the coronary vessels, reducing blood flow.
B. Coronary circulation occurs only during systole:
Coronary blood flow mostly occurs during diastole, because the myocardial contraction during systole compresses the coronary vessels, especially in the left ventricle.
C. Coronary veins return deoxygenated blood to the right atrium:
Coronary veins collect deoxygenated blood from the myocardium and empty it into the right atrium via the coronary sinus, completing the coronary circulation.
D. Coronary arteries supply deoxygenated blood to the heart muscle:
Coronary arteries supply oxygenated blood to the heart muscle, not deoxygenated blood.
Correct Answer is D
Explanation
A. By increasing the threshold for myocardial depolarization:
While ischemia can affect depolarization, the primary effect of CAD is not a generalized change in the threshold of myocardial cells; instead, conduction problems occur due to localized ischemia.
B. By increasing the heart rate through sympathetic stimulation:
CAD does not inherently increase heart rate. Tachycardia may occur as a compensatory response, but it is not the primary mechanism by which CAD affects the conduction system.
C. By enhancing electrical conductivity in the myocardium:
CAD does not improve conduction. In fact, ischemia impairs conduction by damaging cardiac cells, which can lead to arrhythmias.
D. By causing ischemia to the sinoatrial and atrioventricular nodes:
CAD reduces blood flow through coronary arteries, which can lead to ischemia in the SA and AV nodes, causing bradyarrhythmias, heart blocks, or conduction delays. This is a direct consequence of insufficient oxygen supply to the conduction tissue.
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