1. PRACTICAL HEART SOUNDS Dr. Zahoor Ali Shaikh 1

2. PRACTICAL HEART SOUNDS  Objectives 1. To understand how heart sounds are produced [S1, S2, S3, S4]. Audible with stethoscope S1,S2. 2. Sites at which heart sounds are heard – using stethoscope Position of the subject/patient, while listening to the heart sounds – supine, left lateral, sitting 3. Use of stethoscope 4. Phonocardiography – recording of heart sounds and relationship with ECG 5. Listening to the tape – splitting of second heart sound [A2, P2] and murmers. 2

3. 3 Aortic Area – 2 nd right Intercostal space at the right sternal border Pulmonary Area – 2 nd left Intercostal space at the left sternal border Mitral Area – 5 th left Intercostal space 1cm inside mid – clavicular line [Apex beat area] Tricuspid Area – Left side of lower sternum

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5. 5 ECG Phonocardiogram

6. 6 ECG Phonocardiogram

7.  At the end of the practical 1. Student should know how to use stethoscope. 2. Recognize S1, S2 on Auscultation. 3. Should know how to feel pulse, apex beat. 4. Should know about splitting and murmers. 7

8. THANK YOU 8