7. Can be :  Normal due to closure of valaves 1 st HS due do closure of AV valaves 2 nd due do closure of semilunar valaves  Abnormal Murmurs are abnormal heart sounds that are produced as a result of turbulent blood flow, which is sufficient to produce audible noise. This most commonly results from narrowing or leaking of valves or the presence of abnormal passages through which blood flows in or near the heart. Heart Sounds

8. Normal Heart Sounds

9. Abnormal Heart Sounds Normal valve Valve stenosis Valve Regurgitation

10. Physiological definitions  Stroke volume The amount of blood pumped by the left ventricle of the heart in one contraction.  Cardiac output (CO) is the product of heart rate (HR) and stroke volume (SV): CO = HR x SV For a 70kg man normal values are HR=70/min and SV=70ml, giving a cardiac output of about 5litre/min.  The cardiac index is the cardiac output per square metre of body surface area - normal values range from 2.5-4.0 litre/min/m2.  Heart rate is determined by the rate of spontaneous depolarisation at the sinoatrial node, but can be modified by the autonomic nervous system.

11. Thank you