©BRAINBARTER 2024/2025
HAPE Final Exam Study Guide.
Mitral Valve Prolapse - answer✔*systolic click*
caused by regurgitation of the mitral valve
squatting delays quick, standing brings it closer to S1
Mitral Valve Stenosis - answer✔*opening snap*
decrescendo and low-pitched rumble
Physiologic S3 - answer✔normal in children, young adults, and last trimester of pregnancy
Pathologic S3 - answer✔*ventricular gallop, sounds like Kentucky*
adults over 40
decreased contractility, heart failure, or volume overload of a ventricle
S4 - answer✔*atrial gallop, sounds like Tennessee*
caused by resistance to ventricular filling
S3 and S4 - answer✔*summation gallop*
quadruple rhythm
Mitral Regurgitation - answer✔mitral valve fails to close in systole
, ©BRAINBARTER 2024/2025
may have S3
harsh sounding
Tricuspid Regurgitation - answer✔tricuspid fails to close in systole
*blowing quality*
Ventricular Septal Defect - answer✔blood flows from LV to RV through a hole
*harsh, with a thrill*
Aortic Stenosis - answer✔loud with a thrill
*crescendo and decrescendo*
heard best leaning forward
Hypertrophic Cardiomyopathy - answer✔harsh
may have S3 and S4
decreases with squatting, increases with valsalva and standing
Pulmonic Stenosis - answer✔thrill
crescendo and decrescendo
Split S2, maybe S4
Aortic Regurgitation - answer✔*blowing with decrescendo*
heard best sitting, leaned forward, with breath held after expiration
, ©BRAINBARTER 2024/2025
Venous hum - answer✔continuous murmur
heard above clavicles
humming/roaring sounds
Pericardial Friction Rub - answer✔*scratchy, scraping sound*
increases with patient leaned forward, exhale, and hold breath
Patent Ductus Arteriosus - answer✔continuous murmur, fades in diastole
*harsh, machine-like*
Systolic and Diastolic Murmurs - answer✔venous hum
pericardial friction rub
patent ductus arteriosus
Diastolic murmurs - answer✔aortic regurgitation
mitral stenosis
(use pneumonic D-ARMS)
Systolic Murmurs - answer✔mitral regurgitation
physiologic
aortic stenosis
, ©BRAINBARTER 2024/2025
systolic
mitral valve prolapse
(use pneumonic MR PASS MVP)
Murmur Grading - answer✔1. faint, may not be heard in all positions
2. quiet, but heard immediately after placing stethoscope on chest
3. moderately loud
4. loud with palpable thrill
5. very loud, with thrill, may be heard with stethoscope slightly off skin
6. very loud, thrill, may be heard entirely off chest
Jugular Venous Pressure - answer✔measured best at right external jugular vein
hypovolemic patients need to lie flat to see neck veins
head elevated to 30 degrees
>3cm indicates JVD
Dyspnea - answer✔PE
spontaneous pneumothorax
anxiety
HAPE Final Exam Study Guide.
Mitral Valve Prolapse - answer✔*systolic click*
caused by regurgitation of the mitral valve
squatting delays quick, standing brings it closer to S1
Mitral Valve Stenosis - answer✔*opening snap*
decrescendo and low-pitched rumble
Physiologic S3 - answer✔normal in children, young adults, and last trimester of pregnancy
Pathologic S3 - answer✔*ventricular gallop, sounds like Kentucky*
adults over 40
decreased contractility, heart failure, or volume overload of a ventricle
S4 - answer✔*atrial gallop, sounds like Tennessee*
caused by resistance to ventricular filling
S3 and S4 - answer✔*summation gallop*
quadruple rhythm
Mitral Regurgitation - answer✔mitral valve fails to close in systole
, ©BRAINBARTER 2024/2025
may have S3
harsh sounding
Tricuspid Regurgitation - answer✔tricuspid fails to close in systole
*blowing quality*
Ventricular Septal Defect - answer✔blood flows from LV to RV through a hole
*harsh, with a thrill*
Aortic Stenosis - answer✔loud with a thrill
*crescendo and decrescendo*
heard best leaning forward
Hypertrophic Cardiomyopathy - answer✔harsh
may have S3 and S4
decreases with squatting, increases with valsalva and standing
Pulmonic Stenosis - answer✔thrill
crescendo and decrescendo
Split S2, maybe S4
Aortic Regurgitation - answer✔*blowing with decrescendo*
heard best sitting, leaned forward, with breath held after expiration
, ©BRAINBARTER 2024/2025
Venous hum - answer✔continuous murmur
heard above clavicles
humming/roaring sounds
Pericardial Friction Rub - answer✔*scratchy, scraping sound*
increases with patient leaned forward, exhale, and hold breath
Patent Ductus Arteriosus - answer✔continuous murmur, fades in diastole
*harsh, machine-like*
Systolic and Diastolic Murmurs - answer✔venous hum
pericardial friction rub
patent ductus arteriosus
Diastolic murmurs - answer✔aortic regurgitation
mitral stenosis
(use pneumonic D-ARMS)
Systolic Murmurs - answer✔mitral regurgitation
physiologic
aortic stenosis
, ©BRAINBARTER 2024/2025
systolic
mitral valve prolapse
(use pneumonic MR PASS MVP)
Murmur Grading - answer✔1. faint, may not be heard in all positions
2. quiet, but heard immediately after placing stethoscope on chest
3. moderately loud
4. loud with palpable thrill
5. very loud, with thrill, may be heard with stethoscope slightly off skin
6. very loud, thrill, may be heard entirely off chest
Jugular Venous Pressure - answer✔measured best at right external jugular vein
hypovolemic patients need to lie flat to see neck veins
head elevated to 30 degrees
>3cm indicates JVD
Dyspnea - answer✔PE
spontaneous pneumothorax
anxiety
