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Heart Murmurs
Heart murmurs are unique heart sounds produced when blood flows across a heart valve or blood vessel. This occurs when turbulent blood flow creates a sound loud enough to hear with a stethoscope. Turbulent blood flow is not smooth. The sound differs from normal heart sounds by their characteristics. For example, heart murmurs may have a distinct pitch, duration and timing. The major way health care providers examine the heart on physical exam is heart auscultation; another clinical technique is palpation, which can detect by touch when such turbulence causes the vibrations called cardiac thrill. A murmur is a sign found during the cardiac exam. Murmurs are of various types and are important in the detection of cardiac and valvular pathologies (i.e. can be a sign of heart diseases or defects). There are two types of murmur. A functional murmur is a benign heart murmur that is primarily due to physiologic conditions outside the heart. The other type of heart murmur is due to a ...
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Phonocardiogram
A phonocardiogram (or PCG) is a plot of high-fidelity recording of the sounds and murmurs made by the heart with the help of the machine called the phonocardiograph; thus, phonocardiography is the recording of all the sounds made by the heart during a cardiac cycle. Medical use Heart sounds result from vibrations created by the closure of the heart valves. There are at least two; the first (S1) is produced when the atrioventricular valves (tricuspid and mitral) close at the beginning of systole and the second (S2) when the aortic valve and pulmonary valve (semilunar valves) close at the end of systole. Phonocardiography allows the detection of subaudible sounds and murmurs and makes a permanent record of these events. In contrast, the stethoscope cannot always detect all such sounds or murmurs and provides no record of their occurrence. The ability to quantitate the sounds made by the heart provides information not readily available from more sophisticated tests and provides ...
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Systolic Heart Murmur
Systolic heart murmurs are heart murmurs heard during systole, i.e. they begin and end between S1 and S2. Many involve stenosis of the semilunar valves or regurgitation of the atrioventricular valves. Types * Mid-systolic ejection murmurs are due to blood flow through the semilunar valves. They occur at the start of blood ejection — which starts after S1 — and ends with the cessation of the blood flow — which is before S2. Therefore, the onset of a midsystolic ejection murmur is separated from S1 by the isovolumic contraction phase; the cessation of the murmur and the S2 interval is the aortic or pulmonary hangout time. The resultant configuration of this murmur is a crescendo-decrescendo murmur. Causes of midsystolic ejection murmurs include outflow obstruction, increased flow through normal semilunar valves, dilation of aortic root or pulmonary trunk, or structural changes in the semilunar valves without obstruction. * Late systolic murmurs start after S1 and, if left s ...
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Inhalation
Inhalation (or Inspiration) happens when air or other gases enter the lungs. Inhalation of air Inhalation of air, as part of the cycle of breathing, is a vital process for all human life. The process is autonomic (though there are exceptions in some disease states) and does not need conscious control or effort. However, breathing can be consciously controlled or interrupted (within limits). Breathing allows oxygen (which humans and a lot of other species need for survival) to enter the lungs, from where it can be absorbed into the bloodstream. Other substances – accidental Examples of accidental inhalation includes inhalation of water (e.g. in drowning), smoke, food, vomitus and less common foreign substances (e.g. tooth fragments, coins, batteries, small toy parts, needles). Other substances – deliberate Recreational use Legal – helium, nitrous oxide (" laughing gas") Illegal – various gaseous, vaporised or aerosolized recreational drugs Medical use D ...
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Levine Scale
In cardiac physiology, the Levine grading scale is a numeric scoring system to characterize the intensity or the loudness of a heart murmur. The eponym is from researcher Samuel A. Levine who studied the significance of systolic heart murmurs. The grading gives a number to the intensity from 1 to 6: The palpable murmur is known as thrill, which can be felt on grade 4 or higher. # The murmur is only audible on listening carefully for some time. # The murmur is faint but immediately audible on placing the stethoscope on the chest. # A loud murmur readily audible but with no thrill. # A loud murmur with a thrill. # A loud murmur with a thrill. The murmur is so loud that it is audible with only the rim of the stethoscope touching the chest. # A loud murmur with a thrill. The murmur is audible with the stethoscope not touching the chest but lifted just off it. The Levine scaling system persists as the gold standard for grading heart murmur intensity. It provides accuracy, consistency, an ...
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Point Of Maximal Impulse
Point or points may refer to: Places * Point, Lewis, a peninsula in the Outer Hebrides, Scotland * Point, Texas, a city in Rains County, Texas, United States * Point, the NE tip and a ferry terminal of Lismore, Inner Hebrides, Scotland * Points, West Virginia, an unincorporated community in the United States Business and finance *Point (loyalty program), a type of virtual currency in common use among mercantile loyalty programs, globally *Point (mortgage), a percentage sometimes referred to as a form of pre-paid interest used to reduce interest rates in a mortgage loan * Basis point, 1/100 of one percent, denoted ''bp'', ''bps'', and ''‱'' * Percentage points, used to measure a change in percentage absolutely * Pivot point (technical analysis), a price level of significance in analysis of a financial market that is used as a predictive indicator of market movement * "Points", the term for profit sharing in the American film industry, where creatives involved in making the film ...
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Intercostal Space
The intercostal space (ICS) is the anatomic space between two ribs (Lat. costa). Since there are 12 ribs on each side, there are 11 intercostal spaces, each numbered for the rib superior to it. Structures in intercostal space * several kinds of intercostal muscle * intercostal arteries and intercostal veins * intercostal lymph nodes * intercostal nerves Order of components Muscles There are 3 muscular layers in each intercostal space, consisting of the external intercostal muscle, the internal intercostal muscle, and the thinner innermost intercostal muscle. These muscles help to move the ribs during breathing. Neurovascular bundles Neurovascular bundles are located between the internal intercostal muscle and the innermost intercostal muscle. The neurovascular bundle has a strict order of vein-artery-nerve (VAN), from top to bottom. This neurovascular bundle runs high in the intercostal space, and the smaller collateral neurovascular bundle runs just superior to t ...
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Decrescendo
In music, the dynamics of a piece is the variation in loudness between notes or phrases. Dynamics are indicated by specific musical notation, often in some detail. However, dynamics markings still require interpretation by the performer depending on the musical context: for instance, the ''forte'' marking (meaning loud) in one part of a piece might have quite different objective loudness in another piece or even a different section of the same piece. The execution of dynamics also extends beyond loudness to include changes in timbre and sometimes tempo rubato. Purpose and interpretation Dynamics are one of the expressive elements of music. Used effectively, dynamics help musicians sustain variety and interest in a musical performance, and communicate a particular emotional state or feeling. Dynamic markings are always relative. never indicates a precise level of loudness; it merely indicates that music in a passage so marked should be considerably quieter than . There ...
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Crescendo
In music, the dynamics of a piece is the variation in loudness between notes or phrases. Dynamics are indicated by specific musical notation, often in some detail. However, dynamics markings still require interpretation by the performer depending on the musical context: for instance, the ''forte'' marking (meaning loud) in one part of a piece might have quite different objective loudness in another piece or even a different section of the same piece. The execution of dynamics also extends beyond loudness to include changes in timbre and sometimes tempo rubato. Purpose and interpretation Dynamics are one of the expressive elements of music. Used effectively, dynamics help musicians sustain variety and interest in a musical performance, and communicate a particular emotional state or feeling. Dynamic markings are always relative. never indicates a precise level of loudness; it merely indicates that music in a passage so marked should be considerably quieter than . There are m ...
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Diastole
Diastole ( ) is the relaxed phase of the cardiac cycle when the chambers of the heart are re-filling with blood. The contrasting phase is systole when the heart chambers are contracting. Atrial diastole is the relaxing of the atria, and ventricular diastole the relaxing of the ventricles. The term originates from the Greek word (''diastolē''), meaning "dilation", from (''diá'', "apart") + (''stéllein'', "to send"). Role in cardiac cycle A typical heart rate is 75 beats per minute (bpm), which means that the cardiac cycle that produces one heartbeat, lasts for less than one second. The cycle requires 0.3 sec in ventricular systole (contraction)—pumping blood to all body systems from the two ventricles; and 0.5 sec in diastole (dilation), re-filling the four chambers of the heart, for a total of 0.8 sec to complete the cycle. Early ventricular diastole During early ventricular diastole, pressure in the two ventricles begins to drop from the peak reached during systol ...
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Systole (medicine)
Systole ( ) is the part of the cardiac cycle during which some chambers of the heart contract after refilling with blood. The term originates, via New Latin, from Ancient Greek (''sustolē''), from (''sustéllein'' 'to contract'; from ''sun'' 'together' + ''stéllein'' 'to send'), and is similar to the use of the English term ''to squeeze''. The mammalian heart has four chambers: the left atrium above the left ventricle (lighter pink, see graphic), which two are connected through the mitral (or bicuspid) valve; and the right atrium above the right ventricle (lighter blue), connected through the tricuspid valve. The atria are the receiving blood chambers for the circulation of blood and the ventricles are the discharging chambers. In late ventricular diastole, the atrial chambers contract and send blood to the larger, lower ventricle chambers. This flow fills the ventricles with blood, and the resulting pressure closes the valves to the atria. The ventricles now perfor ...
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Mitral Regurgitation
Mitral regurgitation (MR), also known as mitral insufficiency or mitral incompetence, is a form of valvular heart disease in which the mitral valve is insufficient and does not close properly when the heart pumps out blood. Section: Valvular Heart Disease Rupture or dysfunction of the papillary muscle are also common causes in acute cases, dysfunction, which can include mitral valve prolapse.VOC=VITIUM ORGANICUM CORDIS, a compendium of the Department of Cardiology at Uppsala Academic Hospital. By Per Kvidal September 1999, with revision by Erik Björklund May 2008 Pathophysiology The pathophysiology of MR can be broken into three phases of the disease process: the acute phase, the chronic compensated phase, and the chronic decompensated phase. Acute phase Acute MR (as may occur due to the sudden rupture of the chordae tendinae or papillary muscle) causes a sudden volume overload of both the left atrium and the left ventricle. The left ventricle develops volume overload beca ...
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