The activity of the heart depends on intrinsic properties of cardiac muscle and on neural factors. Thus, (a) vagus nerve stimulation of the heart reduces heart rate, (b) sympathetic nerve stimulation of the heart decreases time available for ventricular filling, (c) sympathetic stimulation of the heart increases its force of contraction, (d) all of the above.
You have been called upon to demonstrate the technique for listening to valve sounds. (a) Explain where you would position your stethoscope to auscultate (1) the aortic valve of a patient with severe aortic valve insufficiency and (2) a stenotic mitral valve. (b) During which period(s) would you hear these abnormal valve sounds most clearly? (During atrial diastole, ventricular systole, ventricular diastole, or atrial systole?) (c) What cues would you use to differentiate between an insufficient and a stenotic valve?
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