May 18, 2019

hello everyone today I'm gonna be talking about the basics of how to listen to heart sounds listen to heart sounds can sound crazy and I know because people just don't know what they're listening to so one of my fears are physicians in my medical school said listen let me show you exactly how you listen to art sense and ever since then like the rock star pack I don't know what I listen to actually I really do know what I'm listening to but it took some practice and we're gonna go over that but before we start I want us to understand the basic of what the human chest looks like right so this might sound a little complicated I was trying to put the heart in there with the ribs so here we have the two clavicles yoga manubrium and sternal body desire for process get basic stuff just anatomy and you have the ribs so if you know how to count this is very easy just we always make it no this is rib one rib to rib three rib four three five root 6 and rib 7 alright those are ribs there's a lot of things that keep you everything's on your body intact now in between each reach the space we cannot get a fancy name for it we call it what the intercostal space huh whatever that's fine what can I do so the first place between the first rib and the second rib it's a person mm spits can you imagine that rocket science so this is the person to castor space second third fourth fifth sixth and the list goes on and on which I'm not gonna talk about now we have your lives beautiful heart sitting there just a pump guys I love you I know it's just the pump what's the VIP section in here so and when we listen to heart sounds is we start here at the top in between the the sub before we even go there we have four four valves in our heart let's start with the basic step for vows we have the most beautiful tricuspid valve the mitral valve and we have the the aortic valve then one more bump up I forgot to put in there I might just put it in here right here somewhere that'll be your poor Moneyball now the whip debuffs are set up and the angle at which the heart is set up doesn't make any sense when you listen to the heart but kind of does what we want to listen to any pathologies involving the what the e order we'd go up in between the second and the third intercostal space so that's the call the aortic region and there's a fancy name for it so this is the right side of our body and this is the left how easy can that be and we call this the right which is the right side opera cuz stone Obot border our USB right good right hopper don't know water right upper sternal border but it's in between the second and the third intercostal space so kind of right in this region it's a rigid but kind of little area in order to listen to our pulmonic valves you have to listen next right here that's called the left I'll brush don't know body right this is the left side I'll bore sternal body so listen to anything I have to do with tricuspid you come a little you drop down a little bit and you get the left lower sternal border to tricuspid read you there's our three little valves between your right eh oh you left right ventricle and the apex is between the fifth and the sixth intercostal space so kind of all the way here so the way we listen to a heart sounds is we start up here like that pointed into done drop down and make a left so it's come on more like this mm-hmm so we have a pneumonic for it periodic right pulmonic tricuspid and mitral all physicians taste milk if that works for you good luck if there's it it's fine just you know aori gives you a pulmonary pulmonary tricuspid and mitral now we're gonna start by using this little cartoon guy – Alana heart sounds we're gonna go over the basics and I'm gonna throw in some two pathologies and you can just know DOS trust me everything else don't worry we might pick it up with echo I just think know what it just doesn't sound right so let's know the normal well we're gonna need a stethoscope right so this is not your typical stethoscope this is actually a lip 'men cardiologist at the scope it doesn't have a bell but he does it's a different kind of stethoscope because but the bell and the diaphragm actually combined in one so you have to be really really good at using a stethoscope it was a by this so if you end up buying this and you're like I don't know what the Bell is well the Bell is part of the way it works is it depends on pressure it's a pressure gradient if your breath really really hard guess what you're using the diaphragm now to use the bell you have to lightly place it on the chest to listen so you have to be very good at using this I don't really say you shouldn't buy but most likely I say get the one as a bell and as I sell a diaphragm so at least you know how to switch it back and forth so I'm gonna use this in example now we're gonna start with s1 s2 everybody wants to know what am I losing so I want to know what that is what is that is it ordered regurgitation or York's no no no don't worry about that just know what a normal is any normal is what s1 and s2 we know s1 is what x1 is when the mitral valve and attract us about clothes so when the heart when the blood from the HM goes down into the ventricle and the ventricles trying to squeeze guess what you don't want all that work it's like you don't want to you know have a basket that you keep throwing stuff down the drain and he's just going out the other side right so when you when their heart tried to contract the blood inside the ventricle does not want to go back into a trio because that's not where we want it we wanted to go into your body go through the aorta you go right above the hill and go down so in this case both Bob closes no and with that what did when they close we get a strong look at that that's how we got s1 isn't that smiley I like a smiley face tell me you like it right so how do we get us do well now the blood is trying to get out from the heart your heart is squeezing do what systole it's just a fancy name they give you but it's just contracting when the heart contracts and now has overcome the pressure side of your honor right p.m. this Bob's and this Bob are gonna open up it's like open the blood gotta go through when the blood goes through the order right during systole as the ventricles try to relax so that what he can receive more blood from there the order can see this is a continuous circuit it's not stopping the train is moving this tube out has to close doing what ventricular diastole because when they close the allow the recall of the aorta to put ball back into into the rest of the body and also to prevent blood that's ready in the order to come back down that's like waiting on my tails like oh my god I'm just dragging it up and you're waiting on my tongue so if I could if both Bob's are not shutting during s1 all this was gonna spill back in the aorta into the atrium in also this vows are not closing all the work I'm trying to push what I want for here is gonna come back at me again alright so that is our Ganesh to win this to the pulmonic right when the pulmonic valve let's use that green highlighter here s2 is what when you're a are involved and your pulmonic valve closed s1 is when our what mitral and tricuspid valve the closed so I'm gonna make an illustration and from now on this is how you're going to learn heart cells you will never forget just at the scope and put it around your ears and I want you to take your stethoscope and place this on your arm it's not a hand now the reason why I say to do this is never do this it's very deafening it's not good so you close your hands and I want you to hold your stethoscope like this heart and this is s1 that's s1 yeah I know one sound look at that s what s 1 s 1 that's my turn tricuspid s2 look at that now well you have your stethoscope you can actually hear this is how your ears it's like a little small starter sound one-two one-two one-two one-two one-two one-two so we're going to demonstrate down on the board one-two one-two one-two one-two now let's do that again one two that's s1 s2 y it sounds very a couple you know it's very easy look at that one too if you can just come one and two you'll be good so every time you listen to somebody's heart just listen for one and two okay that's all you need to start with now if we go down here now that we haven't learn how to listen to s1 and s2 remember one two one two because when I go to another pathology you know you give up I didn't hear that okay we'll find out so now that we know that normal this is normal and everybody's happy however we might get a third hat heart Sam now when you have a third heart sound I don't want you to freak out because if it's a young child a young adult may be up to like 40 35 or a pregnant woman in death or trimester of pregnancy s3 which is the next pathology we're gonna talk about or it could be a normal physiologically we're gonna find out how it sounds like so most people say can't turkey you know what I've said contracted for so long I never remember it because I don't know what I'm listening to so I say my attending doctor Scott said this is how you hear s3 you put on your stethoscope just like that we place this in our hands and this is one two again one two one two one two one two now if I'm going to add a third heart sound to it this is what is going to sound like one two three one two three one two three let's do that on the board look at this my smiling face that's our X 1 the second smile of it edge – check this out one two that's normal one two that's normal here now once you hear very carefully one two three one two three guys one two three one two three one two three one two three I'm ready squeeze in the spider face but it's not it's fine it's just illustration now I'm gonna do a little fast cuz we're you're gonna hear it's gonna sound like this hear that that is s3 so what really causes s3 mm-hmm usually it's deal to when you have a heart that's dilated or not contractor ventricle just big and it's full with a lot of blood and it is contracting and spilling a little extra blood down into already non contract out ventricle so basically where you have a huge ventricle let's find a nice big fat dump here so that's put is this is your heart and it looks this big and it's just so much blood inside here and the atrium is not contracting so is the oscillation of blood between the atrium and the ventricle that's usually walk on an s3 why when when does it become a pathology well guess what people with heart failure so if somebody has heart failure congestive heart failure you could be what diastolic dysfunction you could be systolic dysfunction the heart is just knock on track day oh it's what you have severe myocarditis and you've eaten up all you heart muscle and guess what it's just plain muscle left in there they're not contracting well now you got a lot of what a lot of blood inside the ventricles and now the HR is contract with all this bizarre ventricle and that's pathological so this is how I do it if somebody tell me oh you know that patient has congestive heart failure when I go to the patient and try to listen well we am I gonna push my stethoscope well I'm gonna start at it Yanik region right and we're going to go to the pulmonic nieuwegein and then I go down to the left lower sternal border and then go to the apex now here's the trick guys when you listen there's a left side at s3 at the apex you place the patient on the left lateral decubitus position and you can hear this sound that's s3 you can also hear it right at them in between the fourth and the fifth right here in the tricuspid region that's the right-sided s3 that's how you know it so you can cheat if you already know the diagnosis or take your time and listen wow what am I here is an s3 because when I say an s4 you're gonna be surprised how different an X course now that we know s3 and we speaking see not really the happiest guy but you gotta remember occasionally typically just a normal or could be pathological now on to s for s voice very interesting now in America today how many people do you think has a potential a lot of people has a hypertension but the pathophysiology of hypertension is a completely different type of which I'm not gonna cover here we just listen to heart so somebody has a prolonged standing long standing high blood pressure what do you think is gonna harp happen to the left ventricle to kind of get what they can it's like going to the gym and working out the heart is constantly contracting so that they have a really thick and left ventricle now a little piece of atrium this guy has this fairly you know like thinking muscle that's not even enough it's not trying to contract against this big guy having a smaller guy fighting against the big guy you got this small guy fighting against this big guy I think you know who's going to win right push and he's got a point you still tiny little kid is tough to push this guy is like oh my what are you thinking yeah that's what happens when you haven't asked for and as for is an atrium contrada contract against what a non-compliant ventricle a stiffened left ventricle usually eleven to call a hypertrophy so now let's hear as for now experts they're interesting cuz s3 is very close to s2 after the second part cell however s4 is close to s1 so let's see exactly how you're gonna be able to hear it pushes stethoscope again just like we always do and put this on your head just use your hands this is s 1 and s 2 1 2 1 2 right 1 2 1 2 this is s 3 1 2 3 1 2 3 1 2 3 and so what do you scan turkey that's fine it's turkey Turkey turkey get it however if you're gonna do s 4 people often use Tennessee but I don't know what they're talking about this is what they're trying to say can you hear that no that's absolutely different right because it sounds like this now S 4 is so close to s 1 that when I do a real of fashion I never notice look at this because it sounds like Tennessee Tennessee Tennessee Tennessee as far as for s1 s2 that's how I do it very very easy so let's try us 1 s 2 s 3 again 1 2 1 2 1 2 1 2 1 2 3 1 2 3 1 2 3 1 2 3 right s what's different s for guys so this is the basics if you use know s 1 s 2 and your go to detect s 3 and s 4 patience that's great because now you can build on your knowledge and I want you to go to the website I'm going to right below at the description of this video so you can go and learn about the more complicated your ik murmurs your extra noses pulmonary stenosis your regurgitation and tricuspid regurgitation mitral regurgitation mitral stenosis all the complicated pathologies of different heart sounds but honestly this is what I do it when I see you and I sit next to you I'm like okay do you have any medical problem I have high blood pressure well when I listen to your heart I want to listen to s1 s2 but at the back of my mind I said wait a minute maybe you might have an underlying s4 because you have what you might have a left ventricular hypertrophy so let's draw your heart look how thick that muscle is yeah that's what I'm talking about right if you have a loved ventricle hypertrophy I might be looking for an s4 and that's how I pick it up right but if you have heart failure I'll be looking for what an s3 and that's basically how you listen to hard sell I hope I made it very very easy for you so you can go ahead and teach somebody else sit next to each other in the hospital at home bring out your stethoscope put in your hands and just listen you can hear it all loud and clear thank you very much for watching our video today we hope you had a good time learning how to listen to heart sounds and now go and be a rock star and teach somebody else thank you very much have a great day bye bye

You Might Also Like


  • Reply ftplectures May 18, 2019 at 5:45 pm

    Did you enjoy this video? Wait! there are more simple lectures to help you study-
    For USMLE Step 1 or 2CK : ▶▶▶◀◀◀
    For NCLEX: ▶▶▶◀◀◀
    For PANCE, AANC, ABIM : ▶▶▶◀◀◀

  • Reply Binal Patel May 18, 2019 at 5:45 pm

    wow, you r so brilliant, you made it so easy. Thanks a lot!

  • Reply iulia stefan May 18, 2019 at 5:45 pm

    You are good!

  • Reply Teresa Okonji May 18, 2019 at 5:45 pm

    Anatomy rocks..loved it

  • Reply Jungkook chan May 18, 2019 at 5:45 pm

    I need a teacher like you in my life!!!

  • Reply Yeshi Gyalpo May 18, 2019 at 5:45 pm

    Keep making more of these

  • Reply Yeshi Gyalpo May 18, 2019 at 5:45 pm

    Best demonstration I have seen
    I don't usually comment on videos but this has got me to go for it
    I salute you brother 🔥

  • Reply Dr. SpOrT Heart May 18, 2019 at 5:45 pm

    Great Doctor; thank you,, you have made those few cardiac sounds easier to be understood & memorized by our students.

  • Reply Ristina Ingram May 18, 2019 at 5:45 pm


  • Reply clotildepriquet May 18, 2019 at 5:45 pm

    I have had high blood pressure & taking medicines from the time that I was 26 years old. This can be the very first blood pressure level option “Zοtοsο Yuku” (Google it) that has ever actually worked to reduce my pressure the natural way. The medicinal drugs prescribed to me to use were not of used any more after having a calendar month of loyally making use of this manual. .

  • Reply Larah Nelder May 18, 2019 at 5:45 pm

    That was brilliant man! Cheers

  • Reply TieFighterEspresso _134 May 18, 2019 at 5:45 pm

    Very informative video. It made listening to basic heart sounds so easy!

  • Reply ASTHA PANDEY May 18, 2019 at 5:45 pm

    Very innovative way of teaching…. liked it

  • Reply Audrey Mikass May 18, 2019 at 5:45 pm

    wow you made it so easy to understand wow thanks i have my final exam soon thanks a lot for this

  • Reply Digna Oviedo May 18, 2019 at 5:45 pm

    I'm not a medical student, but I liked your lesson, simple😊

  • Reply Chigozirim Ejinkeonye May 18, 2019 at 5:45 pm

    That accent kept on peeking through..😄

  • Reply Liz Keith May 18, 2019 at 5:45 pm

    please, fellow health care providers, watch the movie VAXXED.

  • Reply Kevin Borkloe May 18, 2019 at 5:45 pm

    Pls what about percussion of the heart in children. Love your videos

  • Reply Andile Cyril May 18, 2019 at 5:45 pm

    Thank you Doc.

  • Reply Ekens Uriah May 18, 2019 at 5:45 pm

    You great Dr.. Thanks for the explanation

  • Reply Lena AlSaleem May 18, 2019 at 5:45 pm

    I like you a lot 😂 A huge thank you for making this easy for students! you're the best.

  • Reply Soul Delight May 18, 2019 at 5:45 pm

    Hawt chocolate😍! Can you be my personal/private nursing instructor??? Thanks for the video 👍

  • Reply Sozy Ahmed May 18, 2019 at 5:45 pm

    Funny Doc😂💥

  • Reply Lens man May 18, 2019 at 5:45 pm


  • Reply Glamwshan May 18, 2019 at 5:45 pm

    YESSS! thank youu for posting 🙂 I will be referring to your videos while in Nursing school!!

  • Reply Armando Salgado May 18, 2019 at 5:45 pm

    Mekembay mutumbo

  • Reply Vijai Mankantaa May 18, 2019 at 5:45 pm

    Thank you so much

  • Reply Fadel Milad May 18, 2019 at 5:45 pm

    Beautiful! thank you so much.

  • Reply Karina Ramos May 18, 2019 at 5:45 pm

    What do you do when you hear these two abnormal heart sounds? do you just monitor? or do you have to do something asap?

  • Reply Cody Nelson May 18, 2019 at 5:45 pm

    On account of NP students, awesome! Thank you very much!

  • Reply sha shary May 18, 2019 at 5:45 pm

    Ok ok ok…that s1/s2 trick is the coolest thing i've seen(heard) on youtube…period…tnq

  • Reply Allinna18 May 18, 2019 at 5:45 pm

    First time in my whole medlife I understood what a gallop means and can explain it freely to others. Bless your awesome soul.

  • Reply manish meena May 18, 2019 at 5:45 pm

    One of the best video ..thanks for uploading.

  • Reply susaneluwa May 18, 2019 at 5:45 pm

    I love this guy!😂 Educational and entertaining!

  • Leave a Reply