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• USMLE Audio Review files from our “Gold Standard USMLE Reviews”
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• Following along with the transcription
• Or by watching the video (if available)

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Let’s start our USMLE Review with Anatomy from the Gold Standard USMLE Step 1 Audio Review program.

Play USMLE Audio MP3 56 04 Valve lesions & murmurs – valvular stenosis (2_2) Below

Begin 56 04 Valve lesions & murmurs – valvular stenosis (2_2) Transcription

What can stenotic lesions lead to?

• Ventricular hypertrophy and eventually perhaps ventricular failure.

How does stenosis of the AV valve affect pressures in the cardiovascular system?

• Atrial and venous pressures are high

When do murmurs occur that are produced by AV valve stenosis, there are two times?

• During atrial contraction and the rapid passive filling stage

Mitral valve stenosis may lead to what three heart conditions, the first two directly involve the heart, what are they?

• First, enlargement of the left atrium. Second, Atrial fibrillation.

Mitral valve stenosis may lead to a third condition that is due to high pulmonary venous pressure, what is this third condition?

• Pulmonary edema

What does tricuspid stenosis elevate?

• Venous blood pressure

How might tricuspid stenosis affect atrial pressure during atrial contraction?

• It would increase atrial pressure

How would this effect of the tricuspid stenosis manifest itself graphically?

•  There would be a giant a wave in the atrial pressure tracing

How would this effect of the tricuspid stenosis manifest itself visibly on the body?

• As pulsations in the jugular vein.

What does valvular insufficiency allow for?

• It allows for the backward flow of blood that is regurgitation of blood.

In what two places would this backward flow of blood occur?

• It would occur from the ventricles to the atrial or from the aorta to the left ventricle

Student doctor please pause the tape and summarize the information discussed on valve lesions and murmurs since the last summary.

• The first question was about what stenotic lesions lead to. Stenotic lesions lead to ventricular hypertrophy and eventually perhaps ventricular failure. Stenosis of AV valves causes increases of atrial and venous pressure. Murmurs produced by AV valve stenosis occur during atrial contraction and the rapid passive filling stage. Mitral valve stenosis may lead to enlargement of the left atrium, atrial fibrillation, and pulmonary edema. Tricuspid stenosis elevate venous blood pressure. During atrial contraction tricuspid stenosis may lead to increase atrial pressure which would manifest itself as a giant a wave in the atrial pressure tracing and appear on the body as pulsations in the jugular vein. Valvular insufficiency permits the backward flow of blood from the ventricles to the atrial or from the aorta to the left ventricle.

 

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