The atrial kick becomes important to ventricular filling during which of the following?

(Answer to Q. 1)  ANS: D
The atrial kick occurs just before the beginning of ventricular systole. Contraction of the atria normally contributes only a small amount of blood to ventricular filling. However, it can contrib-ute a significant amount of blood to ventricular filling if the heart rate is increased and the period of diastasis is reduced. This occurs during ventricular tachycardia, because the higher heart rate results in a reduction in the volume of blood that passively enters the ventricle during atrial dias-tole.

(Answer to Q. 2)  ANS: B
The second heart sound occurs at the beginning of ventricular relaxation and is associated with closure of the semilunar valves and opening of the atrioventricular valves. The first heart sound occurs at the onset of ventricular contraction and is associated with closure of the atrioventricular valves and opening of the semilunar valves. The third heart sound occurs during early ventricular filling, and the fourth heart sound occurs during atrial contraction.

(Answer to Q. 3)  ANS: B
The c wave occurs at the beginning of atrial diastole and coincides with the period of ventricular systole and is associated with a transient increase in atrial pressure as the pressure in the ventricle increases and forces the closed atrioventricular valves backward into the atrial chamber.

(Answer to Q. 4)  ANS: C
S3 and S4 are not typically heard with a stethoscope, but these sounds can be amplified and rec-orded graphically with a phonocardiogram.

(Answer to Q. 5)  ANS: C
The examiner should inflate the cuff to a pressure approximately 30 mm Hg above the pressure at which the radial pulse disappears.

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