Essentials of Diagnosis. Arranged in the Form of Questions And Answers Prepared Especially for Students of Medicine

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Analogous conditions of the right and left heart necessarily give rise to murmurs at the same time ; analogous conditions of the auriculo-ventricular and arterial valves give rise to murmurs at difl'erent times ; and conversely. Thus, for example, the mur- murs of mitral insufficiency and of tricuspid insufficiency coin- cide in time with each other and with the murmurs of aortic obstruction and of pulmonary obstruction. Mitral and tricuspid regurgitant murmurs and aortic and pulmonary obstruct
...ive murmurs are heard during the systole — with or in place of Fig. 19.
Auscultation of the heart-sounds. The small letters indicate the situation of the valves ; the large letters, the points for ausmltaMon. aA, aortic ; mM, mitral ; tT, tricuspid ; pP, pulmonary. (Vierordt.) the first sound. Mitral and tricuspid obtructive murmurs and aortic and pulmonary regurgitant murmurs are heard during the diastole ; the latter two with or in place of the second sound ; 8 114 ESSENTIALS OF DIAGNOSIS.
the first two, however, in what is normally the period of silence immediately preceding the first sound— hence presystolic.


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