Question on heart sounds anatomical locations

[purplechicxiii, BSN, RN]

Been re-reading my Kaplan Strategies Book 2011-2012 edition and stumbled to this question: HOT SPOT: Where the nurse should place the steth to auscultate heart sounds heard in the Tricuspid Area.

So, remembering it (by heart lol) that Tricuspid Valve Area is located in the LEFT 4TH INTERCOSTAL SPACE LOWER LEFT OF THE STERNAL BORDER, I pointed out the cursor to it.

But upon checking, I was wrong. Because according to Kaplan, it's located in the 5TH INTERCOSTAL SPACE AT THE LOWER LEFT OF THE STERNAL BORDER.

How could that be?? Can someone please enlighten me on this. Thank you so much!

[diana2520]

dont know, this is why i can't stick to one source only, i will check and check till i find the right answer.

here is what i found on cardiovascular examination - part three - auscultation of the heart | practice | nursing times[color=#333333]standard sites for auscultation[color=#333333]

according to scott and macinnes (2006) and cox and roper (2005), the standard sites for auscultation of the heart are (fig 3):[color=#333333]

- mitral area - left fifth intercostal space, mid-clavicular line. this is where the mitral valve sounds are best auscultated;[color=#333333]

- tricuspid area - left fourth intercostal space, just lateral to the sternum. this is where the tricuspid valve sounds are best auscultated;[color=#333333]-

pulmonary area - left second intercostal space, just lateral to the sternum. this is the area where sounds from the pulmonary valve are best auscultated;[color=#333333]- aortic area - right second intercostal space, just lateral to the sternum. this is where the aortic valve sounds are best auscultated.

[purplechicxiii, BSN, RN]

dont know, this is why i can't stick to one source only, i will check and check till i find the right answer.here is what i found on cardiovascular examination - part three - auscultation of the heart | practice | nursing times[color=#333333]standard sites for auscultation[color=#333333]according to scott and macinnes (2006) and cox and roper (2005), the standard sites for auscultation of the heart are (fig 3):[color=#333333]- mitral area - left fifth intercostal space, mid-clavicular line. this is where the mitral valve sounds are best auscultated;[color=#333333]- tricuspid area - left fourth intercostal space, just lateral to the sternum. this is where the tricuspid valve sounds are best auscultated;[color=#333333]- pulmonary area - left second intercostal space, just lateral to the sternum. this is the area where sounds from the pulmonary valve are best auscultated;[color=#333333]- aortic area - right second intercostal space, just lateral to the sternum. this is where the aortic valve sounds are best auscultated.

thank you so much for sharing your insights/research diana. :) well, i think i'd be sticking with what i know and will just be sure give/point the answer based on what the question is really asking. and i also did some research and opened some of books, and found the same rationale (tricuspid valve being on the 4th ics). thank you once again. :)

[Avocadoloveer]

Yea kaplan said 5th and I even clarified it with an instructor. WEIRD! Just remember APT M 2255 I guess.

[Kiwi82, BSN, RN]

So, is it 5th or 4th? lol

[purplechicxiii, BSN, RN]

So, is it 5th or 4th? lol

I'm planning (if ever I get a question like this in the actual nclex) to answer w/ what I know. So Tricuspid is on the 4th. :)

[Kiwi82, BSN, RN]

That's what I would answer... don't get why there are different answers...

[nursesunflower85]

So I am now preparing for the NCLeX through Kaplan, and I also got the same question, which I also selected the hot spot in the 4th intercostal space. Answer is wrong according to Kaplan, guess they still believe that one to be right. I googled which one is the correct one, led me to this thread. Does anyone know which one NCLEX wants? I hope I don't get a similar diagram, I will be sticking to what I learned as well.