Heart and Lung Sounds Reference Guide Aortic Pulmonic Erb's Point Tricuspid Mitral Lungs Second Heart Sound with Persistent Splitting Auscultation Reference Unlock quizzes, lessons and more. Sign Up Simulated Full Speed play pause Lesson For heart sounds listen to the synthetic sound while reviewing this lesson. This example shows persistent splitting of the second heart sound. Splitting varies between thirty milliseconds at peak expiration and sixty milliseconds at peak inspiration.With normal physiologic splitting the second heart sound is not split at peak expiration. With persistent splitting, the second heart sound is split in both inspiration and expiration although the degree of splitting is reduced in expiration.This type of splitting is associated with Right Bundle Branch Block a condition in which the electrical signal which causes contraction of the right ventricle is blocked. The waveform(s) seen above are a chart of sound amplitude (loudness) on the vertical axis against time on the horizontal axis. Listening Tips A summary of the key aspects of this heart or lung sound. S2: Splitting varies with respiration. Auscultation Method The recommended patient position is supine For this sound, use stethoscope's diaphragm The recommended auscultation position for the stethoscope is pulmonic Relevant Courses If you wish to review a complete mobile concerning Second Heart Sound with Persistent Splitting Auscultation Reference and related heart sounds, the modules(s) listed below may be useful. Each lesson includes text that explains the auscultatory sound and its clinical significance. The lesson also includes an audio track for playback. A waveform provides a great way to visualize the sounds. Finally, we also include an animation video. For heart sounds, the video illustrates heart muscle and valve movements along with blood flow. For lung sounds, the primary source of the sounds can be seen. Each module also includes a quiz. Second Heart Sounds24 Second Heart Sound with Persistent Splitting Auscultation Reference