The Psychology and Physics of Loudness

1. Is the greatest amplitude or loudness of the components of the S2 in the low-, medium-, or high-frequency range?

ANS: In the low- and medium-frequency range.

2. Since the bell is best for bringing out low and medium frequencies, why is it usually better to listen to the splitting of the S2 with the diaphragm?

ANS: The diaphragm separates the two components of the split better. Soft, high-frequency components are masked by louder and longer low and medium frequencies unless they are markedly separated in pitch and width. Because the diaphragm damps out the louder low- and medium-frequencies, which reverberate around the high ones, volume is sacrificed for clarity in separating the components. Therefore, if one of the components of S2 is very soft, the bell may actually bring it out better.

With light pressure, the low and medium frequencies dominate and cause the split sounds (about 50 ms [0.05 s] apart) to run together. Heavy pressure, by turning the skin into a diaphragm, attenuates the reverberations of the low and medium frequencies and helps to separate the components of the split.

With light pressure, the low and medium frequencies dominate and cause the split sounds (about 50 ms [0.05 s] apart) to run together. Heavy pressure, by turning the skin into a diaphragm, attenuates the reverberations of the low and medium frequencies and helps to separate the components of the split.

3. Why does more volume going through the valve make an A2 or P2 loud?

ANS: If the aortic or pulmonary artery root is distended by an increased volume, the distended aorta or pulmonary artery beyond the valve has a greater recoil velocity, which closes the valve with more energy.

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