An S3 originating from the right ventricle is best heard with the
a. bell of the stethoscope over the fifth intercostal space.
b. diaphragm of the stethoscope over the fifth intercostal space.
c. bell of the stethoscope over the third intercostal space.
d. diaphragm of the stethoscope over the third intercostal space.
C
Auscultation of the mitral and tricuspid areas is performed for low-pitched sounds, specifically an S3 (otherwise known as a ventricular diastolic gallop or extra heart sound). Because S3 is a low-pitched sound, it is best heard with the bell. An S3 is an early diastolic filling sound that originates in the ventricles and is thus heard best at the apex of the heart. An S3 originating from the right ventricle is best heard by placing the bell over the third or fourth ICS at the left sternal border. An S3 originating from the left ventricle is best heard by placing the bell over the fifth ICS at the midclavicular line.
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