A - Aortic area - half an inch in diameter with its centre in the right intercostal space close to the parasternal line
P - Pulmonary area - half an inch in diameter with its centre in the left second intercostal space close to parasternal line
E - Erb's point - left third intercostal space close to the sternum ( Second aortic area)
M - Mitral area -Left fifth intercostal space half an inch medial to the midclavicular line
T - Tricuspid area - half an inch in diameter with its centre on the left side close to the sternum towards its lower end
2.) During S1(first heart sound) - Closure of Mitral and Tricuspid Valves at start of systole
During S2(2nd heart sound) - Closure of Aortic and Pulmonary Valves during end of systole.
3.) S3 occurs in early diastole just after S2 when mitral valve opens allowing passive filling of left ventricle
S4 occurs during diastolic filling of ventricle due to atrial contraction and is pathological.
4.) Pulse Deficit - is when a difference is present between the number of beats of the heart in a minute and the number of beats of pulse in a minute observed in diseases of the heart.
Condition of pulse deficit :
Pulmonic Aortic Location: Right of sternal border in second Intercostal space (Base) Sound: 52 "dub" Location: Left of sternal border in second intercostal space (Base) Sound: S2'dub Erb's Point Tricuspid Location: Left of sternal border in second intercostal space (Base) Sound: Si and S2 (line of separation between base and apex! Location: Right of sternal border in fourth intercostal space (Apex) Sound: Sub Mitral Location: Midelavicular on left side of chest in firsth Intercostal space Apex Sound: S1 lub