Self-Teaching System (STS) for Cardiac Auscultation

The UTMB STS is a system for individual student self-instruction in cardiac auscultation. This system was developed at the University of Texas Medical Branch (UTMB) in Galveston, Texas.


Product Details

The lessons include:

  • Introduction to Cardiac Auscultation and Normal Heart Sounds

  • The Normal Variant Heart Sounds

  • Abnormal Heart Sounds

  • Murmurs

Lesson 1 – Introduction to Cardiac Auscultation and Normal Heart Sounds

  • Brief history of auscultation

  • Generation, transmission and detection of physiologic sound

  • Auscultatory anatomical sites

  • Clinical characteristics of sound

  • Nature and use of the stethoscope

  • Clinical maneuvers to improve detection

  • Identification of sounds, plus source and characteristics of cardiac sounds

  • Generation of first and second heart sounds, S1 and S2

  • Sound diagrams

  • Positive identification of S1 and S2, systole and diastole, by palpation

  • Characteristics of normal S1 and S2

  • Review, practice and evaluation

Lesson 2 – Normal Variant Cardiac Sounds

  • Demographics of cardiac sound

  • Normal variations in amplitude and pitch of S1 and S2

  • Inspiratory splitting of S1 and S2

  • Close splitting of S1

  • Normal third heart sounds, S3

  • Innocent ejection murmurs

  • Summary, practice and evaluation

Lesson 3 – Abnormal Heart Sounds

  • The source and characteristics of each sound is described

  • Abnormal variations in pitch and amplitude of S1 and S2

  • Valve opening sounds (ejection sounds, opening snaps, systolic clicks)

  • Third and fourth heart sounds, S3 and S4

  • Summary practice and self evaluation

Lesson 4 – Murmurs

  • Clinical demographics of murmurs

  • Origin of murmurs

  • Classification of murmurs

  • Flow murmurs

    1. Ejection

    2. Classification

  • Stenotic murmurs

    1. Aortic stenosis and pulmonic stenosis

    2. Mitral stenosis and triscuspid stenosis

  • Retrograde flow murmurs

    1. Aortic and pulmonic regurgitation

    2. Mitral and triscuspid regurgitation

  • Mitral valve prolapse

  • Septal defects

    1. Ventricular septal defects

    2. Patent ductus arteriosus

  • Friction rubs

  • Summary, practice and self-evaluation


  • Features

The system consists of:

  • Software that produce instruction, heart sounds and synchronized pulse along with the lesson.

  • Individual text/workbooks with color graphics provide the necessary didactic material to understand the auscultatory process and the basic individual cardiac sounds. As individual sounds are described, the appropriate sounds and pulses are reproduced for demonstration and practice. Students also diagram the sounds for comparison to the correct diagrams and descriptions. A review and self evaluation with typical examples of the studied sounds is part of each lesson.

  • A sound reproducer allows realistic practice with the student’s own stethoscope and includes techniques such as "inching". Cardiac sounds from the software are reproduced over a range that exceeds a stethoscopes’ sound transmission capability thus insuring auditory realism.

  • A pulse reproducer, with force/displacement characteristics that mimic those of hemodynamic pulses providing a simulated carotid pulse with tactile realism.

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