Cardiac Cycle and Hemodynamics · USMLE Step 1

Which of the following best describes the first sound (S1) heard during the cardiac cycle?

  1. Closure of the aortic and pulmonary valves
  2. Closure of the mitral and tricuspid valves
  3. Opening of the semilunar valves
  4. Onset of isovolumetric relaxation
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Correct answer: Closure of the mitral and tricuspid valves

S1 (“lub”) is produced by closure of the atrioventricular valves (mitral and tricuspid) at the beginning of ventricular systole when pressure in ventricles rises. This marks the end of ventricular filling and start of isovolumetric contraction.

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