Auscultation of heart - how important is these sounds?

[Lothric]

Hey,

You can auscultate for flow murmur (e.g., physiologic murmur) and aortic sclerosis in right intercostal space II. You can also ausculate for flow murmur in left intercostal space II.

Now, FA does not delve deeper when it comes to flow murmur and aortic sclerosis. Is it really enough for me for step 1 to know that these sounds can be auscultated there?

Aortic sclerosis is a precursor to aortic stenosis. Yet, I'm assuming aortic sclerosis sounds different than its terminal stage aortic stenosis. But I guess it's not high-yield to know the sound murmur for aortic sclerosis.

Also, what else than "physiologic" murmur can you hear as "flow murmur" in systole? First aid says "e.g.", so physiologic murmur was just one example. I'm assuming even sounds like aortic regurgitation can be heard here (on top of the aortic regurgitation sound in left sternal border during diastole) due to increased preload which affects the ejection flow... Am I correct in this?

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[OrgoCoop]

Hey,

You can auscultate for flow murmur (e.g., physiologic murmur) and aortic sclerosis in right intercostal space II. You can also ausculate for flow murmur in left intercostal space II.
- True
Now, FA does not delve deeper when it comes to flow murmur and aortic sclerosis. Is it really enough for me for step 1 to know that these sounds can be auscultated there?
- It's more of a guide than anything. FA is never 100%
Aortic sclerosis is a precursor to aortic stenosis. Yet, I'm assuming aortic sclerosis sounds different than its terminal stage aortic stenosis. But I guess it's not high-yield to know the sound murmur for aortic sclerosis.
- Aortic sclerosis would cause a similar murmur to aortic stenosis. They are both due to turbulent flow over the valve during systole. Aortic sclerosis is not tested on USMLE step 1.
Also, what else than "physiologic" murmur can you hear as "flow murmur" in systole? First aid says "e.g.", so physiologic murmur was just one example. I'm assuming even sounds like aortic regurgitation can be heard here (on top of the aortic regurgitation sound in left sternal border during diastole) due to increased preload which affects the ejection flow... Am I correct in this?

- I'm not sure what you're asking, but yes you can hear the aortic regurgitation murmur in the L 2nd intercostal space