Answer to Jerry, Jerry Quite Contrary
Correct answer is E. To answer this question correctly, it becomes important to pay close attention to the stem of the question. The stem is asking for two specific responses: 1) the apical beat of the heart, but specifically in a patient known to have situs inversus, i.e., their organs are normal, except they developed as mirror images of each other; 2) the surface projection of the mitral valve. This is not the same as stating where one auscultates the valve. Indeed, because the surface projection of the mitral valve is deep to the sternum, the sound of the beating valve is dampen. Iinstead, the valve is heard at the site where the sound projects.
Postscript. The image of the individual is that of Enrique Iglesias, a well-known Latin singer who is known to have inherited situs inversus.
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Answer to this question is based on material presented in lectures 4 of the Thorax Lecture Series.
= Auscultation of aortic valve
= Auscultation of pulmonic valve
= Surface projection of mitral valve
= Auscultation of mitral valve in a normal heart
= Auscultation of mitral valve in situs inversus