107 Sentences With "pulmonic" | Random Sentence Generator

Schwarzenegger, who had a congenital heart defect, had undergone pulmonic valve replacement in 1997.

The pulmonic valve sends blood from the heart's lower right chamber to the artery that delivers blood to the lungs.

Logan was recently diagnosed with Pulmonic Valve Dysplasia, a heart condition that affects the organ's main valve and prevents the puppy's blood from being properly oxygenated.

The former Cali Guv looks remarkably healthy ... just 2 months after undergoing a procedure to replace a pulmonic valve ... this the result of a heart defect.

"Yesterday, Governor Schwarzenegger underwent a planned procedure at Cedars-Sinai to replace a pulmonic valve that was originally replaced due to a congenital heart defect in 1997," he said.

"Governor Schwarzeneggers' pulmonic valve was successfully replaced and he is currently recovering from the surgery and is in stable condition," Ketchell added, before thanking the "entire medical team for their tireless efforts."

" In a statement, Ketchell said, "Yesterday, Governor Schwarzenegger underwent a planned procedure at Cedars-Sinai to replace a pulmonic valve that was originally replaced due to a congenital heart defect in 20013.

"Governor Schwarzeneggers' pulmonic valve was successfully replaced and his is currently recovering from the surgery and is in stable condition," Ketchell added, before thanking the "entire medical team for their tireless efforts."

The actor has looked healthy lately after undergoing emergency open-heart surgery in March 2018 while his doctor was attempting to replace a pulmonic valve that was originally replaced in 1997 due to a congenital heart defect.

He has gone through weeks of recovery since then, and he recently shared a video to thank well-wishers after the operation which switched out a pulmonic valve that was originally replaced in 1997 due to a congenital heart defect.

Pulmonic egressive sounds are those in which the air stream is created by the lungs, ribs, and diaphragm. The majority of sounds in most languages, such as vowels, are both pulmonic and egressive. Pulmonic egressive sounds are found in all spoken languages.Ogden, Richard.

Initiation by means of the lungs (actually the diaphragm and ribs) is called pulmonic initiation. The vast majority of sounds used in human languages are pulmonic egressives. In most languages, including all the languages of Europe (excluding the Caucasus), all phonemes are pulmonic egressives. The only attested use of a phonemic pulmonic ingressive is a lateral fricative in Damin, a ritual language formerly used by speakers of Lardil in Australia.

The aortic valve closes slightly before the pulmonic, and this difference is accentuated during inspiration when S2 splits into two distinct components (physiological splitting). During expiration, the pulmonic valve closes at nearly the same time as the aortic, and splitting of S2 cannot be heard. Exercise increases the intensity of both the aortic and pulmonic components of S2, whereas deep inspiration increases the intensity of the pulmonic component only.

Six series of pulmonic-contour clicks (as classified by the rear release) are attested. There are two manners of articulation (stop and fricative) and four voicing contrasts, each of which is found for each of the places of articulation (as classified by the front release) that clicks use. ;Linguo-pulmonic stops In linguo-pulmonic stops, the rear articulation is released into a pulmonic stop. This may be tenuis, aspirated, voiced, or murmured (breathy-voiced).

Chihuahuas are also prone to some heart-related disorders, such as heart murmurs and pulmonic stenosis, a condition in which the blood outflow from the heart's right ventricle is obstructed at the pulmonic valve.

Pulmonic-contour clicks, also called sequential linguo-pulmonic consonants, are consonants that transition from a click to an ordinary pulmonic sound, or more precisely, have an audible delay between the front and rear release of the click. All click types (alveolar , dental , lateral , palatal , retroflex , and labial ) have linguo-pulmonic variants, which occur as both stops and affricates, and are attested in four phonations: tenuis, voiced, aspirated, and murmured (breathy voiced). At least a voiceless linguo-pulmonic affricate is attested from all Khoisan languages of southern Africa (the Khoe, Tuu, and Kx'a language families), as well as (reportedly) from the Bantu language Yeyi from the same area, but they are unattested elsewhere.

The International Phonetic Association organizes the letters of the IPA into three categories: pulmonic consonants, non-pulmonic consonants, and vowels."Segments can usefully be divided into two major categories, consonants and vowels." (International Phonetic Association, Handbook, p. 3)International Phonetic Association, Handbook, p. 6.

Both stenosis of the pulmonary artery and pulmonary valve stenosis are forms of pulmonic stenosis (nonvalvular and valvular, respectively) but pulmonary valve stenosis accounts for 80% of pulmonic stenosis. PVS was the key finding that led Jacqueline Noonan to identify the syndrome now called Noonan syndrome.

The lungs drive nearly all speech production, and their importance in phonetics is due to their creation of pressure for pulmonic sounds. The most common kinds of sound across languages are pulmonic egress, where air is exhaled from the lungs. The opposite is possible, though no language is known to have pulmonic ingressive sounds as phonemes. Many languages such as Swedish use them for paralinguistic articulations such as affirmations in a number of genetically and geographically diverse languages.

This ambiguity does not occur with the next airstream mechanism, lingual, which is clearly distinct from pulmonic sounds.

That is, in a simple click, the release of the rear articulation is not audible, whereas in a contour click, the rear (uvular) articulation is audibly released after the front (click) articulation, resulting in a double release. These contour clicks may be linguo-pulmonic, that is, they may transition from a click (lingual) articulation to a normal pulmonic consonant like (e.g. ); or linguo-glottalic and transition from lingual to an ejective consonant like (e.g. ): that is, a sequence of ingressive (lingual) release + egressive (pulmonic or glottalic) release.

Stops may be made with more than one airstream mechanism. The normal mechanism is pulmonic egressive, that is, with air flowing outward from the lungs. All languages have pulmonic stops. Some languages have stops made with other mechanisms as well: ejective stops (glottalic egressive), implosive stops (glottalic ingressive), or click consonants (lingual ingressive).

"The Representation of Clicks". In Oostendorp et al. eds., The Blackwell Companion to Phonology. See pulmonic- contour clicks for discussion.

Pulmonic ingressive describes ingressive sounds in which the airstream is created by the lungs. These are generally considered paralinguistic. They may be found as phonemes, words, and entire phrases on all continents and in genetically-unrelated languages, most frequently in sounds for agreement and backchanneling. Some pulmonic ingressive sounds do not have egressive counterparts.

Others include atrial septal defect, cardiac diverticulum, pulmonic stenosis, double outlet right ventricle, tetralogy of Fallot, dextrocardia, and transposition of the great vessels.

In phonetics and phonology, nonexplosive stops are posited class of non- pulmonic ("non-obstruent") stop consonants that lack the pressure build-up and burst release associated with pulmonic stops, but also the laryngeal lowering of implosive stops. They are reported to occur in Ikwere, an Igboid (Niger–Congo) language of Nigeria. Ikwere's two nonexplosive stops, transcribed as voiced and pre-glottalized , are reflexes of labial-velars and , respectively, in most other Igboid languages, and to implosives and in some varieties of Igbo. Ikwere's stops resemble both, in that they are velarized and have a non-pulmonic airstream mechanism.

For example, the cell for a velar trill in the IPA chart is greyed out as not being possible, but an ingressive velar (or velic) trill is a snort.University of Hawaii Working Papers in Linguistics, 1969, Volume 1, Parts 4–6, Page 115. Pulmonic ingressive sounds are extremely rare outside paralinguistics. A pulmonic ingressive phoneme was found in the ritual language Damin; its last speaker died in the 1990s.

Pulmonic stenosis, is a dynamic or fixed obstruction of flow from the right ventricle of the heart to the pulmonary artery. It is usually first diagnosed in childhood.

This may be because the vocal cavity behind the rearmost closure, behind which the air passing through the glottis for voicing must be contained, is so small that clicks cannot be voiced for long. Allowing the airstream to pass through the nose enables a longer production. Nasal clicks involve a combination of lingual and pulmonic mechanisms. The velum is lowered so as to direct pulmonic airflow through the nasal cavity during the lingual initiation.

The increased blood volume in the right ventricle causes the pulmonic valve to stay open longer during ventricular systole. This causes a normal delay in the P2 component of S2. During expiration, the positive intrathoracic pressure causes decreased blood return to the right side of the heart. The reduced volume in the right ventricle allows the pulmonic valve to close earlier at the end of ventricular systole, causing P2 to occur earlier.

Schwarzenegger was born with a bicuspid aortic valve, an aortic valve with only two leaflets (a normal aortic valve has three leaflets). He opted in 1997 for a replacement heart valve made of his own transplanted tissue (from his pulmonic valve, which itself is replaced with a cadaveric pulmonic valve, in a Ross procedure); medical experts predicted he would require heart valve replacement surgery in the following two to eight years as his valve would progressively degrade. Schwarzenegger apparently opted against a mechanical valve, the only permanent solution available at the time of his surgery, because it would have sharply limited his physical activity and capacity to exercise. On March 29, 2018, Schwarzenegger underwent emergency open-heart surgery for replacement of his replacement pulmonic valve.

Glottal ingressive is the term generally applied to the implosive consonants, which actually use a mixed glottalic ingressive–pulmonic egressive airstream. True glottalic ingressives are quite rare and are called "voiceless implosives" or "reverse ejectives".

In phonetics, ingressive sounds are sounds by which the airstream flows inward through the mouth or nose. The three types of ingressive sounds are lingual ingressive or velaric ingressive (from the tongue and the velum), glottalic ingressive (from the glottis), and pulmonic ingressive (from the lungs). The opposite of an ingressive sound is an egressive sound, by which the air stream is created by pushing air out through the mouth or nose. The majority of sounds in most languages, such as vowels, are both pulmonic and egressive.

This nasal airflow may itself be egressive or ingressive, independently of the lingual initiation of the click. Nasal clicks may be voiced, but are very commonly unvoiced and even aspirated, which is rare for purely pulmonic nasals.

This diagram shows the valves of the heart. The aortic and mitral valves are shown in the left heart, and the tricuspid and pulmonic valves are shown in the right heart. Valvular heart disease is any cardiovascular disease process involving one or more of the four valves of the heart (the aortic and mitral valves on the left side of heart and the pulmonic and tricuspid valves on the right side of heart). These conditions occur largely as a consequence of aging,Burden of valvular heart diseases: a population-based study.

Signs of systemic congestion resulting from right-sided heart failure include jugular venous distension, ascites, and hepatojugular reflux. Evidence of tricuspid insufficiency and pulmonic regurgitation is also sought and, if present, is consistent with the presence of pulmonary hypertension.

The words ('yes') and ('no') are sometimes pronounced with inhaled breath (pulmonic ingressive) in Norwegian. The same phenomenon occurs across the other Scandinavian languages, and can also be found in German, French, Finnish and Japanese, to name a few.

Phonetically, a linguo- glottalic consonant is a click in which the forward and rear articulations are released independently. The forward articulation, made with the lips or the front of the tongue, releases with a lingual airstream as in any click. The rear articulation, however, is held longer, and when it is released, it is with a glottalic airstream. (Linguo-pulmonic consonants are similar, except that the second release is pulmonic, as in English consonants.) That is, such consonants have a double release burst, one ingressive (the air pulled in by the tongue) and the other egressive (the air pushed out by the glottis).

Phonetically, a linguo-pulmonic consonant is a click in which the forward and rear articulations are released independently. The forward articulation, made with the lips or the front of the tongue, releases with a lingual airstream as in any click. The rear articulation, however, is held longer, and when it is released, it is with a pulmonic airstream. (Linguo- ejective consonants are similar, except that the second release is ejective.) That is, such consonants have a double release burst, one ingressive (the air pulled in by the tongue) and the other egressive (the air pushed out by the lungs).

The physical findings in an adult with an ASD include those related directly to the intracardiac shunt and those that are secondary to the right heart failure that may be present in these individuals. Upon auscultation of the heart sounds, a systolic ejection murmur may be heard that is attributed to the pulmonic valve, due to the increased flow of blood through the pulmonic valve rather than any structural abnormality of the valve leaflets. In unaffected individuals, respiratory variations occur in the splitting of the second heart sound (S2). During respiratory inspiration, the negative intrathoracic pressure causes increased blood return into the right side of the heart.

Pulmonic stenosis is usually due to isolated valvular obstruction (pulmonary valve stenosis), but it may be due to subvalvular or supravalvular obstruction, such as infundibular stenosis. It may occur in association with other congenital heart defects as part of more complicated syndromes (for example, tetralogy of Fallot).

The pressure in the ventricles must be greater than the systemic and pulmonary pressure to open the aortic and pulmonic valves, respectively. As afterload increases, cardiac output decreases. Cardiac imaging is a somewhat limited modality in defining afterload because it depends on the interpretation of volumetric data.

Ingressive speech sounds are produced while the speaker breathes in, in contrast to most speech sounds, which are produced as the speaker breathes out. The air that is used to voice the speech is drawn in rather than pushed out. Ingressive speech can be glottalic, velaric, or pulmonic.

Unlike pulmonic voiced sounds, in which a stream of air passes through a usually-fixed glottis, in voiced implosives a mobile glottis passes over a nearly motionless air column to cause vibration of the vocal cords. Phonations that are more open than modal voice, such as breathy voice, are not conducive to glottalic sounds because in these the glottis is held relatively open, allowing air to readily flow through and preventing a significant pressure difference from building up behind the articulator. Because the oral cavity is so much smaller than the lungs, vowels and approximants cannot be pronounced with glottalic initiation. So-called glottalized vowels and other sonorants use the more common pulmonic egressive airstream mechanism.

There is no clear divide between pulmonic and glottalic sounds. Some languages may have consonants which are intermediate. For example, glottalized consonants in London English, such as the t in rat , may be weakly ejective. Similarly, fully voiced stops in languages such as Thai, Zulu, and Maidu are weakly implosive.

Obstructive defects occur when heart valves, arteries, or veins are abnormally narrow or blocked. Common defects include pulmonic stenosis, aortic stenosis, and coarctation of the aorta, with other types such as bicuspid aortic valve stenosis and subaortic stenosis being comparatively rare. Any narrowing or blockage can cause heart enlargement or hypertension.

More appreciable insufficiency is typically the result of damage to the valve due to cardiac catheterization, intra-aortic balloon pump insertion, or other surgical manipulations. Additionally, insufficiency may be the result of carcinoid syndrome, inflammatory processes such a rheumatoid disease or endocarditis, or congenital malformations.Isolated pulmonic valve infective endocarditis: a persistent challenge.

Front of thorax, showing surface relations of bones, lungs (purple), pleura (blue), and heart (red outline). Heart valves are labeled with "B", "T", "A", and "P". First heart sound: caused by atrioventricular valves - Bicuspid/Mitral (B) and Tricuspid (T). Second heart sound caused by semilunar valves -- Aortic (A) and Pulmonary/Pulmonic (P).

VSD with pulmonic stenosis 3\. Large VSD with pulmonary hypertension 4\. VSD with aortic regurgitation For the surgical procedure, a heart-lung machine is required and a median sternotomy is performed. Percutaneous endovascular procedures are less invasive and can be done on a beating heart, but are only suitable for certain patients.

Pulmonic consonant letters are arranged singly or in pairs of voiceless (tenuis) and voiced sounds, with these then grouped in columns from front (labial) sounds on the left to back (glottal) sounds on the right. In official publications by the IPA, two columns are omitted to save space, with the letters listed among 'other symbols',"for presentational convenience [...] because of [their] rarity and the small number of types of sounds which are found there." (IPA Handbook, p 18) and with the remaining consonants arranged in rows from full closure (occlusives: stops and nasals), to brief closure (vibrants: trills and taps), to partial closure (fricatives) and minimal closure (approximants), again with a row left out to save space. In the table below, a slightly different arrangement is made: All pulmonic consonants are included in the pulmonic-consonant table, and the vibrants and laterals are separated out so that the rows reflect the common lenition pathway of stop → fricative → approximant, as well as the fact that several letters pull double duty as both fricative and approximant; affricates may be created by joining stops and fricatives from adjacent cells.

In pulmonic sounds, the airstream is produced by the lungs in the subglottal system and passes through the larynx and vocal tract. Glottalic sounds use an airstream created by movements of the larynx without airflow from the lungs. Click consonants are articulated through the rarefaction of air using the tongue, followed by releasing the forward closure of the tongue.

These clicks are affricates at the posterior place of articulation; they are independent of the fricated alveolar clicks, which are affricates at their anterior place of articulation, a manner which does not affect the airstream. The fricated alveolar clicks may be lingual or linguo- pulmonic—that is, they may be affricates at both places of articulation, or at one.

Front of thorax, showing surface relations of bones, lungs (purple), pleura (blue), and heart (red outline). The locations of best auscultation for each heart valve are labeled with "M", "T", "A", and "P". First heart sound: caused by atrioventricular valves – Mitral (M) and Tricuspid (T). Second heart sound caused by semilunar valves – Aortic (A) and Pulmonary/Pulmonic (P).

In general the Carrier syllable is maximally CVC. All consonants other than the extremely rare are found in syllable- initial position. The possible coda consonants, on the other hand, are restricted. All of the sonorants except for the extremely rare palatal nasal may occur in the coda, but of the obstruents only the pulmonic unaspirated series occur.

The ejectives , on the other hand, have short frication, presumably due to the lack of pulmonic airflow. There is a period of near silence before the glottalized onset of the vowel. In there may be a double glottal release, or a creaky onset to the vowel not found in the other ejective affricates. ;Continuants Navajo voiceless continuants are realized as fricatives.

These holds may be voiceless, voiced, or nasalized. Then lower the body of the tongue to rarefy the air above it. The closure at the front of the tongue is opened first, as the click "release"; then the closure at the back is released for the pulmonic or glottalic click "accompaniment" or "efflux". This may be aspirated, affricated, or even ejective.

Because pulmonic regurgitation is the result of other factors in the body, any noticeable symptoms are ultimately caused by an underlying medical condition rather than the regurgitation itself. However, more severe regurgitation may contribute to right ventricular enlargement by dilation, and in later stages, right heart failure. A diastolic decrescendo murmur can sometimes be identified,( heard best) over the left lower sternal border.

Miller (2003) attributes this to a larger glottal opening than is found in for example Hindustani breathy-voiced consonants. ;Linguo-pulmonic affricates The rear articulation may also be released as a fricative, one which may be either voiceless or voiced. Aspiration / breathy voice is not distinctive, as fricatives are not easily aspirated. However, because the forward articulation may be considered a stop, these are called affricates rather than fricatives.

In human speech, egressive sounds are sounds in which the air stream is created by pushing air out through the mouth or nose. The three types of egressive sounds are pulmonic egressive (from the lungs), glottalic egressive (from the glottis), and lingual (velaric) egressive (from the tongue). The opposite of an egressive sound is an ingressive sound, in which the airstream flows inward through the mouth or nose.

The Impella Device is a generational extension of the Intra aortic balloon pump (IABP) in addressing cardiogenic shock. Tech has allowed a single moving piece floated by magnetically steered mechanisms to deploy an "Archimedes Pump" just north of the Aortic Valve that purports to reduce both preload and afterload. The same tech can apparently also be deployed just above the pulmonary (pulmonic) valve as a gate on right sided heart failure.

Treatments, depending upon the cause and severity, may include a pharmacological approach (i.e., the use of certain steroids), or surgical intervention, like a cochlear implant. Pulmonary, or pulmonic stenosis is an often congenital narrowing of the pulmonary valve; it can be present in nasodigitoacoustic-affected infants. Treatment of this cardiac abnormality can require surgery, or non-surgical procedures like balloon valvuloplasty (widening the valve with a balloon catheter).

The technique was first described by Muller And Dammann at UCLA in 1951.Muller WH, Dammann JF. Treatment of certain congenital malformations of the heart by the creation of pulmonic stenosis to reduce pulmonary hypertension and excessive pulmonary blood flow: A preliminary report. Surgery Gynecol Obstet. 1952;95:213. In recent years, the use of this technique has declined as studies have indicated that early definitive repair is preferable to this form of palliation.

In interjections, but not in normal words, pulmonic ingressive vowels or words occur on all continents.Robert Eklund This is commonly done for back-channeling (as with in Ewe) or affirmation (as with in Swedish). In English, an audible intake of breath, , or an indrawn consonant such as or is used in a conversation to indicate that someone is about to speak or is preparing to continue speaking.Ogden (2009) An Introduction to English Phonetics, p.

There are two conventions for writing the frication: the English convention, with an , and the Afrikaans tradition, with a . Both are used in the orthographies of Khoisan languages. In Juǀ’hõa, for example, they are written voiceless and voiced , and in the old orthography and ; in Naro, they are (voiceless) , and in Khoekhoe . In the IPA, the two series of linguo-pulmonic affricates may be written and , though with a cluster analysis they would be and .

The words tack and sack both begin with alveolar sounds in English, but differ in how far the tongue is from the alveolar ridge. This difference has large affects on the air stream and thus the sound that is produced. Similarly, the direction and source of the airstream can affect the sound. The most common airstream mechanism is pulmonic—using the lungs—but the glottis and tongue can also be used to produce airstreams.

The term initiation refers to the change. Since changes in air pressures between connected cavities lead to airflow between the cavities, initiation is also referred to as an airstream mechanism. The three pistons present in the articulatory system are the larynx, the tongue body, and the physiological structures used to manipulate lung volume (in particular, the floor and the walls of the chest). The lung pistons are used to initiate a pulmonic airstream (found in all human languages).

This can be written with the extended version of the International Phonetic Alphabet as . !Xóõ has ingression as a phonetic detail in one series of its clicks, which are ingressive voiceless nasals with delayed aspiration, . Peter Ladefoged considers these to be among the most difficult sounds in the world. Other languages, for example in Taiwan, have been claimed to have pulmonic ingressives, but these claims have either proven to be spurious or to be occasional phonetic detail.

The respiratory organs used to create and modify airflow are divided into three regions: the vocal tract (supralaryngeal), the larynx, and the subglottal system. The airstream can be either egressive (out of the vocal tract) or ingressive (into the vocal tract). In pulmonic sounds, the airstream is produced by the lungs in the subglottal system and passes through the larynx and vocal tract. Glottalic sounds use an airstream created by movements of the larynx without airflow from the lungs.

Wiggers diagram of various events of a cardiac cycle, with 2nd heart sound at bottom. A split S2 is a finding upon auscultation of the S2 heart sound. It is caused when the closure of the aortic valve (A2) and the closure of the pulmonary valve (P2) are not synchronized during inspiration. The second heart sound (S2) is caused by the closure of the aortic and pulmonic valves, which causes vibration of the valve leaflets and the adjacent structures.

The Dahalo, former elephant hunters, are dispersed among Swahili and other Bantu peoples, with no villages of their own, and are bilingual in those languages. Children no longer learn the language, which would make it moribund, and it may be extinct. Dahalo has a highly diverse sound system using all four airstream mechanisms found in human language: clicks, ejectives, and implosives, as well as the universal pulmonic sounds. In addition, Dahalo makes a number of uncommon distinctions.

Speech sounds are categorized by manner of articulation and place of articulation. Place of articulation refers to where the airstream in the mouth is constricted. Manner of articulation refers to the manner in which the speech organs interact, such as how closely the air is restricted, what form of airstream is used (e.g. pulmonic, implosive, ejectives, and clicks), whether or not the vocal cords are vibrating, and whether the nasal cavity is opened to the airstream.

Many household plants are poisonous to dogs (and other mammals), including Begonia, Poinsettia, and Aloe vera. Some breeds of dogs are prone to specific genetic ailments such as elbow and hip dysplasia, blindness, deafness, pulmonic stenosis, cleft palate, and trick knees. Two severe medical conditions significantly affecting dogs are pyometra, affecting unspayed females of all types and ages, and gastric dilatation volvulus (bloat), which affects the larger breeds or deep-chested dogs. Both of these are acute conditions and can kill rapidly.

In phonetics, a plosive, also known as an occlusive or simply a stop, is a pulmonic consonant in which the vocal tract is blocked so that all airflow ceases. The occlusion may be made with the tongue tip or blade (, ) tongue body (, ), lips (, ), or glottis (). Plosives contrast with nasals, where the vocal tract is blocked but airflow continues through the nose, as in and , and with fricatives, where partial occlusion impedes but does not block airflow in the vocal tract.

Two damaging de novo NAA15 mutations were reported by exome sequencing in parent- offspring trios with congenital heart disease. Patient 1 harbors a frameshift mutation (p. Lys335fs) and displays heterotaxy (dextrocardia, total anomalous pulmonary venous return, left superior vena cava, hypoplastic TV, double outlet right ventricle, hypoplastic RV, D-transposition of the great arteries, pulmonic stenosis) and hydronephrosis, asplenia, malrotation and abnormal neuro-development, the second patient harbors a nonsense mutation (p.S761X) and displays conotruncal defects (tetralogy of Fallot, single left coronary artery).

A pulmonary-to-systemic shunt is a cardiac shunt which allows, or is designed to cause, blood to flow from the pulmonary circulation to the systemic circulation. This occurs when: #there is a passage between two or more of the great vessels; and, #pulmonic pressure is higher than systemic pressure and/or the shunt has a one-way valvular opening. A pulmonary-to-systemic shunt functions as follows: # right-to-left in the absence of arterioventricular discordance. # left-to-right if the great vessels are transposed.

Severe peripheral (pitting) edema Right-sided heart failure is often caused by pulmonary heart disease (cor pulmonale), which is typically caused by difficulties of the pulmonary circulation, such as pulmonary hypertension or pulmonic stenosis. Physical examination may reveal pitting peripheral edema, ascites, liver enlargement, and spleen enlargement. Jugular venous pressure is frequently assessed as a marker of fluid status, which can be accentuated by eliciting hepatojugular reflux. If the right ventricular pressure is increased, a parasternal heave may be present, signifying the compensatory increase in contraction strength.

Pulmonary Artery Banding (PAB) was introduced by Muller and Dammann in 1951 as a surgical technique to reduce excessive pulmonary blood flow in infants suffering from congenital heart defects.Muller WH, Dammann JF. Treatment of certain congenital malformations of the heart by the creation of pulmonic stenosis to reduce pulmonary hypertension and excessive pulmonary blood flow: A preliminary report. Surgery Gynecol Obstet. 1952;95:213. PAB is a palliative operation as it does not correct the problems, but attempts to improve abnormal heart function, relieve symptoms and reduce high pressure in the lungs.

Stenosis of the pulmonary artery is a condition where the pulmonary artery is subject to an abnormal constriction (or stenosis). Peripheral pulmonary artery stenosis may occur as an isolated event or in association with Alagille syndrome, Berardinelli-Seip congenital lipodystrophy type 1, Costello syndrome, Keutel syndrome, nasodigitoacoustic syndrome (Keipert syndrome), Noonan syndrome or Williams syndrome. It should not be confused with a pulmonary valve stenosis, which is in the heart, but can have similar hemodynamic effects. Both stenosis of the pulmonary artery and pulmonary valve stenosis are causes of pulmonic stenosis.

In some treatments, complex clicks are posited to have airstream contours, in which the airstream changes between the front (click) and rear (non-click) release. There are two attested types: Linguo-pulmonic consonants, where the rear release is a uvular obstruent such as or ; and linguo-glottalic consonants, where the rear release is an ejective such as or . Theoretically, a release into an implosive should be possible, but both clicks and dorsal implosives () are rare (the latter because they are difficult to pronounce), and no language is known to combine them.

The description above is typical, characteristic of languages such as Khoekhoe and Gǀui. However, aspirated nasal clicks have a more extreme pronunciation in Taa, where they need to maintain a distinction from both the plain voiceless and breathy-voiced nasal clicks. In this language they are not voiced after vowel sounds except in rapid speech, and in addition do not have nasal airflow; Trail reports that they instead have active ingressive pulmonic airflow (that is, air is breathed in the nose rather than being vented out). Breathy-voiced (murmured) nasal clicks are less common.

In the IPA, the two series of linguo-pulmonic affricates may be written and (also ), though with a cluster analysis they would be and . Miller (2011) distinguishes between two kinds of affricates: homorganic, where the rear articulation has the same uvular place in its release as it held during the front release, and heterorganic, where it is either velar or epiglottal. Although no language contrasts these possibilities from homorganic affricates, she holds that they are different enough in sound that considering them to be different consonants is useful.

On March 2, 2012, a video was posted to her brother, Jake Newton's YouTube channel of the two singing a song cover of Whitney Houston's "I Wanna Dance With Somebody". Newton was born with several congenital heart defects, including a ventricular septal defect, an atrial septal defect, transposition of the great vessels, and pulmonic stenosis. She has undergone 4 open heart surgeries between the ages of 14 days and 13 years old. Due to this, Newton has often said that she is an advocate of people donating organs.

Conversely, a concentrically hypertrophied left ventricle may have a lower afterload for a given aortic pressure. When contractility becomes impaired and the ventricle dilates, the afterload rises and limits output. This may start a vicious circle, in which cardiac output is reduced as oxygen requirements are increased. Afterload can also be described as the pressure that the chambers of the heart must generate to eject blood from the heart, and thus is a consequence of aortic pressure (for the left ventricle) and pulmonic pressure or pulmonary artery pressure (for the right ventricle).

Pulmonary heart disease, also known as cor pulmonale, is the enlargement and failure of the right ventricle of the heart as a response to increased vascular resistance (such as from pulmonic stenosis) or high blood pressure in the lungs. Chronic pulmonary heart disease usually results in right ventricular hypertrophy (RVH), whereas acute pulmonary heart disease usually results in dilatation. Hypertrophy is an adaptive response to a long-term increase in pressure. Individual muscle cells grow larger (in thickness) and change to drive the increased contractile force required to move the blood against greater resistance.

The closure of the aortic valve contributes the A2 component of the second heart sound. The pulmonary valve (sometimes referred to as the pulmonic valve) lies between the right ventricle and the pulmonary artery, and has three cusps. Similar to the aortic valve, the pulmonary valve opens in ventricular systole, when the pressure in the right ventricle rises above the pressure in the pulmonary artery. At the end of ventricular systole, when the pressure in the right ventricle falls rapidly, the pressure in the pulmonary artery will close the pulmonary valve.

We avoid this phrase, preferring to reserve the term 'stop' for sounds in which there is a complete interruption of airflow. In addition, they restrict "plosive" for a pulmonic consonants; "stops" in their usage include ejective and implosive consonants. If a term such as "plosive" is used for oral non-affricated obstruents, and nasals are not called nasal stops, then a stop may mean the glottal stop; "plosive" may even mean non-glottal stop. In other cases, however, it may be the word "plosive" that is restricted to the glottal stop.

Many languages also have labialized velars, such as , in which the articulation is accompanied by rounding of the lips. There are also labial–velar consonants, which are doubly articulated at the velum and at the lips, such as . This distinction disappears with the approximant consonant since labialization involves adding of a labial approximant articulation to a sound, and this ambiguous situation is often called labiovelar. A velar trill or tap is not possible according to the International Phonetics Association: see the shaded boxes on the table of pulmonic consonants.

They are fully nasalized throughout, like the pulmonic nasal and . That is, you pronounce a uvular sound (like English ng) with the back of your tongue, and make the click sound in the middle of it using the front of your tongue. They are typically transcribed something like ; in Khoekhoe, they are written , in Juǀʼhõa as , and in Zulu, Xhosa, Sandawe, and Naro as . Aspirated nasal clicks, often described as voiceless nasal with delayed aspiration, are widespread in southern Africa, being found in all languages of the Khoe, Tuu, and Kx'a language families, though they are unattested elsewhere.

The modally voiced and breathy-voiced clicks tend to be prenasalized in the various languages which use them, for reasons which are not clear. They tend to be written with a before or after the letter for the click, and with an afterward for the aspirated and breathy-voiced clicks. In IPA, using the alveolar series as an example, the four attested series of linguo-pulmonic stops may be transcribed , , , , with the possibility of or to indicate the prenasalization. The breathy-voiced consonants of some languages such as Juǀʼhoansi, including clicks, contain a voiceless interval and are sometimes written with mixed voicing.

Both egressive and ingressive sounds rely on holding the vocal folds in a particular posture and using the lungs to draw air across the vocal folds so that they either vibrate (voiced) or do not vibrate (voiceless). Pulmonic articulations are restricted by the volume of air able to be exhaled in a given respiratory cycle, known as the vital capacity. The lungs are used to maintain two kinds of pressure simultaneously in order to produce and modify phonation. To produce phonation at all, the lungs must maintain a pressure of 3–5 cm H20 higher than the pressure above the glottis.

The pulmonary valve (sometimes referred to as the pulmonic valve) is the semilunar valve of the heart that lies between the right ventricle and the pulmonary artery and has three cusps. Similar to the aortic valve, the pulmonary valve opens in ventricular systole, when the pressure in the right ventricle rises above the pressure in the pulmonary artery. At the end of ventricular systole, when the pressure in the right ventricle falls rapidly, the pressure in the pulmonary artery will close the pulmonary valve. The closure of the pulmonary valve contributes the P2 component of the second heart sound (S2).

An artificial heart valve is a one-way valve implanted into the heart of a patient to replace a disfunctional native heart valve (valvular heart disease). The human heart contains four valves: tricuspid valve, pulmonic valve, mitral valve and aortic valve. Their main purpose is to keep blood flowing in one direction through the heart, and from the heart into the major blood vessels connected to it (the pulmonary artery and the aorta). Heart valves can malfunction for a variety of reasons, which can impede the flow of blood through the valve (stenosis) and/or let blood flow backwards through the valve (regurgitation).

When, in late ventricular diastole, the atrial chambers contract, they send blood down to the larger, lower ventricle chambers. When normal flow is completed, the ventricles are filled and the valves to the atria are closed. The ventricles now perform systole isovolumetrically, which is contraction while all valves are closed—ending the first stage of systole. The second stage proceeds immediately, pumping oxygenated blood from the left ventricle through the aortic valve and aorta to all body systems, and simultaneously pumping oxygen-poor blood from the right ventricle through the pulmonic valve and pulmonary artery to the lungs.

Several superior letters are used in phonetic transcription systems. The International Phonetic Alphabet uses the superscript n ⁿ for nasal release, the superscript w ʷ to indicate labialized or labio-velarized consonants, the superscript h ʰ for aspirated consonants, the superscript j ʲ for palatalized consonants, the superscript gamma ᵞ for velarized consonants, the superscript turned h ᶣ for labio-palatalized consonants, the superscript reversed glottal stop for pharyngealized consonants, the superscript glottal stop is used for glottalized but pulmonic sonorants, such as [mˀ], [lˀ], [wˀ], [aˀ]. Other superscript letters are used as an alternative way to represent double articulated consonants, for example [tˢ] for [t͡s].

Right heart strain (also right ventricular strain or RV strain) is a medical finding of right ventricular dysfunction where the heart muscle of the right ventricle (RV) is deformed. Right heart strain can be caused by pulmonary hypertension, pulmonary embolism (or PE, which itself can cause pulmonary hypertension), RV infarction (a heart attack affecting the RV), chronic lung disease (such as pulmonary fibrosis), pulmonic stenosis, bronchospasm, and pneumothorax. When using an echocardiograph (echo) to visualize the heart, strain can appear with the RV being enlarged and more round than typical. When normal, the RV is about half the size of the left ventricle (LV).

Clicks may be pronounced with a third place of articulation, glottal. A glottal stop is made during the hold of the click; the (necessarily voiceless) click is released, and then the glottal hold is released into the vowel. Glottalised clicks are very common, and they are generally nasalised as well. The nasalisation cannot be heard during the click release, as there is no pulmonic airflow, and generally not at all when the click occurs at the beginning of an utterance, but it has the effect of nasalising preceding vowels, to the extent that the glottalised clicks of Sandawe and Hadza are often described as prenasalised when in medial position.

The concept is primarily used for the production of consonants, but can be used for vowels in qualities such as voicing and nasalization. For any place of articulation, there may be several manners of articulation, and therefore several homorganic consonants. Normal human speech is pulmonic, produced with pressure from the lungs, which creates phonation in the glottis in the larynx, which is then modified by the vocal tract and mouth into different vowels and consonants. However humans can pronounce words without the use of the lungs and glottis in alaryngeal speech, of which there are three types: esophageal speech, pharyngeal speech and buccal speech (better known as Donald Duck talk).

Electrical systole opens voltage-gated sodium, potassium and calcium channels in cells of myocardium tissue. Subsequently, a rise in intracellular calcium triggers the interaction of actin and myosin in the presence of ATP which generates mechanical force in the cells in the form of muscular contraction, or mechanical systole. The contractions generate intra-ventricular pressure, which is increased until it exceeds the external, residual pressures in the adjacent trunks of both the pulmonary artery and the aorta; this stage, in turn, causes the pulmonary and aortic valves to open. Blood is then ejected from the two ventricles, pulsing into both the pulmonic and aortic circulation systems.

When pulmonic stenosis (PS) is present, resistance to blood flow causes right ventricular hypertrophy. If right ventricular failure develops, right atrial pressure will increase, and this may result in a persistent opening of the foramen ovale, shunting of unoxygenated blood from the right atrium into the left atrium, and systemic cyanosis. If pulmonary stenosis is severe, congestive heart failure occurs, and systemic venous engorgement will be noted. An associated defect such as a patent ductus arteriosus partially compensates for the obstruction by shunting blood from the left ventricle to the aorta then back to the pulmonary artery (as a result of the higher pressure in the left ventricle) and back into the lungs.

If both pulmonary arteries are not mobilized adequately, they can become stretched, leading to pulmonic stenosis. Commonly, the maneuver is used during an arterial switch procedure (in which the pulmonary artery and aorta switch positions) or in surgery to correct absent pulmonary valve syndrome. It is also used in corrective surgeries for Tetralogy of Fallot where the pulmonary valve is anomalous, persistent truncus arteriosus with aortopulmonary window that affects the aortic arch, left-to-right shunts, anomalous right pulmonary artery, and ALCAPA (anomalous left coronary artery from the pulmonary artery). Other surgeries that regularly employ the LeCompte maneuver include the Yasui procedure, REV procedure, and Nikaidoh operation, all of which are used to reconstruct hearts with an anomalous left ventricular outflow tract.

The cardiac cycle at the point of beginning a ventricular systole, or contraction: 1) newly oxygenated blood (red arrow) in the left ventricle begins pulsing through the aortic valve to supply all body systems; 2) oxygen- depleted blood (blue arrow) in the right ventricle begins pulsing through the pulmonic (pulmonary) valve en route to the lungs for reoxygenation. P wave depolarization is the start-point of the atrial stage of systole. The ventricular stage of systole begins at the R peak of the QRS wave complex; the T wave indicates the end of ventricular contraction, after which ventricular relaxation (ventricular diastole) begins. The systole () is the part of the cardiac cycle during which some chambers of the heart muscle contract after refilling with blood.

In this defect there is typically a proximal chamber that receives the pulmonic veins and a distal (true) chamber located more anteriorly where it empties into the mitral valve. The membrane that separates the atrium into two parts varies significantly in size and shape. It may appear similar to a diaphragm or be funnel-shaped, bandlike, entirely intact (imperforate) or contain one or more openings (fenestrations) ranging from small, restrictive-type to large and widely open. In the pediatric population, this anomaly may be associated with major congenital cardiac lesions such as tetralogy of Fallot, double outlet right ventricle, coarctation of the aorta, partial anomalous pulmonary venous connection, persistent left superior vena cava with unroofed coronary sinus, ventricular septal defect, atrioventricular septal (endocardial cushion) defect, and common atrioventricular canal.

Since there is an increase in blood volume in the right ventricle during inspiration, the pulmonary valve (P2 component of S2) stays open longer during ventricular systole due to an increase in ventricular emptying time, whereas the aortic valve (A2 component of S2) closes slightly earlier due to a reduction in left ventricular volume and ventricular emptying time. Thus the P2 component of S2 is delayed relative to that of the A2 component. This delay in P2 versus A2 is heard as a slight broadening or even "splitting" of the second heart sound; though it is usually only heard in the pulmonic area of the chest because the P2 is soft and not heard in other areas. During expiration, the chest wall collapses and decreases the negative intrathoracic pressure (compared to inspiration).

The pulmonary (or pulmonic) valve in the right ventricle opens into the pulmonary trunk, also known as the pulmonary artery, which divides twice to connect to each of the left and right lungs. In the left ventricle, the aortic valve opens into the aorta which divides and re- divides into the several branch arteries that connect to all body organs and systems except the lungs. By its contractions, right ventricular (RV) systole pulses oxygen-depleted blood through the pulmonary valve through the pulmonary arteries to the lungs, providing pulmonary circulation; simultaneously, left ventricular (LV) systole pumps blood through the aortic valve, the aorta, and all the arteries to provide systemic circulation of oxygenated blood to all body systems. The left ventricular sytole enables blood pressure to be routinely measured in the larger arteries of the left ventricle of the heart.

There is ongoing discussion as to how the distinction between what were historically described as 'velar' and 'uvular' clicks is best described. The 'uvular' clicks are only found in some languages, and have an extended pronunciation that suggests that they are more complex than the simple ('velar') clicks, which are found in all. Nakagawa (1996) describes the extended clicks in Gǀwi as consonant clusters, sequences equivalent to English st or pl, whereas Miller (2011) analyses similar sounds in several languages as click–non-click contours, where a click transitions into a pulmonic or ejective articulation within a single segment, analogous to how English ch and j transition from occlusive to fricative but still behave as unitary sounds. With ejective clicks, for example, Miller finds that although the ejective release follows the click release, it is the rear closure of the click that is ejective, not an independently articulated consonant.

Like other consonants, clicks can be described using four parameters: place of articulation, manner of articulation, phonation (including glottalisation) and airstream mechanism. As noted above, clicks necessarily involve at least two closures, which in some cases operate partially independently: an anterior articulation traditionally represented by the special click symbol in the IPA—and a posterior articulation traditionally transcribed for convenience as oral or nasal, voiced or voiceless, though such features actually apply to the entire consonant. The literature also describes a contrast between velar and uvular rear articulations for some languages. In some languages that have been reported to make this distinction, such as Nǁng, all clicks have a uvular rear closure, and the clicks explicitly described as uvular are in fact cases where the uvular closure is independently audible: contours of a click into a pulmonic or ejective component, in which the click has two release bursts, the forward (click-type) and then the rearward (uvular) component.

"Velar" clicks in these languages have only a single release burst, that of the forward release, and the release of the rear articulation isn't audible. However, in other languages all clicks are velar, and a few languages, such as Taa, have a true velar–uvular distinction that depends on the place rather than the timing of rear articulation and is audible in the quality of the vowel. Regardless, in most of the literature the stated place of the click is the anterior articulation (called the release or influx), whereas the manner is ascribed to the posterior articulation (called the accompaniment or efflux). The anterior articulation defines the click type and is written with the IPA letter for the click (dental , alveolar , etc.), whereas the traditional term 'accompaniment' conflates the categories of manner (nasal, affricated), phonation (voiced, aspirated, breathy voiced, glottalised), as well as any change in the airstream with the release of the posterior articulation (pulmonic, ejective), all of which are transcribed with additional letters or diacritics, as in the nasal alveolar click, or or—to take an extreme example—the voiced (uvular) ejective alveolar click, .