A29-year-old englishman is seen in the office with complaints of pain in his chest and belly. he has been suffering the pain for 2 weeks and gets temporary relief from alka-seltzer®. the burning pain wakes him at night and radiates up to his chest. which factor favors a diagnosis of gastric ulcer?

Define the apical impulse and describe its normal location, size, and duration. which abnormal conditions may affect the location of the apical impulse? explain the mechanism producing normal first and second heart sounds. describe the effect of respiration on the heart sounds. describe the characteristics of the first heart sound and its intensity at the apex of the heart and at the base. describe the characteristics of the second heart sound and its intensity at the apex of the heart and at the base.