The sounds produced by the closure of the valves do not correspond with the position of the valves, but are as follows.

The bicuspid sound is heard most distinctly at the apex of the heart as far inward as the parasternal line and as high as the third interspace. It is transmitted around the chest toward the axilla.

The tricuspid sound is best heard at the left sternal border between the fifth and sixth costal cartilages (Tyson).

The pulmonary sound is best heard in the second interspace to the left of the sternum; the cartilage above is called the pulmonary cartilage.

The aortic sound is best heard in the second right intercostal space and the cartilage above is called the aortic cartilage. The aortic sounds are transmitted up the neck in the direction of the great blood-vessels.