Which heart sounds are typically associated with a normal physiological state?

The correct answer indicates that all heart sounds are typically present in a normal physiological state. In a healthy heart, the four main sounds, S1, S2, S3, and S4, can be appreciated under specific conditions.

S1 results from the closure of the atrioventricular (AV) valves at the beginning of systole, while S2 is produced by the closure of the semilunar valves at the end of systole. These two sounds are fundamental and are heard during routine examinations in most individuals.

In certain circumstances, S3, often considered a normal finding in younger individuals or athletes, can also be audible but is less commonly present in older adults and may suggest heart failure in older populations. S4, associated with decreased compliance of the ventricle and typically indicative of some form of cardiac dysfunction, may also be present but is not always considered normal.

Thus, in a normal physiological state, while S1 and S2 are definitely present, S3 and S4 can also be heard in specific scenarios. This comprehensive presence of heart sounds characterizes a healthy cardiovascular function, validating that all heart sounds can be part of a normal examination.