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131 Cards in this Set
- Front
- Back
The ability of the Ventricles to efficiently eject blood out of the Heart and into the Systemic and Pulmonary circulations, is called? |
Systolic Function |
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Decreased Systolic Function is an indicator of heart diseases, such as? (5) |
HTN (high blood pressure) MyoCardial Infarction (heart attack) Ischemia (lack of oxygen) Congestive Heart Failure (CHF) CardioMyopathy (heart muscle disease/abnormality) |
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What are 3 symptoms of a decreased Systolic Function? |
Chest pain SOB DOE (dyspnea upon exertion) |
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The ability of the Ventricles to relax and fill is called? |
Diastolic Function |
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What indicates whether the Ventricle filling pressure is normal or increased? |
Ventricular end-diastolic pressure (RVEDP, LVEDP) |
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__________________ function can precede ____________________ dysfunction. |
decreased diastolic systolic |
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Failure of the Ventricle to relax and allow normal filling, is called? |
decreased diastolic function |
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True/False: Decreased systolic or diastolic function are indicators of Heart disease and related symptoms. |
True |
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Regarding Doppler, which wave of the Mitral valve represents the suction into the Heart from the LA into the LV? |
E-wave (cm/s) |
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What does the E-wave of the Mitral valve in Doppler represent? |
suction into the Heart from the LA into the LV |
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Which area of the Mitral valve do you place the cursor in order to obtain the sucking effect or early filling during Doppler? |
leaflet tips (obtains the E and A wave) |
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Measurement of the E wave of the Mitral valve is used to obtain? |
early filling of the LV from the LA sucking effect |
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What is the normal E-wave velocity of the Mitral valve? |
1.3 cm/s |
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Which wave in Doppler of the Mitral valve represents early filling with active relaxation? |
E-wave (cm/s) (want it to be tall) |
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During ________________ the Ventricles of the Heart are at rest. |
diastole |
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During ______________________ there is passive filling from the Left Atrium into the Left Ventricle. |
diastole (75% of filling) |
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Which Doppler wave of the Mitral valve represents Atrial contraction? |
A-wave |
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What percentage of filling happens during Atrial contraction? |
10-30% |
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Which 4 factors determine the function/dysfunction of Systole or Diastole? |
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True/False: When there is a large quantity of blood in a chamber, it can stretch the muscle fibers and cause the chamber to lose it's ability to comply. |
True |
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Which area(s) conduct the emptying of the Ventricles? |
RVOT LVOT |
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Narrowing of the _________________ or _________________ would affect the performance of the Ventricles. |
RVOT LVOT |
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Normal wall thickening/motion is known as? |
Contractility |
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An indication of adequate coronary blood flow and oxygenation is? |
Contractility (normal wall thickening/motion) |
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Normal viable working Ventricular walls should concentrically thicken and contract during? |
Systole |
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During systole, the Ventricle walls should concentrically thicken and contract _________% toward the center of the chamber. |
approx 30% |
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Normal viable working Ventricle walls should ________________ thicken and contract during systole. |
concentrically (all walls at the same time) |
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During ______________, normal walls should concentrically thin and relax. |
diastole |
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During diastole, normal walls should _________________ thin and relax. |
concentrically (all walls at the same time) |
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During diastole, normal walls should concentrically _____________ and _____________. |
thin relax |
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Indirectly, we can examine _________________________________by evaluation of a chambers wall motion. |
coronary blood flow *if the lateral LV wall in an apical 2 is abnormal, something may be wrong with the circumflex vessel *if the apex of the heart is abnormal, something may be wrong with the LAD vessel |
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Ejection Fraction and __________________________ can be used to determine systolic and diastolic function. |
Fractional Shortening |
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Cardiac walls that do not thicken and contract properly are considered to have? |
Wall Motion Abnormality (WMA) |
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Wall Motion Abnormality (WMA) could be an indication of localized or global? |
Ischemia (lack of oxygen from the coronary vessels) |
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Excessive wall motion is called? |
Hyperkinetic |
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Decreased wall motion is called? |
Hypokinetic |
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No wall movement or thickening of the Myocardium, is known as? |
Akinetic |
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Wall movement away from the center of the cavity, is known as? |
Dyskinetic |
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Normal viable chambers should concentrically ________________ in size during systole. |
decrease |
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Normal viable chambers should concentrically ________________ in size during diastole. |
increase |
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What corresponds to the degree of muscle fiber stretch in the ventricles? |
LV end-diastolic pressure (LVEDP) RV end-diastolic pressure (RVEDP) |
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RV end-diastolic pressure (RVEDP) is equivalent to? |
Mean RA pressure |
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LV end-diastolic pressure (LVEDP) is equivalent to? |
Mean LA pressure |
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The degree of ___________________ depends on the quantity of blood in the chamber prior to contraction. |
muscle fiber stretch |
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The degree of muscle fiber stretch depends on the quantity of blood in the chamber prior to ____________________. |
contraction |
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The degree of muscle fiber strength depends on the _________________________ in the chamber prior to contraction. |
quantity of blood |
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The greater the amount of blood entering the chamber, the __________________ the contraction required to expel the blood. |
greater |
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The __________________ the amount of blood entering the chamber, the greater the contraction required to expel the blood. |
greater |
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What can be determined by Doppler examination of the blood flow through the TV, PV, MV, AoV? |
RVEDP LVEDP |
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The quantity of blood filling a chamber is also responsible for the amount of ____________________that is applied to the chamber walls. |
pressure |
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Equation: LVEDP = |
LVEDP = diastolic pressure - AoV press. gradient *AoV pressure gradient = 4V sqd (V is the velocity of aortic regurge jet) |
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The greater the amount of blood entering a chamber the greater the amount of ______________ that is applied. |
contraction |
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What is the Bernoulli equation? |
4V sqd. |
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Equation: AoV pressure gradient = |
AoV PG = 4V sqd (Bernoulli equation) *V is the velocity of the aortic regurge jet |
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Equation: RVEDP = |
RVEDP= 4V sqd + RAP *V is the velocity of the pulmonary regurge jet *right atrial pressure (RAP) = 10mmHg |
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True/False: RAP = 10 mmHg in the presence of Tricuspid regurge. |
False *RAP = 10 mmHg in the ABSENCE of TR |
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During ________________, the body's demand for oxygen will increase dramatically. |
exercise |
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During exercise, the heart increases the supply of _____________________ blood to the body. |
oxygenated |
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What is the normal range for heart beats per minute? |
60-100 bpm |
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During exercise, there is a(n)_______________ in heart rate, and a(n) ________________ in stroke volume. |
increase increase |
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Name the 4 LV function indicators. |
Stroke volume Doppler stroke volume Ejection fraction Cardiac output |
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The volume of blood ejected with each contraction (heart beat), is called? |
Stroke volume |
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What 3 factors of a patient is Stroke volume dependent upon? |
Body habitus (size) HR LV end-diastolic volume (LVEDV) |
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What is the normal range for a resting Stroke volume? |
70-110 ml |
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True/False: Women usually have a higher Stroke volume than Men. |
False *Men have a higher stroke volume than women |
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The Heart rate represents the blood flow entering the ______________________. |
Left Ventricle
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The greater the LV end-diastolic volume, the ________________ the Stroke volume. |
greater |
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The greater the Heart rate, the ________________ the Stroke volume. |
greater |
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Equation: Stroke volume = |
SV = EDV - ESV *end-diastolic volume *end-systolic volume |
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What are the 4 ways to calculate the Ejection Fraction? |
BiPlane Simpson Rule 2D echo M-Mode Cardiac Angio Cardiac Nuclear Study (stress test) |
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What is the normal Ejection Fraction range? |
> 55% *previous test stated 55% - 65% |
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Equation: Ejection Fraction = |
EF = SV / EDV x 100 *end-diastolic volume (EDV) *stroke volume (SV) = EDV - ESV |
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*Boards Equation: Doppler Stroke volume = |
Doppler SV = VTI x CSA *velocity time integral *cross sectional area **VTI = FVI (flow velocity integral)** VTI or FVI trace Doppler spectral CSA = 3.14(d/2) sqd. or 0.785(d) sqd. *d=diameter |
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How do you calculate the Velocity Time Integral (VTI) or Flow Velocity Integral (FVI)? |
tracing the Doppler Spectral display |
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What does the Velocity Time Integral (VTI) and Flow Velocity Integral (FVI) represent? |
how far the blood travels in cm with each ejection |
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What is a normal Mitral valve VTI or FVI? |
12 cm |
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What is a normal Aortic Valve VTI or FVI? |
20 cm |
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Equation(s): Cross Sectional Area (CSA) (cm sqd)= |
either... CSA = 3.14(D/2) sqd CSA = 0.785(D) sqd *D is for diameter *3.14 = Pi |
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Term for the volume of blood being pumped from the Left Ventricle each minute is? |
Cardiac Output *combination of SV and HR |
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What is the normal range of Cardiac Output? |
4 - 8 L/min *varies w/ BSA |
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What is Cardiac Output dependent upon? |
Body Surface Area (BSA) |
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Volume of blood ejected each minute is called? |
Cardiac output |
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Equation: Cardiac output (L/min) = |
CO = (SV x HR) / 1000 *SV = EDV - ESV |
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The Heart's ability to increase the Cardiac output is dependent upon which 4 factors of the overall cardiac function? |
Preload Afterload Inotropic force Chronotropic force |
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The Volume exerted on the Ventricle at end-diastole, is called? |
Preload *volume is equivalent to load |
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What determines the force of contraction? |
Preload (volume) |
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What is the Frank-Starling Law? |
the greater the load, the greater the force of contraction (contractility) |
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The greater the load (volume), the greater the force of contractility (contraction) needed, is known as? |
Frank-Starling Law |
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During Preload (volume) the chambers will be ______________ and the walls will be ____________. |
dilated thin |
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What are 3 main causes of an increase in Preload? |
Regurgitation (MR,TR,AR,PR) Fluid overload Septal defects (VSD, ASD) |
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As the Heart fills with more blood than usual, the force of the muscular contractions will increase, this is known as? |
Frank-Starling Law |
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What is the result of an increase in load experienced by each muscle fiber due to the extraneous blood entering the Heart? |
Frank-Starling Law *the force of the muscular contractions will increase |
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The stretching of the chambers muscle fibers due to extraneous blood entering the Heart causes? |
increased contractile force of the cardiac muscle *Frank-Starling Law |
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In Frank-Starling's Law, the force that any single muscle fiber generates, is proportional to? |
initial length (aka Preload) |
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In Frank-Starling's Law, the stretch on the individual muscle fibers, is related to? |
Ventricular End-Diastolic Volume (LVEDV or RVEDV) |
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If there is an increase in volume (preload), then there will be a _______________ in contractility. |
increase *length-tension relationship |
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If there is an increase in myocardial fiber length, then there will be ________________ tension. |
increased *length-tension relationship |
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True/False: Stretching of the Heart fibers loses their ability to do work. |
True |
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During exercise, blood rushes towards the Heart from the __________________ muscles. |
peripheral |
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True/False: During exercise, the increased venous flow fills the atria and then the ventricles to a greater extent than which occurs at rest. |
True |
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Increased filling stretches individual muscle fibers of the ventricles causing the Heart to produce ______________________ to pump the blood? |
more forceful contractions |
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The Heart has to pump more blood in response to a(n) ____________________ venous inflow. |
increased |
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Electrically, what causes early emptying of the Left Ventricle into the Aorta? |
Premature Ventricular Contraction (PVC) *diastole sets up systole |
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Due to a Premature Ventricular Contraction, the following contraction comes at it's regular timing so the filling time of the Left Ventricle increases causing an? |
increased LVEDV |
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Because of the Frank-Starling Law, the ventricular contraction following a PVC will be? |
more forceful |
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Because of the Frank-Starling Law, the ventricular contraction following a PVC will be more forceful, causing an ejection of the larger volume from the LV and bringing the LVESV? |
back to the baseline |
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In regards to the Frank-Starling Law, ________________ Aortic Insufficiency is hyperdynamic and hypercontractile. |
Acute AI *hyper = increase *shifts UP the curve (graph) |
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In regards to the Frank-Starling Law, _____________________ Aortic Insufficiency is hypocontractile and can result in heart failure. |
Chronic AI *hypo = decrease *shifts downward on the curve (graph) |
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_________________ Aortic Insufficiency damages the myocardium. |
Chronic AI |
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_________________ Aortic Insufficiency stretches the muscle fibers resulting in heart failure. |
Chronic AI |
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An enlarged Left Ventricle will have a _______________ Ejection Fraction. |
low *wall contraction will have very little compliance |
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If a patient has Dilated Cardio Myopathy, their Ejection Fraction will be? |
low *wall contraction will have very little compliance |
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Abnormally increased muscular activity, is called? |
Hyperdynamics |
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Abnormally decreased muscular activity, is called? |
Hypodynamics |
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Abnormal increase in contraction force, is called? |
Hypercontractile |
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____________________ dilates the chamber and causes thin walls. |
Preload (volume) *large volume |
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Resistance against which the ventricle must pump, is called? |
Afterload (pressure) |
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Anything that increases Left Ventricle pressure will __________________ the afterload. |
increase |
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What determines the tension that the Myocardium must generate? |
Afterload (pressure) |
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_________________ causes hypertrophy (enlarge muscle). |
Afterload (pressure) |
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An increase in force will __________________ the velocity. |
decrease *force-velocity relationship |
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As the force generated by the heart muscle increases, there is a(n) _________________ in the velocity of muscle fiber shortening. |
decrease |
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What are 3 main causes of an increase in afterload (pressure)? |
Hypertension (high blood pressure) AS PS |
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If the Heart rate increases, contractions will __________________. |
increase *interval-strength relationship |
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The strength of a beat is related to the ___________________________ preceding that beat. |
diastolic interval |
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The strength of a beat is related to the diastolic interval ______________ that beat. |
preceding |
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The longer the diastolic interval of a heart beat, the _________________ the contraction. |
longer |
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The ___________________ the diastolic interval of a heart beat, the longer the contraction. |
longer |
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True/False: Diastole sets up Systole. |
True |
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The beat following a PVC is forceful due to the _____________________ following the PVC. |
long diastolic interval *compensatory pause |
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The beat following a PVC is forceful due to the compensatory pause following the PVC. This is known as? |
Post-Extra-Systolic Potentiation |