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69 Cards in this Set
- Front
- Back
- 3rd side (hint)
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What are the AV valves?
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Tricuspid btwn RA/RV and mitral valve btwn LA/LV
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What are the 2 semilunar valves?
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Pulmonic and aortic
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What are the:
-wall thickness -compliance -pressure characteristics of the 2 types of heart chambers? |
Ventricles: THick walled esp LV
Low compliance High pressure Atria: Thin walled High compliance Low pressure |
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Define:
Cardiac cycle Systole Diastole |
CC=Systole followed by diastole
D=Period of chamber filling and cardiac vessel perfusion S=Contraction of a chamber, ejecting blood |
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How does blood get into the coronary arteries?
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Via backpressure during diastole on to the closed aortic valve
-arterys located in Left and right aortic sinuses |
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What percentage of coronary blood flow occurs during systole?Diastole
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30% in systole
70% in diastole |
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How do u calculate the duration of the cardiac cycle?
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Duration(beats\sec)=60 sec\min÷ HR(beats\min)
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What is the duration of the cardiac cycle if the HR is 60bpm?
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D=60\60=1beat\sec
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What are the phases of the cardiac cycle?
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A-G
A=Atrial systole B=Isovolumetric contraction C=Rapid ejection D=Reduced ejection E=Isovolumetric relaxation F=Rapid filling G=Reduced filling |
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What occurs with:
-the valves -state of LV in Phase A? |
Atrial Systole
AV open and P/A closed Diastole |
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What occurs with:
-the valves -state of LV in Phase B? |
Isovolumetric contraction
AV closed and P/A closed Systole |
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What occurs with:
-the valves -state of LV in Phase C? |
F=Rapid ejection
AV closed and P/A open Systole |
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What occurs with:
-the valves -state of LV in Phase D? |
G=Reduced ejection
AV closed and P/A open Systole |
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What occurs with:
-the valves -state of LV in Phase E? |
E=Isovolumetric relaxation
AV closed and P\A closed Diastole |
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What occurs with:
-the valves -state of LV in Phase F? |
F=Rapid filling
AV open and P\A closed Diastole |
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What occurs with:
-the valves -state of LV in Phase G? |
G=reduced filling
AV open P/A closed |
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What does the P wave correlate to and what mechanical purpose does it serve?
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Atrial systole=Tops off ventricles
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What causes the 4th heart sound?
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Atrial contraction against ventricles with low compliance
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When is ventricular volume maximized?
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End Diastolic Volume
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What electrical event causes closure of the AV valves?
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Ventricular depolarization causes contraction and increases pressure closing AV valves
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What is the S1 heart sound? Cardiac Phase?
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Av valve closure, Phase B:Isovol. Contraction
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What causes spliting of the S1?
What causes it? |
Mitral valve closes before the tricuspid, could be normal, or right bundle branch block
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How does sympathetic stimulation affect cardiac cycle?
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Increases rate of pressure creation and dissapation which shortens Phase B:IC and Phase E:IR
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During what phase is ventricular pressure the highest?
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Rapid ejection
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What phase coincides with the end of the ST segment?
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Rapid ejection
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What occurs during the T wave electrically and mechanically?
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Ventricular repolarization and stop of ventricular contraction causing reduced pressure
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What occurs in the Atria during the reduced filling phase?
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Venous return is filling atria=Increased pressure
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What causes the second heart sound? During what phase?
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A/P valve closure, during Isovolumetric relaxation?
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What is the name of the blood volume left after ventricular contraction?
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End systolic volume
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How is stoke volume calculated?
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End diastolic volume-end systolic volume= SV
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What physiologic factors contribute to the formation of the P2 sound(split pulmonic sound)?
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Low intrathoracic pressure, increased venous return, increased preload(blood volume)
Prolonged RV ejection time |
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What causes S3?
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Non-compliance of a ventricle that causes sudden deceleration of blood
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What's an example of a pathological cause and physiological cause of S3?
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Childs supple ventricle undergoes rapid expansion then stop before completely filled
Adult=ventricular dialation-myopathy |
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What is the longest phase of the heart cycle? EKG segment?
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Reduced filling: PR interval
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Why does the pressure gradient decrease during the reduced fillling phase of the heart cycle?
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Increase in ventricular pressure relative to atrial pressure due to reduce ventricular compliance
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How can increased heart rate affect EDV?
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Valves close before full contraction of atria, lower preload and stoke volume
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What causes venous pulses a,c and v?
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a=atrial contraction reflected in veins
c= RV contraction pushing on AV valve v=filling of IVC\SVC behind closed tricuspid |
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Are atrial and ventricular contractions of the left and right sides simultaneous?
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NO! RA before LA
LV before RV |
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If LV contraction starts first why does the pulmonary valve open before the aortic valve?
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Because isometric volume contraction is briefer in the RV
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Why does the aortic valve close before the pulmonic if the pulmonic opens first?
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Aortic closes first because afterload is higher. Pulmonic opens first because IVC is shorter\ lower pressure
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Which ventricle fills first?
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RV, RA contracts before LA b\c tricuspid valve opens before mitral valve
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What is ejection fraction and what is it a valuable indicator of?
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Amount of EDV ejected in stroke volume, indicator of contractility
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How is ejection fraction calculated?
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EF=EDV\SVx100%
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How does congestive heart failure affect the ejection fraction?
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Decreases it
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What is cardiac output and how is it calculated?
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Volume of blood pumped per unit time
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What occurs during the T wave electrically and mechanically?
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Ventricular repolarization and stop of ventricular contraction causing reduced pressure
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What occurs in the Atria during the reduced filling phase?
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Venous return is filling atria=Increased pressure
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What causes the second heart sound? During what phase?
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A/P valve closure, during Isovolumetric relaxation?
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What is the name of the blood volume left after ventricular contraction?
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End systolic volume
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How is stoke volume calculated?
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End diastolic volume-end systolic volume= SV
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What is cardiac output and how is it calculated?
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Volume of blood pumped per unit time
CO=HRx SV |
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How is the cardiac index calculated?
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Ci=CO÷body surface area
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What are the 4 heart sounds?
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S1=AV closure
S2=SL closure S3= Rapid ventricular filling due to low compliance of Vent. S4=Atrial contraction against non compliant ventricles |
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What are the 3 pathological conditions that can lengthen S2 splitting?
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Late pulmonic closure(usually after but so close is indistinguishable)
Pulmonary stenosis, RV failure, Right bundle block |
usually PV after but so close is indistinguishable
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what can decrease the S2 split?
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Left bundle branch block-delayed LV depolarization
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What is a paradoxical split?
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PV closes before AV due to severe aortic stenosis
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What are the 5 types of splitting of the S2?
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Normal
Inspiration=increased preload Pulmonary stenosis= increases splitting, PV closes later Aortic stenosis=decreased splitting, AV closes later Paradoxical splitting= PV closes before AV |
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What causes murmurs? 2 example conditions?
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Turbulent blood flow. Insufficient AV valves, stenotic valves
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What are the 4 causes of systolic murmurs?
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Aortic stenosis, Pulmonic stenosis
Tricuspid insufficiency\regurgit Mitral insufficiency\regurg |
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What are the 2 types of systolic murmurs? Causes?
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Mid-systolic=PV\AV stenosis
Holosystolic murmur=Mitral/tricuspid regurgitation or ventricular septal defect |
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When are diastolic murmurs heard and what causes them?
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After S2=
PV/AV regurgitation Stenotic AV valves=blood forced during atrial contraction |
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What are 3 common causes of mitral stenosis?
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Calcium deposits, congenital lesions, myxoma
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An individual with aortic stenosis will have high Left ventricular pressures, what does this signal to occur in the heart?
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Cardiac Hypertrophy and failure
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Why is LAP higher in the case of mitral stenosis?
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They must contract harder to force blood through stenotic AV valve
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What can an increase in LAP cause in the body?
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Pulmonary congestion and diastolic murmur
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How does aortic regurgitation affect blood volume and how does the LV compensate?
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Increases preload and the LV compensates by increasing stroke volume and pressure
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IF the LV compensates for aortic regurgitation by increasing SV and pressure what ill effects can that cause on the pulmonary system?
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Increase in LAP which causes pulmonary congestion
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why does the rate of decline of Aortic pressure increase with aortic regurgitation?
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Blood escaping back through Aortic valve
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What effects does mitral regurgitation have on the LV, atrial pressure during LV contraction and blood flow?
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Lowers LVSV, causes LA enlargment and increases atrial pressure that can cause pulmonary congestion
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