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40 Cards in this Set
- Front
- Back
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What is the cause of the first heart sound?
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vibration of the AV valves after closure (during systole)
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When do we hear S1? During systole or diastole?
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systole; the A/V valves close and vibrate during systole
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Chorda tendinae are found connected to which valves? AV or semilunars?
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AV valves have chorda tendinae
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Function of chorda tendinae?
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prevent bulging of AV valves into the atrium
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What causes S2?
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reverberations in the aorta or pulmonary artery; after the semilunar valves bulge into ventricles and rebound more blood out
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Which heart sound is longer? S1 or S2. Why?
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S1 is longer. semilunar valves are more taut = shorter vibrations
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Which heart sound has a higher frequency? S1 or S2? Why?
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S2 has higher frequency. taut semilunar valves, high elasticity coefficient in aortic walls = higher frequency
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What causes S3?
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moving of blood between walls of the ventricles during diastole; S3 is not normally heard
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During what part of the cardiac cycle is S3 heard?
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middle of diastole; not normal though
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What causes S4?
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atrial contraction = flow into ventricles; not normally heard
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Where do we auscultate the aortic valve?
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2nd Intercostal space; right sternal border
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Where do we auscultate the pulmonary valve?
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2nd Intercostal space; left sternal border
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Where do we auscultate the tricuspid valve?
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5th Intercostal space; left sternal border = right ventricle
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Where do we auscultate the mitral valve?
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5th Intercostal space; median clavicular line = over apex of heart
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How does rheumatic fever lead to valve disease?
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streptococcal infection = antibody production = bind to valves = lesions/fibrosis
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Which valve is most often damaged?
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mitral
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When valve leaflets adhere to each other and blood cannot flow through, it is called ...
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stenosis
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When valve leaflets are scarred and cannot adequately close when ventricles contract, it is called ...
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regurgitation
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Aortic stenosis murmurs are heard during which part of the cardiac cycle? systole or diastole?
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systole; ventricle contraction causes major turbulence as it tries to force blood through a narrow aortic valve
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Aortic regurgitation murmurs are heard during which part of the cardiac cycle? systole or diastole?
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diastole; when the aortic valve is supposed to be closed (diastole), some blood flows into the ventricle causing "blowing" murmur.
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Mitral stenosis murmurs are heard during which part of the cardiac cycle? systole or diastole?
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diastole; while the blood is moving from atrium to ventricle, their is turbulence through the narrow AV valve
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Mitral regurgitation murmurs are heard during which part of the cardiac cycle? systole or diastole?
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systole; when ventricles contract, the AV valves are closed so no blood enters the atrium. but if there is mitral regurgitation, blood enters the atrium during ventricle contraction
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What is a "thrill"?
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When sound vibrations are so noticeable that they can be felt over the chest
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Why does aortic stenosis lead to a lower net stroke volume?
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less blood can be forced out of the narrowed aortic valve
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Why does aortic regurgitation lead to a lower net stroke volume?
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less blood is ejected since some of it falls back into the ventricles during diastole
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Why do aortic stenosis/regurgitation lead to left ventricular hypertrophy?
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both lead to a decreased stroke volume, so the ventricle hypertrophies to compensate
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Why do patients with aortic stenosis have an increase in blood volume and hematopoiesis following stenosis?
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decreased cardiac output (stroke volume) = hypoxia = hematopoiesis. blood volume increases just to get the stroke volume up
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How can aortic regurgitation lead to pulmonary edema?
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aortic regurgitation = lower stroke volume = left ventricular hypertrophy = left ventricle failure = back up of blood into pulmonary capillaries = fluid movement into lung tissue
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How does mitral valve disease lead to atrial fibrillation?
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mitral valve disease = high left atrial pressure = atrial hypertrophy = longer time to spread conduction signal
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During fetal development, the open foramen ovale is what type of shunt?
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right to left
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A patent ductus arteriosus in an adult is what type of shunt?
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left to right
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What do we see regarding blood pressure in patients with coarctation of the aorta?
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BP in upper limb higher than BP in lower limb
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After birth, what happens to pulmonary and systemic pressures?
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pulmonary resistance decreases (lungs expand); systemic pressure increases (no more placental circulation)
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Would patients with a patent ductus arteriosus appear cyanotic?
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no, patent ductus arteriosus is a left to right shunt. right to left shunts put deoxy blood into systemic circulation causing cyanosis (However, if this leads to heart failure then cyanosis could be seen)
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What is a machinery murmur?
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long continuous murmur seen in patent ductus arteriosus; has periods of high and low sounds
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What type of shunt is Tetralogy of Fallot?
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right to left
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Does Tetralogy of Fallot cause cyanosis?
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yes, it is a right to left shunt so deoxy blood enters systemic circulation
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What is extra-corporeal circulation?
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use of a heart-lung machine during surgery
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What is physiological cardiac hypertrophy?
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normal compensatory response of the ventricles to hypertrophy to meet increased demand; not a problem
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Why does excess cardiac hypertrophy lead to heart failure?
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fibrosis can develop; the cardiac blood vessels do not increase to the same limits. so more growth = higher chance of ischemia
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