Physiology Test #3: Cardiac Physiology Part 2

Front 1

1) what is the cardiac cycle?

Back 1

1) events of one complete heart beat

Front 2

Cardiac Cycle 1) Atria___
2) Ventricles also __
3) Atria __, then ___
4) systole = __
5) diastole = ___
6) BOTH atria and ventricles CAN'T ___, but CAN ___

Back 2

1) contract simultaneously
2) contract simultaneously
3) contract; ventricles contract
4) contraction
5) relaxation
6) contract at the same time; relax at the same time

Front 3

Cardiac Cycle 1) Normal duration is ___ (at___)
2) Can be divided into ___:___
3) Cardiac cycle begins in ___

Back 3

1) 0.8 sec (at 75 beats/min)
2) 3 periods: mid-to-late diastole, ventricular systole, early diastole
3) late diastole

Front 4

**Cardiac Cycle: Keep track of the following 1) __(electrical activity)
2) ___changes (look on ___): ___
3) ___ (open or closed?)
4) __in the__
5) heart ___ (___)

NOTE:
6) __lead to ___ (contract or relax)
7) normally described with __in mind

Back 4

1) ECG (wave)
2) Pressure; (left side); atrial pressure, ventricular pressure, and aortic pressure
3) valves
4) blood volume; ventricle
5) sounds; (phonocardiogram)
6) electrical activity; mechanical activity
7) left side

Front 5

Cardiac Cycle 1) AV valves:
open: ___
close: __
2) SL valves
open: ___
close: ___

Back 5

1) AtP > VP (atrial pressure > ventricular pressure); VP > AtP (ventricular pressure > atrial pressure)
2) VP> AoP (ventricular pressure > aortic pressure); AoP > VP

Front 6

Cardiac Cycle 1) Normal duration is ___ (at___)
2) MID-TO-LATE DIASTOLE:
a. ___during ___ (nothing is __)
b.__- __will complete___

Back 6

1) 0.8 sec (75 beats/min)
2)
a. PASSIVE ventricular filling; atrial and ventricular diastole (relaxation); (contracting)
b. atrial systole; active filling; ventricular filling

Front 7

Cardiac Cycle: MID-TO-LATE DIASTOLE
STEP 1: passive ventricular filling during atrial and ventricular diastole (relaxation)
1) heart is __
2) blood flows __
3) AV valves are __
4) SL valves are ___

Back 7

1) relaxed
2) into ventricles
3) open
4) closed

Front 8

Cardiac Cycle: MID-TO-LATE DIASTOLE
STEP 2: active ventricular filling during atrial systole (contraction)
1) __on ___
2) atria __ (__)
3) completes ___

Back 8

1) P wave; ECG
2) contract (atrial systole)
3) ventricular filling

Front 9

Cardiac Cycle: VENTRICULAR SYSTOLE
1) ___
2) ___

Back 9

1) isovolumetric ventricular contraction (IVC)
2) ventricular ejection

Front 10

1) there is a time when ALL valves are closed and ventricular pressure is somewhere in the middle; the time between ___&___

Back 10

1) Isovolumetric ventricular contraction (IVC); AV valve closing & SL valve opening

Front 11

Cardiac Cycle: VENTRICULAR SYSTOLE (contraction)
STEP 1: Isovolumetric ventricular contraction (IVC)
1) lasts about ___
2) atria __
3) ___wave
4) AV valves __
5) ALL valves __

Back 11

1) 0.05 sec
2) relax
3) QRS
4) close
5) closed (IVC)

Front 12

Cardiac Cycle: VENTRICULAR SYSTOLE (contraction)
STEP 2: Ventricular Ejection
1) lasts about __
2) Ventricular pressure___pressure in the ___
3) as a result, __
4) blood is __to the __and ___

NOTE:
5) you get __during __

Back 12

1) 0.25 sec
2) exceeds; large arteries
3) SL valve opens
4) pumped; aorta; pulmonary arteries
5) EDV (end diastolic volume); IVC

Front 13

Cardiac Cycle: EARLY DIASTOLE
1) ___
2) ___

Back 13

1) Isovolumentric ventricular relaxation (IVR)
2) Ventricular filling

Front 14

Cardiac Cycle: EARLY DIASTOLE Step 1: Isovolumetric ventricular relaxation (IVR)
1) duration is __
2) __wave
3) ventricles__
4) SL valves __ (ventricular pressure __)
5) ALL valves ___ (__)

Back 14

1) 0.05 sec
2) T wave
3) relax
4) close; decreases
5) closed (IVR)

Front 15

Cardiac Cycle: EARLY DIASTOLE Step 2: Ventricular filling
1) ventricular pressure___
2) AV valves __
3) __begins again-->___

Back 15

1) drops below atrial pressure
2) open
3) ventricular filling; mid-to-late diastole

Front 16

1) __-when ventricular pressure is high

Back 16

1) systole

Front 17

What happens to the cardiac cycle during tachycardia? 1) Diastole duration is ___to ___
2) possible b/c of __in __

Back 17

1) cut short; increase heart rate
2) rapid filling; early diastole

Front 18

The Entire Cardiac cycle lasts ___
1) ventricular systole = ___
-IVC = ___
-ventricular ejection = ___
2) ventricular diastole = __
- IVR = __
- ventricular filling = __
- rapid filling = __
- diastasis = ___
- atrial systole = ___
3) rapid filling and diastasis = ___
4) atrial systole = __

Back 18

0,8 sec
1) 0.3sec; 0.05 sec; 0.25 sec
2) 0.5 sec; 0.05 sec; _VF (0.45sec)__; 0.15 sec; 0.15 sec; 0.15 sec
3) passive filling
4) active filling

Front 19

Cardiac Cycle: Heart Sounds
1) does NOT create any sound; this will be maintained if there is no __
2) can be heard; it is this that causes heart sounds

Back 19

1) Laminar flow; turbulence
2) Turbulent flow

Front 20

Cardiac Cycle: Heart Sounds
1) There are __normal sounds; ___

Back 20

1) 2; Lub-dup

Front 21

Cardiac Cycle: Heart Sounds- There are 2 normal sounds; Lub-Dup
1) S1: During ___; __why you get this
2) S2: During ___; sets up ___
3) S3: ___; during __
4) S4: ___; during ___

Back 21

1) IVC; AV valves close
2) IVR; turbulence for sound 2
3) abnormal; rapid ventricular filling
4) abnormal; atrial systole

Front 22

Cardiac Cycle: Heart Sounds
Two Normal Sounds
1) S1: __and ___; when ___
2) S2: __and___; when ___
3) ___: abnormal heart sounds

Back 22

1) louder and longer; AV valves close in IVC
2) shorter and sharper; SL valves close in IVR
3) heart murmur

Front 23

Cardiac Cycle: Heart Sounds
Abnormal Sounds
1) S3: During __after___; in ___, severe __, __or__
2) S4: At the __of__; in ___, __, ___, ___

Back 23

1) diastole; IVR; dilated CHF; HT; MI; mitral incompetence
2) end; atrial systole; hypertrophic CHF, PE, tricuspid incompetence; cor pulmonale

Front 24

Cardiac Output & Its regulation: Important Terms
1) volume of blood pumped by each ventricle in one contraction
2) amount of blood pumped by each side of the heart in one minute

Back 24

1) Stroke Volume (SV)
2) Cardiac Output (CO)

Front 25

Cardiac Output & Its Regulation
1) Stroke Volume (__)- is volume of ___by ___in___; Normal SV = __
2) Cardiac Output (__)-is the ___
3) ___ = ___ X___
4) What is the normal CO?

Back 25

1) (SV); blood pumped; each ventricle; one contraction (a single heart beat); Normal SV = 70ml
2) (CO); amount of blood pumped by each side of the heart in one minute
3) CO = (Heart Rate [HR]) X (Stroke Volume [SV])
4) Normal CO = 70 x 70 ml = ~5L/min

Front 26

Cardiac Output & Its Regulation
1) volume of blood present in a ventricle just before systole
2) volume of blood remaining in a ventricle at the end of systole
3) __ = ___-___

Back 26

1) End-diastolic volume (EDV)
2) End-systolic volume (ESV)
3) ESV = EDV - SV

Front 27

Cardiac Output & Its Regulation
1) End Diastolic Volume (EDV)- the___; Normal EDV = ___
2) End Systolic Volume (ESV)- the__; Normal ESV = ___
3) Note: the heart CAN'T ___

Back 27

1) the volume of blood present in the ventricle just before systole; 135ml
2) volume of blood remaining in the ventricle at the end of systole; 135-70 = 65 ml
3) pump everything out

Front 28

Cardiac Output & Its Regulation
1) what is Ejection Fraction (EF); normal EF = __

Back 28

1) SV/EDV; 0.5-0.55 (~50%)

Front 29

Regulation of Cardiac Output
CO = HR X SV
1) you can change the CO by changing the ___
2) Stroke volume usually___
3) if we were to change CO momentarily, would use ___

Back 29

1) HR, SV, or BOTH
2) remains relatively constant (~70ml)
3) HR not SV

Front 30

Determinants of SV

Back 30

1) preload
2) contractility
3) afterload

Front 31

Determinants of SV
1) Preload-is the ____ (__)
2) Contractility- is the __ (__)
3) Afterload-is the___; increased SV leads to ___ and vise versa; is the ___to blood flowing out of the heart; how much ___the ventricles have to exert to get blood out of the heart

Back 31

1) blood available for pumping (LVEDV) (Left ventricular EDV)
2) force of contraction (inotropy)
3) resistance (pressure) against which heart needs to pump; increased afterload; resistance; force

Front 32

Regulation of Cardiac Output
1) SV depends mainly on ___
2) _____: the more cardiac muscle is stretched, the stronger the contraction; means ___
3) i.e. the heart ___

Back 32

1) EDV (preload)
2) Frank-Starling Law of the Heart; increased EDV --> increased stroke volume
3) pumps out all that it receives

Front 33

Regulation of Cardiac Output: Frank-Starling Law of the Heart (the more cardiac muscle stretches, the stronger the contraction)
____control-from within; the heart does it by itself without the nervous system
1) increased venous return-->
2) ___-->
3) ____-->
4) ___-->
5) ___-->

Back 33

Intrinsic control
2) increased stretching of heart wall (distension)
3) increased EDV
4) increased force of contraction
5) increased SV

Front 34

Regulation of Cardiac Output
1) changing __is the most common way to change CO
2) HR is controlled mainly by, ___

Back 34

1) heart rate (HR)
2) Autonomous Nervous System (ANS)

Front 35

Regulation of Cardiac Output
1) intrinsic control
2) extrinsic control

Back 35

1) Frank-Starling law of the heart
2) Autonomous Nervous system

Front 36

Regulation of Cardiac Output: HR
The Role of the Autonomous Nervous System (__)
1) Sympathetic activity __
2) Parasympathetic activity___
3) epinephrine ___ (like__)

Back 36

Extrinsic control
1) increases HR
2) decreases HR
3) increases HR (sympathetic activity)

Front 37

Regulation of Cardiac Output: HR
INCREASE HEART RATE:
1)
2)

Back 37

1) sympathetic nervous system
2) hormones-epinephrine & thyroxine

Front 38

Regulation of Cardiac Output: HR
INCREASE HEART RATE: Sympathetic nervous system
1) ___nerve (__,__,&__)
2) for ___; ___
3) it ___pacemaker potential
4) __&__-->___
5) if sympathetic stimulation we see it getting __&__; would contract more __

Back 38

1) cardiac sympathetic; (SA node, AV node, & ventricles)
2) emergency; low BP
3) speeds up
4) increased PCa2+ & decreased PK+--> faster depolarization
5) faster; bigger; powerfully

Front 39

Regulation of Cardiac Output: HR
DECREASE HEART RATE:
1)
2)

Back 39

1) parasympathetic nervous system
2) vagal tone

Front 40

Regulation of Cardiac Output: HR
DECREASE HEART RATE: Parasympathetic Nervous System
1) ___nerve stimulations (mainly to __; __)
2) ___pacemaker potential
3) __-->___
4) decreases___
5) it takes __to get to TP

Back 40

1) vagus; SA & AV nodes only; not to ventricles
2) slows down
3) increased PK+-->hyperpolarization
4) PNa+ & PCa2+
5) longer

Front 41

Regulation of Cardiac Output: HR
DECREASE HEART RATE: Vagal Tone
1) Normal SA rate = ___
2) it __and__
3) a.k.a. it __
4) If removed, HR __

Back 41

1) 100 beats/min
2) reduces HR; maintains it at 75 beats
3) puts the breaks on
4) will go up

Front 42

If we ___, we can raise the heart rate without needing sympathetic nervous system

Back 42

reduce vagal tone

Front 43

Ventricular Pressure-Volume Loops
1) show the relationship between ___(___) and ___(__) over a ___
2) useful ___

Back 43

1) LV Pressure (mmHg); LV volume (ml); single cardiac cycle
2) pathophysiological tool