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26 Cards in this Set
- Front
- Back
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What stage of cardiac cycle is this in?
- coincides with QRS in EKG - first heart sound heard - rising ventricular pressure - no change in blood volume in ventricle. - rise of venous c pulse |
isovolumic contraction
- beginning of venrticular systole. - closing of AV valve - c-venous pulse caused by bulging of AV valves. |
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What stage of cardiac cycle is this in?
- semilunar valve open - sharp fall in ventricular volume - sudden increase in aortic blood flow - sharp increase in ventricular and aortic pressure - initial sharp decrease in atrial pressure - peak of venous c pulse |
Rapid ejection
- ventricular pressure exceeds aortic pressure - initial sharp decrease in atrial pressure due to descent of the base of the heart and stretching of the atria |
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What stage of cardiac cycle is this in?
- blood flow to aorta reduced - slow reduction in pressure in both ventricle and aorta - aortic valve closes at the end of this phase - gradual rise in atrial pressure |
Reduced ejection
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What stage of cardiac cycle is this in?
- aortic valve closes, hear 2nd heart sound - small increase in aortic pressure - large decrease in ventricular pressure - increase in venous pulse, reach v peak at the end of this phase - mitral valve opens at the end of this phase |
Isovolumic relaxation
- small increase in aortic pressure due to rebound effect - peak of venous v wave, peak of atrial pressure: filling of atria - follows T wave in EKG: ventricular repolarization |
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What stage of cardiac cycle is this in?
- mitral valve opens - blood rushes to ventricles - gradual decline in pressure of both atria and ventricles - may hear diastolic gallop |
Rapid ventricular filling
- ventricular pressure follows atria pressure - diastoci gallop heard when residual volume is high |
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Compare the 2nd heart sound to the 1st.
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- shorter duration
- lower intensity - higher frequency - snapping quality |
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What does a high residual volume and low stroke volume tell you?
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a failing heart
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What stage of cardiac cycle is this in?
- blood flow from atria to ventricles - gradual rise in atrial, ventricular, and pulse pressure |
Diastasis
- reduces when there is an increase in heart rate |
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Which phase in the cardiac cycle is reduced when there is an increase in heart rate?
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diastasis
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What stage of cardiac cycle is this in?
- pressure increase in atria - venous a wave - atrial contraction - may hear 4th heart sound |
Atrial systole
- final transfer of blood to ventricles - corresponds to p wave on EKG - 4th sound seen with phonocardiogram - becomes important in tachycardia |
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The following EKG wave corresponds to which phase of cardiac cycle?
- QRS |
isovolumic contraction: ventricular contraction
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The following EKG wave corresponds to which phase of cardiac cycle?
- T wave |
isovolumic relaxation: repolarization of ventricles
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The following EKG wave corresponds to which phase of cardiac cycle?
- P wave |
atrial systole: atrial depolarization
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List the phases of cardiac cycles starting from isovolumic contraction.
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- isovolumic contraction
- rapid ejection - reduced ejection - isovolumic relaxation - rapid ventricular filling - diastasis - atrial systole |
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Which cardiac valve problem is this? What heart sound variation can be heard?
- ventricular pressure greatly exceeds aortic pressure during ventricular systole. |
Aortic stenosis:
- sustained blowing murmur heard throughout ventricular systole.(s1-s2)can feel the "thrills". - flaps of aortic valve are fused die to scarring, creating only a small opening when valves open (eg. rheumatic fever) |
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Which cardiac valve problem is this? What heart sound variation can be heard?
- atrial pressure greatly exceeds ventricular pressure during diastole when mitral valve is open |
Mitral stenosis
- low blowing murmur begin midway through diastole with the loudest sound during atrial systole. - aortic ans ventricular curves are normal - mitral flaps fused due to scarring, creating only a small opening when the valves open. |
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Which cardiac valve problem is this? What heart sound variation can be heard?
- rapid drop in aortic pressure (much lower than 80mmHg) after aortic valve closes - ventricular pressure exceeds atrial pressure during ventricular diastole. |
Aortic regurgitation
- loud blowing murmur immediately following s2, which wanes in time. - valve flaps have scarred edges, can't close completely |
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Which cardiac valve problem is this? What heart sound variation can be heard?
- atrial pressure increases rapidly during ventricular systole - aortic and centricular pressure curves look normal. |
Mitral regurgitation:
- low murmur from s1-s2, great sound during isovolumic contraction and repid ejection. - scarred edges of mitral vlaves, can't close completely - due to blood back flow from ventricle. |
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What does it suggest when a murmur increases with inspiration?
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The murmur originates from the right side of the heart.
- inspiration increases venous return to right heart and increases output from right ventricle. |
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Which valve defect is this?
- low murmur from s1-s2 - murmur increases during inspiration - no s2 split during inspiration |
tricuspid regurgitation
- no s2 splitting because blood (increased due to increased venous return) also going back to atria. |
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Which valve defect is this?
- low murmur from s1-s2 - murmur increases during exspiration - no s2 split during exspiration |
mitral regutgitation
- widened s2 splitting due to earlier closing of aortic valve - expiration increases volume of blood that is ejected by the left ventricle,increasing the murmur. |
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Which valve defect is this?
- low blowing murmur begin at midway through diastole, loudest during atrial systole - murmur increases during exspiration - s2 split during inspiration |
mitral stenosis
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What valve defect can cause this?
- low murmur form s1-s2, louder during isovolumic contraction and rapid ejection - widened s2 split during inspiration - s2 split during expiration |
mitral regurgitation
- early closing of aortic valve due to back flow of blood into atria |
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What can cause this?
- widened s2 split during inspiration - s2 split during expiration - no murmur heard |
right bundle block
- delay in closing of pulmonic valve - delay in closing of tricuspid valve due to delay in right ventricular depolarization |
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What valve defect can cause this?
- s2 split heard during expiration but not inspiration |
paradoxal splitting
1) left bundle branch block - delayed left ventricular contraction 2) aortic stenosis, severe hypertention, left sided congestive heart failure - prolonged left sided ventricular systole 3) Wolf-Parkinson White syndrome on the right side - conduction bypass the AV node -> early right ventricular systole |
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What valve defect can cause this?
- sustained blowing murmur thoughout ventricular systole (s1-s2) - s2 split heard during expiration but not inspiration |
aortic stenosis
- prolonged left ventricular systole |
