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CPR1 Exam 1 > 10- Cardiac Cycles & Sounds > Flashcards

10- Cardiac Cycles & Sounds Flashcards

1
Q

What are the electrical events in the heart that are associated with the heartbeat?

A

Depolarization

Repolarization

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2
Q

What are the mechanical events in the heart that are associated with the heartbeat?

A

Contraction

Relaxation

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3
Q

The (MECHANICAL/ELECTRICAL) event of the heart occurs before the (MECHANICAL/ELECTRICAL) event.

A

Electrical

Mechanical

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4
Q

This is what is used to measure the electrical events in the heart.

A

Electrocardiogram (ECG or EKG)

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5
Q

In an EKG, this wave marks the start of the cardiac cycle and is associated with Atrial depolarization.

A

P wave

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6
Q

What initiates the P wave?

A

SA Node

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7
Q

This is measured from the start of the P wave to the start of the QRS complex. It is considered a “pause” between the depolarization of the Atria and the depolarization of the ventricles.

A

PR Interval

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8
Q

Why does the PR Interval occur?

A

Due to the slow conduction velocity of the AV Node

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9
Q

Why is the PR Interval critical?

A

It lets the Atria completely depolarize and contract before the Ventricles start to, because the Atria are what push blood to the Ventricles.

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10
Q

The AV Node transmits the action potential to the Ventricles via specialized cardiac muscle, which are…

A

Bundle Branches

Purkinje Fibers

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11
Q

What is depolarized by the action potential in the Ventricles, and in what order?

A

1) Septum

2) Free walls of both Ventricles starting from Apex and back up

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12
Q

Why is it critical that the Septum be the first to depolarize?

A

It gives the most efficient contraction to be able to eject blood out and into the arteries (Aorta and Pulmonary).

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13
Q

On an EKG, this is what represents the Ventricular depolarization.

A

QRS Complex

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14
Q

The time delay between the QRS and the increase in Ventricular pressure is due to the time it takes to begin __________.

A

Contraction

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15
Q

On an EKG, this indicates Ventricular repolarization and occurs before the actual relaxation of the Ventricle.

A

T wave

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16
Q

Prior to the T wave, would you expect the Ventricular myocytes to be above or below 0 mV?

A

At or above 0 mV because the Ventricle is depolarizing until it reaches the T wave.

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17
Q

Around how much time passes for one full cardiac cycle (from P wave to P wave)?

A

0.8 seconds

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18
Q

(DIASTOLE/SYSTOLE) can be defined as when contraction is occurring. It begins from the start of Isovolumetric Contraction of the Ventricles, to the start of Isovolumetric Relaxation.

A

Systole

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19
Q

(DIASTOLE/SYSTOLE) can be defined as the relaxation period.

A

Diastole

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20
Q

During the P wave, the Atria is depolarizing so that means it is contracting. What is happening to the Ventricular pressure at this time?

A

It is increasing, causing a small pressure wave.

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21
Q

During the QRS Complex, the Ventricles are depolarizing so that means they are contracting. What is happening to the Ventricular pressure at this time?

A

There is a high increase in the pressure because this is during Isovolumetric Contraction. At this time, all the valves are closed and the Ventricle is contracting with nowhere for the blood to go.

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22
Q

What happens after Isovolumetric Contraction of the Ventricles?

A

Ejection of blood

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23
Q

During the T wave, the Ventricles are repolarizing so that means they are relaxing. What is happening to the Ventricular pressure at this time?

A

Pressure is decreasing, because there is less blood.

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24
Q

What happens to Ventricular pressure after Isovolumetric Relaxation?

A

At this point, the AV valves have opened back up so the Atria are refilling the Ventricles. There is no pressure change at this time.

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25
Q

During the P wave, the Atria is depolarizing so that means it is contracting. What is happening to the Atrial pressure at this time?

A

It rises slightly above the Ventricular pressure, because the Atria are needing to eject blood into the Ventricles. In order for ejection to occur, the pressure of the Atria has to be higher than that of the Ventricles. This process is called “topping off”.

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26
Q

During the QRS Complex, the Ventricles are depolarizing so that means they are contracting. What is happening to the Atrial pressure at this time?

A

There is a very small increase in Atrial pressure because blood continues to return to the heart but can’t move into the Ventricles because the AV valves are closed and the Ventricles are contracting.

27
Q

During the T wave, the Ventricles are repolarizing so that means they are relaxing. What is happening to the Atrial pressure at this time?

A

During this the AV valves are closed, so the Atrial pressure is slowly increasing because venous return is filling them with blood.

28
Q

What marks the beginning and end of Isovolumetric Contraction?

A 
Start = AV valve closes
End = Aortic valve opens
29
Q

What marks the beginning and end of Isovolumetric Relaxation?

A 
Start = Aortic valve closes 
End = AV valve opens
30
Q

Diastole is measured where the ______ _____ opens (about 80 mmHg).

A

Aortic Valve

31
Q

For Jugular Vein pressure, this wave is created by the Atrial contraction. Since there is no valve between the Atria and great veins, the pressure is reflected backwards.

A

A wave

32
Q

For Jugular Vein pressure, this wave is created by the period of Isovolumetric Contraction in the Ventricles. There is bulging of the wall back into the Atria.

A

C wave

33
Q

For Jugular Vein pressure, this wave is created as blood returns back to the heart but can’t enter the Ventricle. AV valves are closed, but Aortic and Pulmonary valves are open. Ventricular blood ejection is occurring.

A

V wave

34
Q

Since the Atria depolarize first, they contract first and this (INCREASES/DECREASES) the pressure in the Atria.

A

Increases

***Also increases Ventricular pressure

35
Q

What are the pressures in the Ventricle at the lowest and the highest?

A

120 mmHg

0 mmHg

36
Q

During Atrial Systole, the pressure in the _______ exceed that in the ________ and forces the blood to move from the _______ into the ________.

A

Atria
Ventricle
Atria
Ventricle

37
Q

Ventricular volume (INCREASES/DECREASES) as the Atrial contraction forces blood into the Ventricle.

A

Increases

38
Q

What are two important things to note about Aortic Pressure?

A

1) The aortic pressure is quite a bit above the atrial and ventricular pressures (because needs to push blood to rest of body).
2) It is decreasing throughout the atrial contraction and even into ventricular contraction.

39
Q

After the atria contract and begin to relax, the ventricles start to contract. Almost immediately, the ventricular pressure exceeds the atrial pressure, causing the _______ ________ to close. This prevents blood from flowing back into the atria. During this time, the aortic pressure continues to fall while the ventricular volume is constant.

A

AV valves

40
Q

During Isovolumetric Contraction, the pressure is building in the ventricles but is any blood being ejected?

A

No, the pressure in the Ventricle must exceed the pressure in the Pulmonary A. and Aorta before the valves leaving the Ventricles will open.

41
Q

In order for the Pulmonary A. (Right Ventricle) or the Aorta (Left Ventricle) to open their valves, the ventricular pressure must be (HIGHER/LOWER) than the pressure in those arteries.

A

Higher

42
Q

Once the ventricular pressure exceeds the aortic pressure, the aortic valves open and blood is ejected from the ventricle. This ends the period Isovolumetric Contraction. The aortic pressure now starts to (INCREASE/DECREASE) as blood is ejected into the aorta, and ventricular volume (INCREASES/DECREASES) rapidly as blood is ejected.

A

Increase

Decreases

43
Q

T/F. Blood is ejected until the ventricle begins to relax and pressure within the ventricle begins to decrease.

A

True

44
Q

Aortic pressure starts to (INCREASE/DECREASE) even as blood continues to be ejected as the rate of ejection slows down. Ventricular volume continues to (INCREASE/DECREASE) during this period.

A

Decrease

Decrease

45
Q

When the pressure in the ventricle drops below the arterial pressure, the aortic and pulmonary valves (OPEN/CLOSE). The aortic and ventricular pressures will now start to diverge rapidly.

A

Close

46
Q

The closing of the Aortic valve produces the ________ ________ in the Aortic pressure wave. The Atrial pressure shows a similar “wiggle”.

A

Dicrotic Notch

47
Q

This is a period in which no blood enters or leaves the ventricle while it is relaxing because both the AV and Aortic valves are closed. This period is called…

A

Isovolumetric Relaxation

48
Q

What pressure does the Left and Right Ventricle have to be at for the blood to enter from the Atria?

A

The Ventricular pressure must be lower than all other pressures during diastole for blood to move from high pressure to low pressure.

49
Q

During Ventricular Systole, the Ventricular pressure must exceed the (SYSTOLIC/DIASTOLIC) pressure on each side to open the valves.

A

Diastolic

50
Q

What is the normal Aortic and Pulmonary pressures, and what would the ventricular pressure have to be to open their valves?

A

Aortic Pressure = 120/70
Left Ventricular pressure would have to hit 70 or more

Pulmonary A. Pressure = 25/15
Right Ventricular pressure would have to hit 15 or more

51
Q

Because the Ventricular pressure and volume are both very low when the AV valves open, blood flows into the ventricles very (RAPID/SLOW).

A

Rapid

52
Q

During diastole, why is the Aortic pressure still dropping?

A

The blood is leaving the Aorta and flowing into the smaller vessels in the periphery. The rate of this peripheral run-off is determined by the resistance to blood flow.

53
Q

The first heart sound, the “LUB”, is associated with what?

A

Closure of AV valves

54
Q

What actually makes the sound of the first heart sound?

A

The sound is the result of blood in the Atria hitting the closed valves as it tries to enter the Ventricle. That impact creates vibration in the cardiac tissue that can be heard.

55
Q

The second heart sound, the “DUB”, is associated with what?

A

Closure of the Aortic and Pulmonary valves

56
Q

What actually makes the sound of the second heart sound?

A

It is produced when the blood in the Aorta/Pulmonary A. backflows and “bounces” off the closed valves.

57
Q

When the second heart sound is made, why does the blood backflow?

A

When the valves close, the force driving the blood forward (the pressure in the Ventricle) is “cut-off” from the blood and gravity is free to pull the blood back down.

58
Q

What makes the third heart sound, which is normal in children but may not be heard in normal adults?

A

The blood rushing into the Ventricle during the rapid filling phase creates the sound. Like milk filling a glass.

59
Q

There is a fourth heart sound that can be heard when?

A

During Atrial contraction and is the result of that last little bit of blood being squeezed into the Ventricle (“Topping Off”).

***Like the 3rd heart sound, it is normal in children but not generally in adults.

60
Q

When is murmur heard?

A

– When blood is moving in a direction it shouldn’t be moving.

– When blood is having a hard time moving in the direction it should be moving in.

61
Q

T/F. Murmurs are only heard during diastole, and can give you a clue as to what the problem is.

A

False. Murmurs may be heard in either systole or diastole, and can give you a clue as to what the problem is.

62
Q

For a systolic murmur, when is it heard?

A

– Blood is moving in a direction it shouldn’t be moving - in this case, back into the atria caused by regurgitation (bicuspid regurgitation)

– Blood is having a hard time moving in the direction it should be moving in - in this case, the blood can’t get into the Aorta/Pulmonary A. due to stenosis

63
Q

For a diastolic murmur, when is it heard?

A

– Blood is moving in a direction it shouldn’t be moving in - in this case, back from the Aorta or Pulmonary A. into the Ventricle caused by regurgitation (aortic regurgitation)

– Blood is having a hard time moving in the direction it should be moving in - in this case, the blood can’t get into the Ventricle due to stenosis

CPR1 Exam 1 (22 decks)

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