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Block 3 Found Sci > 3-Cardiac Cycle > Flashcards

3-Cardiac Cycle Flashcards

1
Q

excitation-contraction coupling

A

stim for muscle contraction = depolarizing impulse
-electric events precede mechanical events
-slower/inc time delay in cardiac than skeletal muscle
-calcium induced calcium release

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2
Q

calcium cycling

A
  1. Ca entry thru voltage Ca channels
  2. diffuse to ryanodine receptor on SR membrane
  3. Ca released from SR
  4. troponin interaction = contraction from shortening sarcomere (actin/myosin
  5. Ca channels close (phase 3) = dec intracell Ca bc no more enters cell
  6. Ca sequestered to SR by SERCA pump and out of cell by Ca exchanger (NCX) and pump
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3
Q

sympathetic stim excitation-contraction

A
  1. beta adrenergic act of muscle
  2. inc cAMP and PKA
  3. enhance act of Ca channels
  4. inc intracell Ca and release from SR
  5. enhance myosin ATPase activity
  6. inc toponin C ‘iontropy’
  7. inc Ca reupatake ‘lusitropy’
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4
Q

inotropy

A

force of contraction

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5
Q

lusitropy

A

rate of relaxation

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6
Q

phases of cardiac cycle

A
  1. atrial systole
  2. isovolumic (ventricular) contraction
  3. ejection - rapid + reduced
  4. isovolumic (vent) relaxation
  5. filling- rapid + reduced
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7
Q

ventricular systole is what parts

A

contraction
isovolumic contraction + ejection

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8
Q

ventricular diastole

A

aka relaxation
isovolumic relaxation + ventricular filling + atrial systole

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9
Q

things on Wigger’s diagram

A
  1. ECG
  2. muscle tension
  3. pressures- aortic, LV, LA
  4. valves
  5. phonocardiogram/heart sounds
  6. LV volume
  7. aortic flow
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10
Q

atrial systole wave components

A

follows P wave + includes SOME of QRS complex

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11
Q

LV pressure and volume during atrial systole

A

pressure slightly inc bc atrial kick adds last 20% of volume to ventricle = end diastolic volume, total filling volume

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12
Q

valves during atrial systole

A

aortic valve closed
mitral valve open-blood entering ventricle

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13
Q

sounds during atrial systole

A

S4
always abnormal - from forcing blood into non compliant/stiffened ventricle

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14
Q

isovolumic contraction - waves

A

begins during portion of QRS

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15
Q

pressure/volume
isovolumic contraction

A

LV pressure inc from ventricular muscle contraction
-volume stays the same

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16
Q

valves - isovolumic contraction

A

-aortic closed
-mitral closed passively bc pressure differential across valve, mitral>aortic

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17
Q

sounds-isovolumic contraction

A

S1
first heart sound from closing mitral valve vibrating chordae tendinae and blood

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18
Q

rapid ejection pressure/volume

A

LV pressure inc more from isovolumic contraction bc still contracting

LV volume dec fastest of any phase

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19
Q

rapid ejection valves

A

-aortic is open from pressure of other phases, need to overcome aortic pressure
-mitral closed

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20
Q

rapid ejection sounds

A

none 0 zilch

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21
Q

phase of AP corresponding to rapid ejection

A

phase 2, ventricle contracting

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22
Q

reduced ejection waves

A

just before T when relaxation begins in ventricular myocardium, Ca channels close

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23
Q

reduced ejection pressure and volume

A

LV pressure falls as muscle cells relax
LV volume dec but slower/reduced than rapid ejection
-vol at end of phase = end systolic volume, residual volume after ejection

24
Q

reduced ejection valves

A

-aortic open as blood ejected
mitral closed

25
Q

isovolumic relaxation pressure & volume

A

LV pressure dramatically dec since myocytes complete relax
LV vol not change

26
Q

isovolumic relaxation valves

A

both aortic and mitral closed

27
Q

isovolumic relaxation sounds

A

S2
closure of semilunar valves = vibrations of fluid and tissue

28
Q

rapid filling ECG

A

isoelectric line, flat
myocytes are relaxed

29
Q

rapid filling pressure & volume

A

LV pressure low (lower than LA pressure) so passive move blood from atrium to ventricle

LV volume inc rapidly

30
Q

rapid filling valves

A

aortic closed
mitral open

31
Q

rapid filling sounds

A

S3
from ventricles filling fast

can be healthy or pathologic

32
Q

reduced filling ECG

A

isoelectric line still
-myocytes relaxed
ends with P wave

33
Q

reduced filling pressure & volume

A

LV pressure low
LV volume inc but slower/reduced

34
Q

reduced filling valves

A

aortic closed
mitral open

35
Q

reduced filling sounds

A

natta

36
Q

differences with right heart pump

A

all other cycle cards about left heart
-R same events just lower pressure
-only gets to 20 mmHg vs 120 on L

resistance of pulmonary circ lower than systemic circ

37
Q

waves of atrial pressure curve

A
  1. a wave = contraction, H ascent before as venous return inc pressure, X descent after a wave
  2. c wave = early systole, tricuspid valve bulges into RA from isovolumic contraction of vent, X’ descent after
  3. v wave= venous return then open AV valve, isovolumic relaxation of vent, Y descent

low yield for exam, importnat 2nd year

38
Q

stroke volume is

A

end diastolic vol - end systolic vol

amount blood ejected by heart in one beat

39
Q

ejection fraction is

A

stroke volume (end diastolic-systolic) / end diastolic vol
x 100

proportion of blood ejection with each contraction, index of cardiac fxn 65-70% normal

40
Q

fractional shortening is

A

(end diastolic-end systolic diameter) / end diastolic diameter
x100

index of cardiac contractility/myocyte shortening

41
Q

relationship b/t HR and cycle duration

A

inverse- as HR inc CC dec

diastole duration changes the most, not uniform over all phases

42
Q

bookends of systole

A

S1 = close AV valve
S2 = close semilunar

43
Q

heart sounds during inspiration

A

S2 split into A2 and P2

P2 is delayed (comes after A2), inc venous return

A2 is earlier than during expiration, dec venous return

aortic valve closes before pulmonic

44
Q

wide splitting

A

A2 and P2 are farther apart
-pulmonic stenosis

pulmonic valve closes slower than normal

45
Q

paradoxical splitting heart sounds

A

aka reverse, P2 before A2
-aortic stenosis, during expiration

aortic valve close slower than normal

46
Q

narrow splitting

A

higher resistance in pulmonary circ
-hypertension, age?

47
Q

blood flow

closed circulation

A
  1. vena cava
  2. R atrium
  3. tricuspid valve (AV)
  4. R ventricle
  5. pulmonic valve (semilunar)
  6. pulmonary circulation- to lungs
  7. L atrium
  8. mitral valve (AV)
  9. L ventricle
  10. aortic valve (semilunar)
  11. aorta
  12. systemic circulation
48
Q

regurgitant murmur

A

from blood flow across valve when it should NOT be
-regurgitant valves don’t close

49
Q

stenotic murmur

A

blood flow turbelently across valve when it normally should be
-stenotic valves don’t open

50
Q

ejection murmur

A

type of systolic (b/t S1 and S2)

from aortic or pulmonic valve stenosis

51
Q

pansystolic/holosystolic murmur

A

type of systolic

from regurgitant AV valve or VSD

52
Q

late murmur

A

type of systolic murmur

from mitral valve prolapse

53
Q

early murmur

A

type of diastolic (after S2 before S1)

from regurgitant aortic or pulmonic valve
-if aortic then lower forward stroke volume bc blood goes back into ventricle

54
Q

mid-late murmur

A

type of diastolic murmur

from stenotic AV valve

55
Q

what phases is mitral valve open

A

ventricular filling so
1. atrial systole
2. rapid filling
3. reduced filling

Block 3 Found Sci (60 decks)

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