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LSS 1: CVS > 3 - Cardiovascular Mechanics 2 > Flashcards

3 - Cardiovascular Mechanics 2 Flashcards

1
Q

What diagram is used to represent the cardiac cycle?

A

Wiggers diagram

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2
Q

What is used to measure preload on the left side of the heart?

A
  • PAWP: Pulmonary Artery Wedge Pressure
  • By measuring the pulmonary artery pressure you get an indirect measurement of the left atrial pressure
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3
Q

What three factors affect cardiac output?

A
  • Preload
  • Afterload
  • Contractility
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4
Q

How does the Frank-Starling Relationship change with increased contractility?

A

The gradient of the ESV line changes

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5
Q

What are the phases of the cardiac cycle?

A
  • atrial systole
  • isovolumetric contraction
  • rapid ejection
  • reduced ejection
  • isovolumetric relaxation
  • rapid passive filling
  • reduced passive filling
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6
Q

What are the systolic phases of the cardiac cycle?

A
  • isovolumetric contraction
  • rapid ejection
  • reduced ejection
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7
Q

What are the diastolic phases of the cardiac cycle?

A
  • atrial systole
  • isovolumetric relaxation
  • rapid passive filling
  • reduced passive filling
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8
Q

What happens during atrial systole?

A
  • P wave
  • S4 (abnormal)
  • contraction from top to bottom tops up blood volume in ventricles (atria almost full from passive filling)
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9
Q

What causes an S4 heart sound?

A
  • congestive heart failure
  • pulmonary embolism
  • tricuspid incompetence
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10
Q

What happens during isovolumetic contraction?

A
  • QRS complex
  • S1 (lub - closure of AV valves)
  • ventricular contraction, no volume change
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11
Q

What happens during rapid ejection?

A
  • c wave
  • semi-lunar valves open
  • ventricular contraction causes greater ventricular pressure than aortic/pulmonary artery pressure so valves open
  • ventricular volume decreases
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12
Q

What happens during reduced ejection?

A
  • t wave (repolarisation of ventricles)
  • semi-lunar valves start closing
  • ventricular volume decreases more slowly
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13
Q

What happens during isovolumetric relaxation?

A
  • v wave
  • atrial pressure increases
  • dichrotic notch (rebound pressure against aortic valve as aortic wall relaxes)
  • S2 (dub - close of semilunar valves)
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14
Q

What happens during rapid passive filling?

A
  • isoelectric ECG (ventricular pressure lower than atrial between cycles)
  • AV valves open and blood flows into ventricles
  • S3 (abnormal)
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15
Q

What causes the S3 heart sound?

A
  • severe hypertension
  • mitral incompetence
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16
Q

What happens during reduced passive filling?

A
  • diastasis (middle of diastole)
  • ventricular volume fills slower
  • ventricles fill without atrial contraction
17
Q

What is diastole?

A
  • 2/3 beat
  • ventricular relaxation
  • ventricles fill with blood
18
Q

What is systole?

A
  • 1/3 beat
  • ventricular contraction
  • ventricles generate pressure then eject blood into arteries
19
Q

What is the ejection fraction?

A
  • stroke volume/end-diastolic volume
  • proportion of blood pumped out of heart in a contraction
20
Q

What are the average systemic and pulmonary circuit pressures?

A
  • systemic: 120/80 mmHg (high)
  • pulmonary 25/5 mmHg (low)
21
Q

What are the labels of the Wiggers diagram?

A
  1. P
  2. Q
  3. R
  4. S
  5. T
  6. a
  7. c
  8. v
  9. S4
  10. S1
  11. S2
  12. S3
    a. aorta
    b. atrium
    c. ventricle
22
Q

What are the effects of sympathetic and parasympathetic stimulation on the SA node?

A
  • parasympathetic: present at rest, slows SA node
  • sympathetic: increases SA nde through hormonsl (adrenaline) and neural (noradrenaline) mechanisms
23
Q

What are the effects of exercise on pressure-volume loops?

A
  • increased skeletal muscle pump work in legs leads to increased venous return
  • increased stretch so more blood enters ventricles (increased EDV so graph shifts to right)
  • increased sympathetic heart activity so increased contractility (graph shifts to left)
  • increased volume ejected, lower ESV so lower SV
  • no pressure effects with preload change
24
Q

What do the 4 points on a pressure-volume loop represent?

A
  1. end-diastolic volume (preload)
  2. after isovolumetric contraction (afterload)
  3. after isovolumetric relaxation
  4. end-systolic volume
25
Q

How is stroke volume calculated from a pressure-volume loop?

A

distance between points 2 and 3

26
Q

What happens to changes in preload and afterload on a pressure-volume loop?

A
  • increased preload = increased SV: graph shifts to right
  • increased afterload = decreased SV: grpah shortens towards right and increases in height
27
Q

What are the labels of the pressure-volume loop?

A

a. left ventricular pressure (mmHg)
b. left ventricular volume (mL)
c. end-systolic PV line
d. active force
e. passive force

LSS 1: CVS (17 decks)

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