(5) Cardiac Cycle and Sounds (Karius)

Question 1

Please draw the:

Aortic Pressure

Ventricular Pressure

Atrial pressure (blue)

Ventricular Volume

EKG

Following the EKG as an anchor

Answer 1

Question 2

Label on your diagram of (Aortic pressure, ventricular pressure, atrial pressure, ventricular volume and the EKG)…

Where atrial systole and ventricular systole and ventricular diastole are occuring

Answer 2

Question 3

What is standard aortic pressure?

Answer 3

Question 4

What are the typical ventricular pressure readings?

Answer 4

Question 5

What are the typical ventricular volumes?

Max and min?

Answer 5

Question 6

Draw out the relationship between atrial pressure and ventriular pressure in response to the p wave!!!

Answer 6

Question 7

Why is the atrial pressure increasing during ventricular systole?

Answer 7

Blood continues to return to the heart during the period of ventricular systole, but can’t move into the ventricles because of the ventricular contraction.

This causes the atrial pressure to increase

Question 8

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

Answer 8

Question 9

Describe what is occuring with ventricular volume in relation to atrial contraction:

Answer 9

Ventricular volume increases as the atrial contraction forces blood nito the ventricle

Question 10

What are 2 important notes about aortic pressure at this point?

Answer 10

1. Aortic pressure is above the atrial and ventricular pressures
2. It is decreasing throughout the atrial contraction and even into ventricular contraction (peripheral run-off)

Question 11

What causes blood to be ejected from the ventricle?

Answer 11

The pressure in the ventricle must

exceed the pressure in the pulmonary artery and aorta

before the valves leaving the ventricles will open

Question 12

Describe what is occuring here:

Answer 12

ISOVOLUMETRIC CONTRACTION

Ventricular volume remains constant, while the ventricular pressure increases dramatically

Question 13

Answer 13

C. 68

Must be the diastolic pressure in the aorta that determines how hard the left ventricle has to squeeze to open valve

Question 14

What pressure does the L and R ventricle have to reach before those valves open?

Answer 14

The ventricular pressure must exceed the diastolic pressure on each side to open the valve

Question 15

What is normal pulmonary artery pressure?

Answer 15

25/15

Question 16

What is normal aortic pressure?

Answer 16

120/ (80/70)

Question 17

Describe what is happening at the green and magenta arrows:

Answer 17

Green= The aortic pressure now starts to increase as blood is ejected into the aorta

Magenta = Ventricular volume decreases rapidly as blood is ejected

Question 18

Describe what is occuring with the

Aortic Pressure

Ventricular Volume

@ this phase

Answer 18

Aortic pressure starts to decrease even as blood continues to be ejected as the rate of ejection slows down

Ventricular volume continues to decrease during this period

Question 19

What is the dicrotic notch?

Answer 19

The closing of the aortic valve produces the dicrotic notch in the aortic pressure wave

Arterial pressure shows a similar ‘wiggle’

Question 20

What is this period called?

Answer 20

ISOVOLUMETRIC RELAXATION

Question 21

During an isovolumetric event, what is the state of the valves?

Answer 21

ALL ARE CLOSED

Question 22

Why is the aortic pressure still dropping?

Answer 22

The blood is leaving the aorta and flowing into the smaller vessels in the periphery.

PERIPHERAL RUN-OFF

Question 23

Add the jugular pressure into your drawing!

Answer 23

Question 24

What are the waves of jugular pressure?

Answer 24

A wave= pressure from atrial contraction

C wave= pressure wave from isovolumetric contraction in ventricles (*blue arrow)

V wave = venous return

Question 25

Answer 25

A. P wave

Question 26

Answer 26

C. R wave

Question 27

Answer 27

B. Ventricular repolarization

Question 28

Recreate major events!!!

Answer 28

Question 29

The first heart sound is associated with...

Answer 29

(LUB) Associated with the closure of the **AV Valves**

Question 30

What actually "makes" the heart sounds?

Answer 30

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

Question 31

What is the second heart sound associated with?

Answer 31

Closing of the **aortic** and **pulmonary valves**

Question 32

What is the third heart sound?

Answer 32

Blood rushing into the ventricle during the **rapid filling phase** (sound normal in children, but may not be heard in adults) \*sounds like filling a cup with water

Question 33

What is the fourth heart sound?

Answer 33

May be heard during **atrial contraction** result of: last bit of blood being sqeezed into the ventricle (like the third heart sound, it is normal in children, but not generally heard in a normal adult)

Question 34

When is a **murmur** heard?

Answer 34

- Blood is moving in a direction it **shouldn't be moving** - Blood is having a hard time moving in the direction **it should be moving in**